COVID-19 vaccines were a historic triumph, with less than a year between the initial identification of the microbe and effective vaccines being administered. They were also a public administration challenge, demanding that governments of the world procure and administer billions of doses in widely different contexts. In many countries they were intensely polarizing, catalyzing a rise in anti-vaccination politics.Vaccination Politics brings together public health and political science expertise for a global, systematic comparison of vaccination politics. The authors look at 32 countries’ experiences, from Austria to Malawi and the United States to Hong Kong, to understand how trust, wealth, pharmaceutical industries, regulators, international organizations, and health systems succeeded or failed at acquiring vaccines and vaccinating citizens. It shows how different governments and populations navigated challenges. Global inequality, political trust, contestation over health system priorities, and opportunistic politicians all played roles in shaping the subsequent politics of health and vaccination around the world. A conclusion brings together lessons for policy and key issues for further research. While the next pandemic is unknown to us today, the response to it will be shaped by the positive and negative legacies of COVID-19 vaccination politics.