Departamento de Economía, Universidad de Cantabria, Santander, Spain.
Health Economics Research Group, Valdecilla Biomedical Research Institute-IDIVAL Santander, Spain.
PLoS One. 2024 Mar 21;19(3):e0300404. doi: 10.1371/journal.pone.0300404. eCollection 2024.
Vaccination is widely considered to be one of the most important prevention measures as a health strategy. This paper examines trends in basic childhood vaccination coverage and which country and time-dependent determinants may have influenced childhood immunization rates (1-dose BCG, 1- and 3-dose DTP (diphtheria, tetanus, pertussis), 1-dose measles, and 3-dose polio) between 1980 and 2020 across 94 countries. We identify economic, inequality, demographic, health, education, labor market, environmental, and political stability factors of immunization. To do this, we use data from the annual WHO and United Nations International Children's Emergency Fund (UNICEF) coverage estimates. The empirical analysis consists of generalized estimating equation models to assess relationships between immunization rates and socioeconomic factors. Additionally, we follow the Barro and Sala-i-Martín approach to identify conditional convergence. Our findings show the strongest positive statistically significant association between immunization rates and GDP per capita, as well as births attended by skilled health staff. Moreover, our research demonstrates conditional convergence, indicating that countries converge towards different steady states. The present study brings new insights to investigating the determinants of childhood vaccination coverage and provides significant implications for health policies.
接种疫苗被广泛认为是作为卫生战略的最重要的预防措施之一。本文研究了基本儿童疫苗接种覆盖率的趋势，以及哪些国家和时间相关的决定因素可能影响了 1980 年至 2020 年期间 94 个国家的儿童免疫接种率（1 剂卡介苗、1 剂和 3 剂白喉、破伤风、百日咳、1 剂麻疹和 3 剂脊髓灰质炎）。我们确定了免疫接种的经济、不平等、人口、健康、教育、劳动力市场、环境和政治稳定因素。为此，我们使用了来自世界卫生组织和联合国儿童基金会（UNICEF）年度覆盖范围估计数的数据。实证分析包括广义估计方程模型，以评估免疫接种率与社会经济因素之间的关系。此外，我们遵循 Barro 和 Sala-i-Martín 的方法来确定条件收敛。我们的研究结果表明，免疫接种率与人均国内生产总值以及熟练卫生人员接生的婴儿之间存在最强的正显著关联。此外，我们的研究表明存在条件收敛，表明各国向不同的稳定状态收敛。本研究为调查儿童疫苗接种覆盖率的决定因素提供了新的见解，并为卫生政策提供了重要启示。
