Associations between economic crises and childhood vaccination coverage: Evidence from 160 countries, 2000-2019

Childhood vaccination is among the most effective public health interventions, preventing millions of deaths each year. However, global vaccination coverage remains uneven, and economic crises may challenge immunization efforts by disrupting healthcare systems and straining household resources. This study examines the negative association between economic crises, specifically banking collapses, currency devaluations, and sovereign debt crises. Using data from Nguyen et al. (2022), and childhood vaccination rates for DTP, Hepatitis B, Measles, and Polio, based on coverage data from the World Health Organization (WHO) Immunization Data Portal (WHO, 2024). Using a cross-national time-series framework, we analyze 160 countries from 2000 to 2019. Results show that economic crises are negatively associated with vaccination coverage across all vaccine types, with the associations observed only in the short term. Among crisis types, banking and sovereign debt crises display the most pronounced negative associations, while currency crises show weaker links. Although coverage often improves as economies stabilize, these findings suggest that vaccination programs remain vulnerable to macroeconomic instability, underscoring the importance of policy measures to sustain immunization systems during economic distress.