Decomposing socioeconomic inequalities in COVID-19 vaccination uptake among Nigerian women of reproductive age: A further analysis of population-based data

Background: Understanding COVID-19 vaccine uptake is particularly important in studies of inequity in vaccination access, as differences in uptake may reflect underlying social and structural inequalities. Evidence suggests that socioeconomic status is a key driver for COVID-19 vaccination uptake in Nigeria. This study examines the socioeconomic inequality in COVID-19 vaccination uptake among reproductive-age Nigerian women. Methods: Data from the 2024 Nigeria Demographic and Health Survey (NDHS) was analyzed for a sample of 36,555 women of reproductive age (15–49 years). COVID-19 vaccination uptake was the outcome variable measured in this study. A socioeconomic decomposition analysis was conducted to identify the factors contributing to inequalities in COVID-19 vaccination uptake across the socioeconomic gradient. Results: The least disadvantaged women had the highest COVID-19 vaccination uptake (31.6%), whereas the most disadvantaged women had the lowest COVID-19 vaccination uptake (19.2%). The concentration index curve showed that COVID-19 vaccination uptake among Nigerian women was significantly higher among the least disadvantaged group. In addition, having higher education, secondary education, being exposed to mass media, employed, covered by health insurance, being aged 30 years or older, from South West, South South and South East geopolitical zones respectively, were positive contributors to socioeconomic inequality in COVID-19 vaccination uptake. Conclusion: There was low uptake rate of COVID-19 vaccination among Nigerian women, with approximately one-third of the least disadvantaged, one-quarter of the moderately disadvantaged, and one-fifth of the most disadvantaged women reported receiving a COVID-19 vaccine. This shows that the dream of achieving equitable vaccination coverage will require concerted efforts and targeted strategies that prioritize disadvantaged women, including context-specific policies aimed at reducing socioeconomic barriers to access.