WHO 2016 Report: State of Inequality: Childhood Immunization
In late 2016, WHO issued a report based on Global Health Observatory (GHO) data collected in the least wealthy nations worldwide looking at inequities in the coverage of childhood immunization. Using available data, the report evaluates what type, to what extent and where inequalities in coverage persist worldwide and also examines trends in coverage over the past decade. The report and related interactive visuals are available here.
Key findings of the report – which focused on 69 low- and middle-income countries – include:
- Rural vs Urban: The median absolute difference in coverage (for BCG, measles, DTP3, polio, full immunization) between rural and urban settings is less than five percentage points. Moreover, in the last decade, improvements in immunization coverage observed in rural settings have been coupled with increased coverage at the national level.
- Female vs Male: Less than one percentage point difference in immunization coverage between female and male children across five indicators (BCG, measles, DTp3, polio, full immunization) was observed. The study data also suggest minimal change in absolute inequality comparing female and male children in the last ten years for the same indicators.
- Wealthy vs Poor: Approximately one-third of countries reported the greatest absolute inequities in DTP3, measles and full immunization – that is, at least a 20 percentage point gap in coverage between the richest 1/5 of the population vs the poorest 1/5 of the population.
- Education level: The greatest absolute inequality in vaccine coverage, across 3 sub-groups of maternal education, is most striking for measles vaccine – with a median difference in coverage between the most and least educated of 18 percentage points; the smallest difference is observed for BCG vaccine (8 percentage points). In other words, children of the most educated mothers were much more likely to be vaccinated than children of the least educated mothers. 44% of 54 countries with available data reported at least 20% higher measles vaccine coverage among children of the most-educated compared to the least-educated mothers.