Key Concept

Key Evidence: Children in U.S. families living below the poverty line have significantly lower rotavirus vaccination rates than children at or above the poverty line (67% vs. 77%).

Pindyck T, Tate JE, Parashar UD 2018. A decade of experience with rotavirus vaccination in the United States – vaccine uptake, effectiveness, and impact. Expert Review of Vaccines. 17(7).
View Publication >

Key Evidence: Non-Somali children in Kenya in the poorest households were nearly three times as likely to be unvaccinated than children from middle-income households, while wealthier children were significantly less likely to be unvaccinated.

Masters NB, Wagner AL, Carlson BF et al. 2018. Childhood vaccination in Kenya: socioeconomic determinants and disparities among the Somali ethnic community. International Journal of Public Health. 64(3).
View Publication >

Key Evidence: In India, inequities in vaccination coverage exist between states, within states, and in urban vs. rural settings. Lower parental education resulted in lower coverage, girls had lower coverage than boys and infants born to families with a large number of children also had lower coverage than others. A direct relationship between household wealth and coverage was also found.

Devasenapathy, N., Ghosh Jerath, S., Sharma, S., et al. 2016. Determinants of childhood immunisation coverage in urban poor settlements of Delhi, India: a cross-sectional study. BMJ Open. 6:e013015.
View Publication >

Key Evidence: In a systematic review of qualitative research from low- and middle-income countries, women’s low social status was shown to be a barrier to their children accessing vaccinations. Specific barriers included access to education, income, resource allocation, and autonomous decision-making related to time. The authors suggest that expanding the responsibility for children’s health to both parents (mothers and fathers) may be one important element in removing persistent barriers to immunization often faced by mothers.

Merten, S., Hilber, A.H., Biaggi, C., et al. 2015. Gender Determinants of Vaccination Status in Children: Evidence from a Meta-Ethnographic Systematic Review.. PloS ONE. 10(8).
View Publication >

Key Evidence: Globally, coverage of the third dose of DTP is 15% higher among children in the highest compared to lowest wealth quintile. However, this masks differences of up to 64% in the most inequitable countries (Nigeria).

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

Key Evidence: Inequity in vaccination coverage in India was found between states, within states, and in urban vs. rural. Lower parental education resulted in lower coverage, girls had lower coverage than boys, and infants born to families with a large number of children also had lower coverage than others. A direct relationship between household wealth and coverage was also found.

Mathew, J.L. 2012. Inequity in childhood immunization in India: a systematic review. Indian Pediatrics. 49.
View Publication >

Key Evidence: In a study designed to explore the association of maternal education and empowerment with childhood polio vaccination rates in Pakistani mothers, it was observed that the highest percentage of completely vaccinated children (72.6%) was seen among mothers of the richest quintile, followed by 63.4%, 58.0%, 49.8%, and 39% for the richer, middle, poorer, and poorest wealth quintiles, respectively.

Khan, M.T., Zaheer, S., Shafique, K. 2017. Maternal education, empowerment, economic status, and child polio vaccination uptake in Pakistan: a population based cross sectional study. BJM Open. 7(3).
View Publication >

Key Evidence: In Tanzania, poverty was found to have a negative effect on receiving vaccines on time (at the recommended age). Children in the wealthiest quintile experienced 19% fewer delays for BCG vaccination, 23% fewer delays for the third dose of DTP vaccination, and 31% fewer delays for the first dose of measles-containing vaccine compared to children of the poorest quintile.

Le Polain de Waroux, O., Schellenberg, J.R., Manzi, F., et al. 2013. Timeliness and completeness of vaccination and risk factors for low and late vaccine uptake in young children living in rural southern Tanzania.. International Health. 5(2).
View Publication >