COVAX is a WHO global plan to, among other goals, deliver and administer sufficient Covid vaccines in each country to reach worldwide herd immunity. It is an ambitious plan that would require enormous coordination and resources to achieve, especially in Africa. Perhaps the key to such a plan’s success is to model delivery of the vaccines to an inhalation-based Covid Vaccine using a Synthetic Attenuated Virus Engineering (SAVE) for delivery. This version may eliminate the need for complicated refrigeration protocols in preparation for vaccine delivery to Africa and Asia. As Covid vaccines are currently administered, countries with fully functioning and resourced universal health systems will benefit significantly from the plan. Countries with little or no coordinated health systems will experience significant difficulties achieving herd immunity under COVAX. The goal of universal healthcare is to ensure adequate healthcare access to the population in need. There are various theories on the best approach to delivering universal healthcare in a country. These theories seek to achieve the same healthcare access outcome with controlled out of pocket expenses. Fully implemented universal healthcare systems target the general population, encourage high healthcare utilization at local clinics, and ultimately complement COVAX goals. These considerations are essential to the success of COVAX.