Trends in Socioeconomic Inequalities in Full Vaccination Coverage among Vietnamese Children Aged 12–23 Months, 2000–2014: Evidence for Mitigating Disparities in Vaccination

Abstract

There has been no report on the situation of socioeconomic inequalities in the full vaccination coverage among Vietnamese children. This study aims to assess the trends and changes in the socioeconomic inequalities in the full vaccination coverage among Vietnamese children aged 12–23 months from 2000 to 2014. Data were drawn from Multiple Indicator Cluster Surveys (2000, 2006, 2011, and 2014). Concentration index (CCI) and concentration curve (CC) were applied to quantify the degree of the socioeconomic inequalities in full immunization coverage. The prevalence of children fully receiving recommended vaccines was significantly improved during 2000–2014, yet, was still not being covered. The total CCI of full vaccination coverage gradually decreased from 2000 to 2014 (CCI: from 0.241 to 0.009). The CC increasingly became close to the equality line through the survey period, indicating the increasingly narrow gap in child full immunization amongst the poor and the rich. Vietnam witnessed a sharp decrease in socioeconomic inequality in the full vaccination coverage for over a decade. The next policies towards children from vulnerable populations (ethnic minority groups, living in rural areas, and having a mother with low education) belonging to lower socioeconomic groups may mitigate socioeconomic inequalities in full vaccination coverage.

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“…Although they were used mainly for national-level reporting, data from these surveys have the capacity to present progress of equity gaps in GAPPD indicators amongst subgroups within countries. Previous studies from Vietnam and Nepal using data from the DHS and MICS between 2000 to 2014, found national level improvements in immunisation coverage and health seeking behaviours for acute illnesses [38,39]. However, when the data was disaggregated by household socioeconomic status, geographical location, parental education and ethnicity, inequities amongst these subpopulations persisted over the 13 to 14-year period.…”

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“…Neonatal BCG vaccination is included in the Expanded Program on Immunization, and coverage has been at a high level since 2009. In 2019, 95% of neonates in Vietnam received BCG, though vaccination rates were lower for children who were born in rural areas, in ethnic minority communities, or to mothers with low education [74]. The high BCG coverage will impact on severe disease in young children, but clinical diagnosis is an ongoing challenge as a reliance on bacteriological confirmation results in under-detection, especially among high-risk young children [75].…”

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“…It is assumed that health insurance is influenced by other specific attributes of the families in which the individuals are born. It has been argued that many socio-economic disparities are accountable for accessing childhood healthcare services ( 25 ). For instance, the education of the population ( 35 ), especially the mother's level of education ( 23 ), is crucial.…”

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