The Knowledge Hub

Immunization against rotavirus is cost-effective, especially in poorer regions, saving lives and reducing disabilities

According to a cost-effectiveness study of rotavirus vaccination in Pakistan, the vaccine would be the most cost-effective in the poorer provinces of Sindh and Balochistan (that also have the highest rates of death from rotavirus)- with a cost per disability-adjust life year averted $155-$167 compared to almost $600 in the wealthier region of Islamabad. Within all regions, vaccination was the most cost-effective among the two poorest income groups (quintiles), and was almost 12 times more cost-effective in the poorest households in the most marginalized region than in the wealthiest households in the most advantaged region (cost/DALY averted of $76 vs. $897).

Rheingans R, Anderson JD, Bagamian KH et al.. 2018. Effects of geographic and economic heterogeneity on the burden of rotavirus diarrhea and the impact and cost-effectiveness of vaccination in Pakistan. Vaccine. 36(51).

Children from the poorest households in India are more likely to have delayed vaccinations, increasing disease risk

Indian children in households from the lowest wealth quintile were 30-95% more likely to be delayed in their vaccinations than those from the wealthiest households [depending on the vaccine]. Delayed vaccination increases the window of susceptibility to vaccine preventable diseases and can lead to outbreaks.

Data in this analysis was from the National Family and Health Survey 4.

Choudhary TS, Reddy NS, Apte A et al.. 2019. Delayed vaccination and its predictors among children under 2 years in India: Insights from the national family survey-4. Vaccine. 37(17).

Children from poor households in Kenya are less likely to be vaccinated compared to wealthier children

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.. 2019. Childhood vaccination in Kenya: Socioeconomic determinants and disparities among the Somali ethnic community. International Journal of Public Health. 64(3).

Children in communities with high unemployment are less likely to be fully immunized

The 2008 Nigerian Demographic Health Survey data suggest that children in communities with high unemployment were 1/3 as likely to be fully immunized than children in communities with a medium level of unemployment.

Antai, D. 2012. Gender inequities, relationship power, and childhood immunization uptake in Nigeria: a population-based cross-sectional study. Journal of Infectious Disease. 16(2).

Immunization helps protect low-income populations from financial burden and prevents diseases like measles and pneumonia

In a financial risk model analysis of 41 Gavi-eligible countries, the burden of Catastrophic Health Costs (CHC) and Medical Impoverishment (MI) would be greatest in the lowest income populations. With expanded vaccine coverage, the share of prevented cases of measles, pneumococcal disease, and rotavirus, in relation to the total number of cases prevented, would be larger in the lowest income populations thereby providing a larger financial risk protection (FRP) to these populations.

Riumallo-Herl, C., Chang, A.Y., Clark, S., et al.. 2018. Poverty reduction and equity benefits of introducing or scaling up measles, rotavirus, and pneumococcal vaccines in low-income and middle-income countries: a modeling study. British Journal of Medicine Global Health. 3:e000612.

Children of wealthier mothers in Pakistan have higher polio vaccination rates compared to poorer mothers

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).

Children from poorer households are more likely to die from measles

A study of measles vaccine in Bangladesh found that children from the poorest quintile were more than twice as likely to die than those from the least quintile in the absence of measles vaccination. The difference in mortality between unvaccinated and vaccinated was statistically significant and robust across alternative measures of socioeconomic status.

Bishai, D., Koenig, M., and Khan, M.A.. 2003. Measles vaccination improves the equity of health outcomes: evidence from Bangladesh. Health Economics. 12(5).

Children from the poorest households experience greater benefits from immunization

A package of 5 vaccines was delivered, and it was found that children from poorer households benefited more in terms of health outcomes from immunization than did those from relatively wealthier households. Results suggest that most of the risk of dying before age five can be eliminated with full immunization in the severely health-deprived setting.

Bawah, A.A., Phillips, J.F., Adjuik, M., et al. 2010. The impact of immunization on the association between poverty and child survival: Evidence from Kassena-Nankana district of northern Ghana. Scandanavian Journal of Public Health. 38(1).