Bergen Nicole, Cata-Preta Bianca O, Schlotheuber Anne, Santos Thiago M, Danovaro-Holliday M Carolina, Mengistu Tewodaj, Sodha Samir V, Hogan Daniel R, Barros Aluisio J D, Hosseinpoor Ahmad Reza
Department of Data and Analytics, World Health Organization, 20 Avenue Appia, 1211 Geneva, Switzerland.
International Center for Equity in Health, Federal University of Pelotas, Rua Mal Deodoro 1160, Pelotas 96020-220, Brazil.
Vaccines (Basel). 2022 Apr 18;10(4):633. doi: 10.3390/vaccines10040633.
Despite advances in scaling up new vaccines in low- and middle-income countries, the global number of unvaccinated children has remained high over the past decade. We used 2000-2019 household survey data from 154 surveys representing 89 low- and middle-income countries to assess within-country, economic-related inequality in the prevalence of one-year-old children with zero doses of diphtheria-tetanus-pertussis (DTP) vaccine. Zero-dose DTP prevalence data were disaggregated by household wealth quintile. Difference, ratio, slope index of inequality, concentration index, and excess change measures were calculated to assess the latest situation and change over time, by country income grouping for 17 countries with high zero-dose DTP numbers and prevalence. Across 89 countries, the median prevalence of zero-dose DTP was 7.6%. Within-country inequalities mostly favored the richest quintile, with 19 of 89 countries reporting a rich-poor gap of ≥20.0 percentage points. Low-income countries had higher inequality than lower-middle-income countries and upper-middle-income countries (difference between the median prevalence in the poorest and richest quintiles: 14.4, 8.9, and 2.7 percentage points, respectively). Zero-dose DTP prevalence among the poorest households of low-income countries declined between 2000 and 2009 and between 2010 and 2019, yet economic-related inequality remained high in many countries. Widespread economic-related inequalities in zero-dose DTP prevalence are particularly pronounced in low-income countries and have remained high over the previous decade.
尽管在低收入和中等收入国家扩大新疫苗接种方面取得了进展，但在过去十年中，全球未接种疫苗的儿童数量仍然居高不下。我们使用了来自代表89个低收入和中等收入国家的154项调查的2000 - 2019年家庭调查数据，以评估国内一岁儿童白喉 - 破伤风 - 百日咳（DTP）疫苗零剂次接种率与经济相关的不平等情况。零剂次DTP接种率数据按家庭财富五分位数进行了分类。计算了差异、比率、不平等斜率指数、集中指数和超额变化量度，以评估17个零剂次DTP数量和接种率较高的国家按国家收入分组的最新情况和随时间的变化。在89个国家中，零剂次DTP的中位接种率为7.6%。国内不平等大多有利于最富有的五分位数群体，89个国家中有19个报告贫富差距≥20.0个百分点。低收入国家的不平等程度高于中低收入国家和中高收入国家（最贫困和最富有五分位数群体的中位接种率差异分别为14.4、8.9和2.7个百分点）。低收入国家最贫困家庭的零剂次DTP接种率在2000年至2009年以及2010年至2019年期间有所下降，但许多国家与经济相关的不平等仍然很高。零剂次DTP接种率中广泛存在的与经济相关的不平等在低收入国家尤为明显，并且在过去十年中一直居高不下。
