SynthesisBMJ global health2025
Association of gross domestic product with equitable access to childhood vaccines in 195 countries: a systematic review and meta-analysis.
Synthesis in BMJ global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Global immunisation planning and economic development potential: a panel data analysis for the macroeconomic impact of hepatitis B vaccination from 2000 to 2018.BMC medicine · 2026Article
- Global burden of diphtheria, 1990-2021: a 204-country analysis of socioeconomic inequality based on SDI and DTP3 vaccination differences before and after the COVID-19 pandemic (GBD 2021).Frontiers in public health · 2025Article
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionGross domestic product (GDP) has been shown to affect government spending on various budget heads including healthcare and the purchase and distribution of vaccines. This vulnerable situation has been exacerbated by the COVID-19 pandemic which disrupted and exposed the fragile nature of equitable access to vaccines for childhood immunisation globally. A systematic review and meta-analysis to assess the association of country income status and GDP with vaccination coverage of vaccines for childhood immunisation and other major infectious diseases around the globe will inform global and national policy on equity in living standards and vaccine uptake. This study was carried out to identify factors influenced by GDP that affect access, distribution, and uptake of childhood vaccines around the world using a systematic review and meta-analysis approach.
methodsData were extracted for the burden of major infectious diseases of childhood immunisation programmes, factors affecting access to vaccines, vaccine procurement platforms, vaccination coverage and percentage of GDP used for the procurement of vaccines. Factors influencing the global vaccination coverage rate were also assessed. The protocol was registered on PROSPERO (ID: CRD42022350418) and carried out using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
resultsData from 195 countries showed that the following infectious diseases had the highest burden; human papillomavirus (HPV), measles, Ebola and yellow fever. Low-income and some lower-middle-income countries (LMICs) used COVAX and UNICEF for vaccine procurement while high-income countries (HICs) preferred national and regional public tenders. Global vaccination coverage for tuberculosis, diphtheria/tetanus/pertussis, hepatitis B,
conclusionLow-income countries and LMICs should prioritise vaccine research and improve on development capacity. Countries worldwide should share data on vaccine expenditure, vaccination coverage, and the development and introduction of new vaccines and technologies to facilitate equitable vaccine access.
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