The global inequality in vaccines has led countries with an abundance of vaccines to donate vaccines to countries in need. These vaccine donations were not only provided out of pure altruism but were part of vaccine diplomacy. This thesis finds through descriptive case studies and quantitative research that political factors were often more important than factors of need in the determination of who to donate vaccines to. For China, political alignment was an important factor, just as GDP per capita, Taiwan relations, whether they are part of the Belt and Road Initiative, and geographical distance. For the United States, the pre-existing trade relations and whether a country is democratic were important. And India primarily donated to countries that politically align with them, are democratic, support Taiwan, and have a large Indian diaspora. These findings extend the literature on bilateral foreign aid and provides a better understanding of the global political economy of vaccine donations. Overall, the conclusion is that, even though vaccine donations have helped countries in need significantly, it was primarily an extension of the donor countries’ foreign policy.