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. 2024 May 9:12:1371258.
doi: 10.3389/fpubh.2024.1371258. eCollection 2024.

Trends and projections of age-appropriate vaccination coverage in 41 low- and middle- income countries in Asia and Sub-Saharan Africa, 2000-2030

Md Rashedul Islam  1   2 , Md Mizanur Rahman  1 , Md Shafiur Rahman  3   4   5 , Sarah Krull Abe  5 , Manas K Akmatov  6 , Masahiro Hashizume  2
Affiliations

Trends and projections of age-appropriate vaccination coverage in 41 low- and middle- income countries in Asia and Sub-Saharan Africa, 2000-2030

Md Rashedul Islam et al. Front Public Health. .

Abstract

Introduction: Routine immunization programs have focused on increasing vaccination coverage, which is equally important for decreasing vaccine-preventable diseases (VPDs), particularly in low- and lower-middle-income countries (LMICs). We estimated the trends and projections of age-appropriate vaccination coverage at the regional and national levels, as well as place of residence and wealth index in LMICs.

Methods: In total, 174 nationally representative household surveys from 2000 to 2020 from 41 LMICs were included in this study. Bayesian hierarchical regression models were used to estimate trends and projections of age-appropriate vaccination.

Results: The trend in coverage of age-appropriate Bacillus Calmette-Guérin (BCG), third dose of diphtheria, tetanus, and pertussis (DTP3), third dose of polio (polio3), and measles-containing vaccine (MCV) increased rapidly from 2000 to 2020 in LMICs. Findings indicate substantial increases at the regional and national levels, and by area of residence and socioeconomic status between 2000 and 2030. The largest rise was observed in East Africa, followed by South and Southeast Asia. However, out of the 41 countries, only 10 countries are estimated to achieve 90% coverage of the BCG vaccine by 2030, five of DTP3, three of polio3, and none of MCV. Additionally, by 2030, wider pro-urban and -rich inequalities are expected in several African countries.

Conclusion: Significant progress in age-appropriate vaccination coverage has been made in LMICs from 2000 to 2020. Despite this, projections show many countries will not meet the 2030 coverage goals, with persistent urban-rural and socioeconomic disparities. Therefore, LMICs must prioritize underperforming areas and reduce inequalities through stronger health systems and increased community engagement to ensure high coverage and equitable vaccine access.

Keywords: Bayesian model; VPDs; age-appropriate childhood vaccination; coverage; projection; trends.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Figures

Figure 1
Figure 1
Overall and regional coverage of age-appropriate vaccines from 2000 to 2030. (A) BCG (B) DPT3 (C) Polio3 (D) MCV.
Figure 2
Figure 2
Coverage of age-appropriate vaccinations differentiated by the urban/rural place of residence in 41 LMICs in Asia and Sub-Saharan Africa, 2030. CAF, Central African Republic; DRC, Democratic Republic of the Congo; Sao TP, Sao Tome and Principe. (A) BCG (B) DPT3 (C) Polio3 (D) MCV.
Figure 3
Figure 3
Projected coverage of age-appropriate vaccines in 2030 by different scenarios. Note: CAF, Central African Republic; DRC, Democratic Republic of the Congo; Sao TP, Sao Tome and Principe. (A) BCG (B) DPT3 (C) Polio3 (D) MCV.
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