As the roll out of coronavirus (COVID-19) vaccines begins, this policy brief asks how to ensure vaccines for all. In doing so, it examines the case for multilateral approaches to access and delivery, maps key challenges, and identifies priority actions for policy makers. The absence of a comprehensive approach to ensure vaccine access in developing countries threatens to prolong the pandemic, escalating inequalities and delaying the global economic recovery. While new collaborative efforts such as ACT Accelerator and its COVAX initiative are helping to bridge current gaps, these are not enough in circumstances where demand far outstrips supply. Based on the current trajectory, mass immunisation efforts for poorer countries could be delayed until 2024 or beyond, prolonging human and economic suffering for all countries. Policy actions to support equitable vaccine access in developing countries include: (i) supporting multilateral frameworks for equitable allocation of vaccines and for crisis response, resilience and prevention; (ii) highlighting the role of development finance; and, (iii) promoting context-driven solutions.