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Construction of Development Scores to Analyze Inequalities in Childhood Immunization Coverage: A Global Analysis from 2000 to 2021

Author

Listed:
  • Andrea Maugeri

    (Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, Via S. Sofia 87, 95123 Catania, Italy)

  • Martina Barchitta

    (Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, Via S. Sofia 87, 95123 Catania, Italy)

  • Syed Muhammad Zaffar

    (Department of Economics and Business, University of Catania, Corso Italia 55, 95129 Catania, Italy)

  • Antonella Agodi

    (Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, Via S. Sofia 87, 95123 Catania, Italy)

Abstract

Immunization coverage is a key public health indicator reflecting healthcare accessibility and socio-economic conditions. This study employs Principal Component Analysis (PCA) to construct composite development scores and analyze their relationship with immunization coverage for measles and diphtheria-tetanus-pertussis (DTP) vaccines across 195 countries (2000–2021). The analysis comprises a training period (2000–2015) for score development and a test period (2016–2021) for validation. Variables were selected based on correlation with immunization coverage and standardized before PCA extraction. PC1, the principal component explaining the largest variance, was identified as a key indicator of development disparities. Findings reveal that higher PC1 scores (lower socio-economic development) are associated with reduced immunization rates, while lower PC1 scores (higher socio-economic development) correspond to greater coverage, a trend consistent across both periods. Geospatial analysis highlights stark disparities, particularly in sub-Saharan Africa and South Asia, whereas North America, Europe, and East Asia maintain significantly higher coverage. These results provide policy-relevant insights, demonstrating the utility of PCA-derived scores for resource allocation and targeted interventions.

Suggested Citation

  • Andrea Maugeri & Martina Barchitta & Syed Muhammad Zaffar & Antonella Agodi, 2025. "Construction of Development Scores to Analyze Inequalities in Childhood Immunization Coverage: A Global Analysis from 2000 to 2021," IJERPH, MDPI, vol. 22(6), pages 1-17, June.
    • Handle: RePEc:gam:jijerp:v:22:y:2025:i:6:p:941-:d:1679888
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    References listed on IDEAS

    as
    1. Asif Khaliq & Alfaraz Ashraf Elahi & Asima Zahid & Zohra S. Lassi, 2022. "A Survey Exploring Reasons behind Immunization Refusal among the Parents and Caregivers of Children under Two Years Living in Urban Slums of Karachi, Pakistan," IJERPH, MDPI, vol. 19(18), pages 1-11, September.
    2. Amber Sacre & Clare Bambra & Josephine M Wildman & Katie Thomson & Natalie Bennett & Sarah Sowden & Adam Todd, 2023. "Socioeconomic inequalities in vaccine uptake: A global umbrella review," PLOS ONE, Public Library of Science, vol. 18(12), pages 1-18, December.
    3. Andrea Maugeri & Martina Barchitta & Antonella Agodi, 2020. "A Clustering Approach to Classify Italian Regions and Provinces Based on Prevalence and Trend of SARS-CoV-2 Cases," IJERPH, MDPI, vol. 17(15), pages 1-14, July.
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