INTRODUCTION:
Global health, framed as a universal humanitarian pursuit, often masks deep-seated inequities rooted in colonial history. Contributions from the Global South have regularly been overlooked by dominant Eurocentric paradigms that valorize Western scientific achievements. Immunization history and vaccine policy offers a powerful lens through which to examine how power imbalances affect the intersection of power, trust and equity, particularly in the context of recurrent pandemics and ongoing vaccine hesitancy.

METHODS:
Employing a critical historical and narrative review methodology, this analysis integrates diverse sources—from historical texts to contemporary case studies—and applies decolonial and equity frameworks. It traces early immunization practices (like variolation) to their origins in Chinese, African, and Asian knowledge systems, contrasting this with later European and American resistance and modern vaccine hesitancy.

RESULTS:
Analysis demonstrates that foundational immunization knowledge emerged through diverse, multicultural knowledge systems but was subsequently reframed as Western scientific discovery. Such epistemic erasures have contributed to enduring power imbalances in global health and have undermined trust in marginalized populations. Historically and today, vaccine resistance stems from political exclusion and structural violence, not ignorance. The inequitable vaccine rollout during COVID-19, hindered by access and patent barriers, is a clear example of these ongoing colonial injustices.

CONCLUSIONS:
These findings show that to build vaccine trust, prepare for pandemics, and achieve health equity, we must decolonize global health education. This requires reforming education to include diverse medical histories, prioritize knowledge from the Global South, tackle unconscious bias and "white savior" attitudes, and support community-led health practices. A decolonized approach to immunization is vital—it is both historically correct and the only way to ensure future global health actions are ethical, effective, and trusted.