The global Covid-19 pandemic has profoundly impacted countries in the Mediterranean region. As in other parts of the world, health systems have seen an increasing number of infections during the various pandemic waves. In 2020, international actors attempted to support the southern shore countries by providing medical teams and general technical assistance, an effort marked by competition and rivalry. In 2021, this situation has grown even more acute as several vaccines have gone onto global markets. The competition for increased influence in the Mediterranean is occurring mainly between China, Russia, the United States and Europe, role-players which have lobbied for their vaccine variants to enter the global market. The Chinese and Russian vaccine variants were initially met with skepticism, but recent preliminary studies have shown that they may be just as effective as the vaccines produced by the US and European companies. Furthermore, both China and Russia have very quickly managed to supply large quantities to those countries interested, gaining territory in the struggle to lead the global vaccination program.