Vaccination Inequality in India, 2002-2013.

Area of Science:

• Public Health
• Epidemiology
• Health Policy

Background:

• India has implemented national policies to boost childhood vaccination coverage.
• Contemporary studies comparing state-level vaccination rates across India are limited.
• Socioeconomic status (SES)-based inequalities in childhood vaccination require further investigation.

Purpose of the Study:

• To assess socioeconomic status (SES)-based inequalities in childhood vaccination across Indian states from 2002 to 2013.
• To compare vaccination rates between government-designated high focus and non-high focus states.
• To analyze trends in vaccination coverage and associated inequalities over time.

Main Methods:

• Utilized national survey data from 2002-2004, 2007-2008, and 2012-2013.
• Assessed household SES using a principal component analysis-derived asset index.
• Defined full vaccination and stratified inequality analyses by time period and state focus group.

Main Results:

• Childhood vaccination increased in high focus states but declined in some non-high focus states between 2002-2013.
• SES-based vaccination inequalities generally decreased across both state types.
• Rural areas showed lower vaccination rates than urban areas in high focus states by 2012-2013.

Conclusions:

• Overall childhood vaccination improved in India, with greater gains in high focus states.
• The gap in vaccination coverage between high and non-high focus states narrowed.
• Persistent SES-based vaccination disparities necessitate improved vaccination strategies for underserved populations.