Gender-related barriers to vaccination have an important role in public health. To understand these issues, we used a measure of women’s empowerment and explored its association with the prevalence of zero-dose in children aged 12-23 months from 50 low- and middle-income countries. We found that children of women with lower empowerment level presented a zero-dose prevalence 3 times higher than children of mothers with higher empowerment level. Mother’s empowerment had a higher effect in children's vaccination status in countries with higher prevalence of zero-dose, suggesting that less effective immunisation programs contribute to increasing inequalities, once they require stronger engagement by mothers in order to get their children vaccinated. In summary, our analyses support the importance of women’s empowerment for child vaccination, especially where the health systems needed for routine vaccination are weaker. Making progress towards the ambitious zero-dose target of Immunisation Agenda 2030 will require focused efforts to address and overcome gender-related barriers to immunisation.

The complete paper is published in the Journal of Global Health