The Knowledge Hub

The introduction of PCV13 vaccine in Tennessee reduced racial disparities in pneumococcal disease

Population-based surveillance data collected in the state of Tennessee from 1998 – 2016 found that the introduction of PCV13 was associated with reductions in socioeconomic and racial disparities in PCV13-serotype invasive pneumococcal disease (IPD). PCV13 introduction was associated with the prevention of IPD in the overall population as well as substantial decreases in racial disparities in IPD over time between Black and White populations. Before PCV13 was introduced, Black people in the study had an IPD incidence 1.5 times higher than White people – 24.7 and 16.4, respectively. After PCV13 introduction, Black people had an IPD incidence 1.15 times the incidence among Whites: 15 and 13.1, respectively.

Raman R, Brennan J, Ndi D et al.. 2021. Marked Reduction of Socioeconomic and Racial Disparities in Invasive Pneumococcal Disease Associated With Conjugate Pneumococcal Vaccines. The Journal of Infectious Diseases. 223(7).

Immunization coverage can vary dramatically across regions, with some areas having better access than others

An equity impact analysis of the 2016 Ethiopia Demographic and Health Survey dataset identified significant disparities in full immunization coverage across different regions of Ethiopia among children aged up to 36 months. Children in the Addis Ababa and Dire Dawa regions of Ethiopia were 7 times more likely to have full vaccination coverage compared to children living in the Afar region, a rural region with large numbers of pastoralist nomadic communities.

Geweniger A, Abbas KM. 2020. Childhood vaccination coverage and equity impact in Ethiopia by socioeconomic, geographic, maternal, and child characteristics. Vaccine. 38(20).

Children in female-headed households were less likely to be fully vaccinated compared to male-headed households

An equity impact analysis of the 2016 Ethiopia Demographic and Health Survey dataset for full vaccination coverage among children aged up to 36 months found that children living in female-headed households were 49% less likely to have full vaccination coverage compared to children living in male-headed households.

Geweniger A, Abbas KM. 2020. Childhood vaccination coverage and equity impact in Ethiopia by socioeconomic, geographic, maternal, and child characteristics. Vaccine. 38(20).

Immunization rates are low among pregnant adolescents in rural areas with less education and lower wealth

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 OE, 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(1).

Immunizing with pneumococcal conjugate vaccine in India can greatly reduce deaths, especially among the poor

A modeled analysis of the potential impact of pneumococcal conjugate vaccine (PCV) in India estimated that the greatest reductions in deaths due to PCV vaccination would be among the poorest segments of the population. Assuming a vaccination coverage rate of 77% (the current DTP3 coverage rate), PCV would prevent nearly 2.5 times as many deaths per 100,000 children under five in the 2 poorest income quintiles than in the 2 wealthiest groups (313 vs. 134), and nearly 3 times as many deaths per 100,000 if coverage reaches 90% (446 vs. 167).

The model used was specific to the epidemiology, health system situation, and population characteristics of India.

Megiddo I, Klein E, Laxminarayan R. 2018. Potential impact of introducing the pneumococcal conjugate vaccine into national immunisation programmes: an economic epidemiological analysis using data from India. BMJ Global Health. 3(3).

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 of mothers with no education or primary education are more likely to have delayed vaccinations

A study of delayed vaccination in India found that children whose mothers had no formal education were 37-81% more likely to have delayed vaccinations than children of mothers with 12 or more years of schooling [depending on the vaccine]. Children whose mothers had a primary school eduction fared only slightly better with 33-62% greater odds of getting their vaccination late, when compared to those with highly educated mothers.

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).

Screening tests in Italy found high rates of infectious diseases in newly-arrived migrants, emphasizing the need for universal screening

Screening tests given to more than 300 newly-arrived economic migrants and asylum seekers in Italy — the majority from sub-Saharan Africa — found high rates of chronic hepatitis B infection and latent and active tuberculosis (with 8% having signs of current infection or active TB). These findings underscore the important of universal screening for infectious diseases for all newly-arrived migrants.

Cuomo G, Franconi I, Riva N et al.. 2019. Migration and health: a retrospective study about the prevalence of HBP, HIV, HCV, tuberculosis and syphilis infections amongst newly arrived migrants screened at the Infectious Diseases Unit of Modena, Italy. Journal of Infection and Public Health. 12(2).

Immunization is important for recent migrants to overcome health barriers and prevent diseases like tuberculosis

Recent migrants face barriers to accessing health care including language and cultural barriers, limited knowledge, food and housing insecurity, stress, and lack of resources available during prolonged travel. In Canada, though foreign-born populations make up only 22% of the total population, 70% of active tuberculosis cases occurred in this population.

. 2018. CPHO Spotlight on Eliminating Tuberculosis in Canada. Public Health Agency of Canada. .

Immunization can help overcome barriers to healthcare access and reduce high rates of TB in Inuit populations

Native populations experience barriers to health care access such as limited knowledge, stigma, community social isolation, and geographic isolation. As a result, Inuit populations in Canada suffer 300 times higher rates of TB than the Canadian-born non-Indigenous population.

. 2018. CPHO Spotlight on Eliminating Tuberculosis in Canada. Public Health Agency of Canada. .