Zhang Yanqin, Zhang Xinyu, Long Qian
Global Health Research Center, Duke Kunshan University, Kunshan 215316, China.
Duke Global Health Institute, Duke University, Durham, NC 27708, USA.
Vaccines (Basel). 2025 Aug 27;13(9):907. doi: 10.3390/vaccines13090907.
Equitable access to childhood vaccines remains a challenge in many low- and middle-income countries. This study assessed coverage of WHO-recommended childhood vaccines in Cambodia and the Philippines, focusing on urban-rural and wealth disparities, and examined maternal demographic and socioeconomic factors influencing vaccination coverage. Cross-sectional data from Demographic and Health Surveys from Cambodia (2000-2021/22) and the Philippines (2003-2022) were used. Descriptive analyses were performed to elucidate vaccination coverage trends (BCG, hepatitis B birth dose, DTP, OPV, PCV, and measles). Urban-rural and wealth-related disparities were assessed by calculating absolute differences and Slope Index of Inequality. Logistic regression was used to analyze the impact of maternal demographics and socioeconomic status on vaccination coverage. Cambodia showed significant increases in BCG, DTP, and OPV coverage over the past two decades, whereas those coverage in the Philippines declined slightly since 2017. In 2022, 75.2% of Filipino children received the BCG and hepatitis B (birth dose) vaccines, and around two-thirds completed DTP, OPV, and PCV vaccinations on schedule, lower than the rates in Cambodia. Only half of the children completed measles vaccination in both countries. Urban-rural disparities declined over time in both countries, but wealth inequalities persisted and widened in the Philippines between 2017 and 2022. Women with higher education attainment, from a wealthy household and having fewer children, was associated with increased likelihood of completing childhood vaccinations in both countries. Persistent socioeconomic disparities in childhood vaccination in low- and middle-income countries highlight the need for targeted pro-poor and community-based strategies to ensure equitable access.
在许多低收入和中等收入国家，公平获得儿童疫苗仍然是一项挑战。本研究评估了柬埔寨和菲律宾世卫组织推荐的儿童疫苗接种覆盖率，重点关注城乡和财富差距，并研究了影响疫苗接种覆盖率的孕产妇人口统计学和社会经济因素。使用了柬埔寨（2000 - 2021/22年）和菲律宾（2003 - 2022年）人口与健康调查的横断面数据。进行描述性分析以阐明疫苗接种覆盖率趋势（卡介苗、乙肝首剂疫苗、白百破疫苗、口服脊髓灰质炎疫苗、肺炎球菌结合疫苗和麻疹疫苗）。通过计算绝对差异和不平等斜率指数评估城乡和财富相关差距。使用逻辑回归分析孕产妇人口统计学和社会经济状况对疫苗接种覆盖率的影响。在过去二十年中，柬埔寨的卡介苗、白百破疫苗和口服脊髓灰质炎疫苗接种覆盖率显著提高，而菲律宾自2017年以来这些覆盖率略有下降。2022年，75.2%的菲律宾儿童接种了卡介苗和乙肝（首剂）疫苗，约三分之二的儿童按时完成了白百破疫苗、口服脊髓灰质炎疫苗和肺炎球菌结合疫苗接种，低于柬埔寨的接种率。在这两个国家，只有一半的儿童完成了麻疹疫苗接种。随着时间的推移，两国的城乡差距均有所下降，但菲律宾的财富不平等在2017年至2022年间持续存在且有所扩大。在这两个国家，受过高等教育、来自富裕家庭且子女较少的女性完成儿童疫苗接种的可能性更高。低收入和中等收入国家儿童疫苗接种中持续存在的社会经济差距凸显了需要有针对性的扶贫和基于社区的战略，以确保公平获得疫苗。
