New Vaccines Research Reported from Johns Hopkins University Bloomberg School of Public Health (Comparing Multivariate with Wealth-Based Inequity in Vaccination Coverage in 56 Countries: Toward a Better Measure of Equity in Vaccination Coverage): Immunization – Vaccines

2023 MAR 14 (NewsRx) -- By a News Reporter-Staff News Editor at Vaccine Daily -- Researchers detail new data in vaccines. According to news reporting out of Baltimore, Maryland, by NewsRx editors, research stated, “Following a call from the World Health Organization in 2017 for a methodology to monitor immunization coverage equity in line with the 2030 Agenda for Sustainable Development, this study applies the Vaccine Economics Research for Sustainability and Equity (VERSE) vaccination equity toolkit to measure national-level inequity in immunization coverage using a multidimensional ranking procedure and compares this with traditional wealth-quintile based ranking methods for assessing inequity. The analysis covers 56 countries with a most recent Demographic & Health Survey (DHS) between 2010 and 2022.”

Financial supporters for this research include Bill & Melinda Gates Foundation.

Our news reporters obtained a quote from the research from Johns Hopkins University Bloomberg School of Public Health: “The vaccines examined include Bacillus Calmette-Guerin (BCG), Diphtheria-Tetanus-Pertussis-containing vaccine doses 1 through 3 (DTP1-3), polio vaccine doses 1-3 (Polio1-3), the measles-containing vaccine first dose (MCV1), and an indicator for being fully immunized for age with each of these vaccines. The VERSE equity toolkit is applied to 56 DHS surveys to rank individuals by multiple disadvantages in vaccination coverage, incorporating place of residence (urban/rural), geographic region, maternal education, household wealth, sex of the child, and health insurance coverage. This rank is used to estimate a concentration index and absolute equity coverage gap (AEG) between the top and bottom quintiles, ranked by multiple disadvantages. The multivariate concentration index and AEG are then compared with traditional concentration index and AEG measures, which use household wealth as the sole criterion for ranking individuals and determining quintiles. We find significant differences between the two sets of measures in almost all settings. For fully-immunized for age status, the inequities captured using the multivariate metric are between 32% and 324% larger than what would be captured examining inequities using traditional metrics. This results in a missed coverage gap of between 1.1 and 46.4 percentage points between the most and least advantaged.”

According to the news editors, the research concluded: “The VERSE equity toolkit demonstrated that wealth-based inequity measures systematically underestimate the gap between the most and least advantaged in fully-immunized for age coverage, correlated with maternal education, geography, and sex by 1.1-46.4 percentage points, globally. Closing the coverage gap between the bottom and top wealth quintiles is unlikely to eliminate persistent socio-demographic inequities in either coverage or access to vaccines. The results suggest that pro-poor interventions and programs utilizing needs-based targeting, which reflects poverty only, should expand their targeting criteria to include other dimensions to reduce systemic inequalities, holistically. Additionally, a multivariate metric should be considered when setting targets and measuring progress toward reducing inequities in healthcare coverage.”

For more information on this research see: Comparing Multivariate with Wealth-Based Inequity in Vaccination Coverage in 56 Countries: Toward a Better Measure of Equity in Vaccination Coverage. Vaccines, 2023,11(3). (Vaccines - http://www.mdpi.com/journal/vaccines). The publisher for Vaccines is MDPI AG.

A free version of this journal article is available at https://doi.org/10.3390/vaccines11030536.

Our news journalists report that more information may be obtained by contacting Bryan N. Patenaude, International Vaccine Access Center, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, United States. Additional authors for this research include Salin Sriudomporn, Deborah Odihi, Joshua Mak, Gatien de Broucker.

ORCID is an identifier for authors and includes bibliographic information. The following is ORCID information for the author of this research: Gatien de Broucker (http://orcid.org/0000-0001-6603-5124).

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