A new study published in Vaccines examines the persistence of wealth-based inequities in childhood immunization across 10 middle-income countries in the WHO Western Pacific Region, finding that substantial gaps remain even as average coverage improves. Researchers from the WHO analyzed full immunization (BCG, PV3, DTP3, MCV1) data for one-year-olds using both simple (difference, ratio) and complex (slope index of inequality, relative index of inequality) metrics. While some nations, such as Mongolia and Viet Nam, have shown declines in inequality over time, in several others (notably the Philippines, Lao PDR, and Papua New Guinea), the richest 20 % of households had markedly higher coverage.
The authors estimate that closing wealth-based immunization gaps could boost national coverage by double-digit percentage points in three of the countries studied. In Papua New Guinea, for example, eliminating the disparity could raise national full immunization coverage by up to 17.9 points (a relative gain of ~50 %). These findings underscore that to meet the Equity Goal of Immunization Agenda 2030, policy interventions cannot simply aim for higher average coverage, they must deliberately target the underserved populations left behind.
Thumbnail image credit: WHO / Yoshi Shimizu
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