ArticleValue in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research2020
Comparative Distributional Impact of Routine Immunization and Supplementary Immunization Activities in Delivery of Measles Vaccine in Low- and Middle-Income Countries.
Article in Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Vaccine equity in low and middle income countries: a systematic review and meta-analysis.International journal for equity in health · 2022Pooled it
- A measles and rubella vaccine microneedle patch in The Gambia: a phase 1/2, double-blind, double-dummy, randomised, active-controlled, age de-escalation trial.Lancet (London, England) · 2024Trial
- Trends in vaccination coverage and equity in the Democratic Republic of the Congo from 2017 to 2023.Vaccine · 2025Article
- Article
- Group-based trajectory models of integrated vaccine delivery and equity in low- and middle-income countries.International journal for equity in health · 2024Article
- Health effects of routine measles vaccination and supplementary immunisation activities in 14 high-burden countries: a Dynamic Measles Immunization Calculation Engine (DynaMICE) modelling study.The Lancet. Global health · 2023Article
- Essential childhood immunization in 43 low- and middle-income countries: Analysis of spatial trends and socioeconomic inequalities in vaccine coverage.PLoS medicine · 2023Article
- Impact of health system strengthening on delivery strategies to improve child immunisation coverage and inequalities in rural Madagascar.BMJ global health · 2022Article
- Vaccination strategies for measles control and elimination: time to strengthen local initiatives.BMC medicine · 2021Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
Abstract
objectivesIn many countries, measles disproportionately affects poorer households. To achieve equitable delivery, national immunization programs can use 2 main delivery platforms: routine immunization and supplementary immunization activities (SIAs). The objective of this article is to use data concerning measles vaccination coverage delivered via routine and SIA strategies to make inferences about the associated equity impact.
methodsWe relied on Demographic and Health Survey and Multiple Indicator Cluster Surveys multi-country survey data to conduct a comparative analysis of routine and SIA measles vaccination status of children by wealth quintile. We estimated the value of the angle, θ, for the ratio of the difference between coverage levels of adjacent wealth quintiles by using the arc-tangent formula. For each country/year observation, we averaged the θ estimates into one summary measurement, defined as the "equity impact number."
resultsAcross 20 countries, the equity impact number summarized across wealth quintiles was greater (and hence less equitable) for routine delivery than for SIAs in the survey rounds (years) during, before, and after an SIA about 65% of the time. The equity impact numbers for routine measles vaccination averaged across wealth quintiles were usually greater than for SIA measles vaccination across country-year observations.
conclusionsThis analysis examined how different measles vaccine delivery platforms can affect equity. It can serve to elucidate the impact of immunization and public health programs in terms of comparing horizontal to vertical delivery efforts and in reducing health inequalities in global and country-level decision-making.
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