The WHO Immunization Agenda 2030 (IA2030) envisions ‘a world where everyone, everywhere, at every age, fully benefits from vaccines to improve health and well-being’ and has as one of its targets the reduction of the number of zero-dose children globally by 50% by 2030.

Although analyses of inequalities in immunization coverage are plentiful in the literature, studies on ethnicity remain poorly investigated in low- and middle-income countries (LMIC). Therefore, we examined ethnic gaps in zero-dose prevalence as measured by lack of receipt of any doses of DPT-containing vaccine among children aged 12–23 months.

We studied 64 countries with 339 ethnic groups. The median gap between the ethnic group with highest zero-dose prevalence and the lowest was 10 pp. Afghanistan (84 pp), Chad (70 pp), Nigeria (57 pp) were the countries with the largest prevalence gaps between extreme groups. Children belonging to a majority ethnic group had 29% lower prevalence of zero-dose compared with the rest of the sample.

Our results showed important inequalities in zero-dose prevalence regarding ethnicity. We highlight the importance of such analysis for monitoring trends, targeting resources and assessing the impact of health interventions to ensure zero-dose children are not left behind.

You can access the full paper at: BMJ Global Health