Evidence map›Paper›PMID 42013154›Full record

ArticlePLOS global public health2026

Availability of Hib, Pneumococcal, Rotavirus, and HPV vaccines in China: Implication for equity in access to immunization services.

Lei Guo, Feng Guo, Weixi Jiang, Xinyu Zhang, Di Dong, Shu Chen, Quan Wan, Shenglan Tang

Abstract read
In one paragraph

Article in PLOS global public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Lei GuoGlobal Health Research Center, Duke Kunshan University, Kunshan, China.ORCID https://orcid.org/0000-0002-7365-0405
Feng GuoDepartment of Health Economics and Healthcare Security, China National Health Development Research Center, Beijing, China.
Weixi JiangSchool of Public Health, Fudan University, Shanghai, China.ORCID https://orcid.org/0000-0002-5643-6255
Xinyu ZhangGlobal Health Research Center, Duke Kunshan University, Kunshan, China.ORCID https://orcid.org/0000-0002-5979-244X
Di DongThe World Bank Group, Washington D.C, United Stated of America.ORCID https://orcid.org/0009-0008-7421-004X
Shu ChenDuke Global Health Institute, Duke University, Durham, North Carolina, United States of America.ORCID https://orcid.org/0000-0002-1108-3863
Quan WanDepartment of Health Economics and Healthcare Security, China National Health Development Research Center, Beijing, China.
Shenglan TangGlobal Health Research Center, Duke Kunshan University, Kunshan, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Vaccines are cornerstones of public health, yet equitable access remains a major global challenge. While China has achieved sustained high coverage of National Immunization Program (NIP) vaccines, some WHO-recommended cost-effective non-NIP vaccines, such as Hib, pneumococcal conjugate (PCV), rotavirus, and human papillomavirus vaccines (HPV) are not universally accessible and often require out-of-pocket payment. This study examines geographic and urban-rural disparities in the availability of these four vaccines across China using data from a nationally representative China's National Health Accounts survey in 2022, covering 355 district- and county-level disease control centers and 2,609 public primary health facilities across 27 provinces. Availability was defined as the presence of at least one dose delivered or administered. Inequality was assessed using Slope Index of Inequality (SII) and the Erreygers-corrected Concentration Index (CI), based on provincial GDP per capita. We found significant disparities in vaccine availability across economic development levels and urban-rural settings in China. Overall, HPV vaccines were most available (96.9%) and PCV13 the least (86.5%) at the district/county level. Urban areas had markedly higher availability than rural areas, particularly for PCV13 (94.2% vs. 79.1%). At the clinic level, over 70% of urban clinics provided all four vaccine types, compared to just 40% in rural areas. The vaccines with the highest inequality were DTaP-IPV-Hib (CI: 0.408), PCV13 (CI: 0.362), and RV5 (CI: 0.343), indicating strong pro-rich distribution. In contrast, the Hib vaccine demonstrated the lowest inequality (CI: 0.209). These findings highlight significant inequities in the availability of WHO-recommended non-NIP vaccines across China, particularly affecting rural and economically disadvantaged regions underscoring the need of expanding vaccine provision in underserved areas, strengthening rural service capacity, and considering the inclusion of these vaccines in the NIP.

Identifiers

PMID42013154
PMCPMC13098980

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.