A new study in the Bulletin of the World Health Organization evaluates the outcome of Peru’s strategy to introduce new vaccines in the poorest regions with high child mortality rates, finding that the strategy increased coverage in the poorest districts initially and, as national coverage grew, regional disparities were eliminated though socioeconomic differences persisted. Researchers analyzed data for 49,023 children aged 18-29 months from nationally representative annual health surveys conducted between 2004 and 2022, examining associations between vaccine coverage and poverty at the ecological level using the country’s 25 regions and at the individual child level using household wealth quintiles.
The findings showed that coverage for Haemophilus influenzae type b, pneumococcal conjugate and rotavirus vaccines was positively associated with poverty prevalence in the initial post-introduction period, but these associations disappeared over time. In contrast, the individual-level analyses indicated that children from wealthier families were consistently more likely to be vaccinated than children from poorer families. In the most recent period (2018–2022), vaccination coverage in the wealthiest quintile was about 10 percentage points higher than in the poorest quintile. Coverage levels for boys and girls were similar. Children whose low-income families were enrolled in the Juntos cash transfer program had higher coverage than the rest of the population.
The authors underscore the potential of vaccination strategies to promote health equity. They emphasize that while prioritizing vaccine introduction in vulnerable regions can reduce regional disparities, persistent socioeconomic inequalities highlight the need for complementary interventions at the household and community levels. Victora, Silva, and colleagues further argue that robust population data and continuous monitoring are critical for designing vaccination policies that are both effective and equitable. Their study serves as an example for other countries, showing how expanding vaccination coverage can address historical inequities and advance universal health coverage.
Thumbnail image credit: Shutterstock / Ruslana Iurchenko
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