Significant differences in immunization coverage exist in urban vs. rural settings. – VoICE
Key Concept

Key Evidence: Wealth and mother’s education are significant predictors of vaccination rates in both urban and rural settings.  However, low paternal education, lack of antenatal care, and home births were significantly associated with low vaccination rates only in rural settings. This suggests the need for tailored vaccine programs.

From the VoICE editors: This study compared the significance of risk factors for low vaccination rates in rural versus urban settings in Tanzania. 

Nadella, P., Smith, E.R., Muhihi, A., et al. 2019. Determinants of delayed or incomplete diphtheria-tetanus-pertussis vaccination in parallel urban and rural birth cohorts of 30,956 infants in Tanzania.. BMC Infectious Diseases. 19(188).
View Publication >

Key Evidence: Children living in urban areas are significantly more likely to be only partially immunized compared to children in rural areas. In this study, the authors suggest this may be the result of the tendency for those living in urban slums to move frequently, resulting in only partial immunization.

From the VoICE Editors: In this study, conducted in India, no significant difference was found in rates of non-vaccination (children receiving no vaccines) in rural versus urban communities.

Prinja, S., Monga, D., Rana, S.K., et al. 2018. District level analysis of routine immunization in Haryana State: implications for Mission Indradhanush under Universal Immunization Programme. Indian Journal of Community Medicine. 43(3).
View Publication >

Key Evidence: The use of antenatal care (ANC) services among pregnant adolescents in low- and middle-income countries, including tetanus toxoid vaccination, was lowest among women who lived in rural areas, had completed less education, and who were of poorer wealth quintiles.

Banke-Thomas QE, Banke-Thomas AO, Ameh CA 2017. Factors influencing ultilisation of maternal health services by adolescent mothers in Low- and middle-income countries: a systematic review. BMC Pregnancy Childbirth. 17(65).
View Publication >

Key Evidence: Globally, coverage of the third dose of DTP is 8% higher among urban dwellers compared to children raised in a rural environment.

Hinman, A.R., and McKinlay, M.A. 2015. Immunization equity. Vaccine. 33(2015).
View Publication >