Vaccine nationalism is not unethical from a political ethics perspective: Learning from the global COVID-19 vaccine distribution failure.

During the COVID-19 pandemic, there was an apparent conflict between medical and political ethics regarding the ethical evaluation of vaccine nationalism - the "My Country First" vaccine allocation policy. Medical ethics sees this policy as selfish, leading to an unequal global vaccine allocation. Political ethics, however, argues that this policy is in the national interest and should not be labeled unethical. This conflict is one of the fundamental reasons why various medical ethics-based global vaccine allocation schemes, including the COVID-19 Vaccines Global Access Facility, have been difficult to implement. As long as the international community remains composed of different countries, vaccine nationalism will be difficult to eradicate. Therefore, international organizations, including World Health Organization, should focus on universal vaccine access rather than allocation based solely on medical ethics. Countries, especially low-income countries, must strengthen vaccine-related capacity-building to immunize their citizens as early as possible. Otherwise, they may still be at the bottom of the global vaccine allocation queue when the next globally challenging outbreak occurs. High-income countries should work to expand the distribution of vaccines, including donating vaccines to countries that lack them, helping other countries set up vaccine factories, and sharing vaccine production technology and intellectual property, which is the right choice from medical and political ethics perspectives.