This peer-reviewed article introduces the Vaccine Economics Research for Sustainability & Equity (VERSE) toolkit, a standardized methodological approach for measuring multivariate equity in vaccination coverage, cost-of-illness, and health outcomes. The study presents the underlying framework and demonstrates its application using concentration indices and regression-based decomposition to assess inequities across multiple determinants.
Key highlights
- The VERSE toolkit combines multiple dimensions of disadvantage (e.g., socioeconomic status, maternal education, geography) into a single composite equity metric
- It generates both a concentration index (relative inequality) and an absolute equity gap between the most and least advantaged populations
- Regression decomposition enables identification of the relative contribution of different factors to observed inequity
- Application to India shows substantial inequities, with the most disadvantaged groups 12 percentage points more likely to be zero-dose and 37.1 percentage points less likely to be fully immunized
- Maternal education is a key driver of inequity, accounting for 27.4% of inequality in zero-dose status and 19.1% in full immunization
- The framework supports comparison across outcomes and enables analysis of trade-offs between coverage and equity
The VERSE toolkit can support policymakers and researchers in systematically measuring inequity, identifying its key drivers, and tracking progress toward more equitable immunization outcomes across settings and over time.
