Lesson 5 Social inequalities in vaccination

  • Every individual should have equal rights and access to any vaccination and especially the COVID-19 vaccination
  • Various individuals are left unprotected from COVID-19 due to unequitable access
  • Wealthier nations have reserved the majority of vaccination , enhancing even more the gap between rich and poor
  • The best example is the fact that some people got their booster shot while others have yet to receive their first shot.
  • The Global Dashboard for Vaccine Equity depicts that as of September 15, 3.07% of people in low income countries have been vaccinated with at least their first dose while the respective figure is 60.18% in high-income countries.
  • WHO and UNICEF aim to provide vaccine equity through COVAX. Unfortunately, this is the only source of vaccination for some countries.
  • Unfortunately, inequities in vaccination affect children as well, leaving them unprotected against some vaccine preventable diseases
  • Migrant and refugee children are considered as one of the most vulnerable groups against vaccine preventable diseases
  • Simultaneously, Roma children experience higher infection rates than the rest of the population
  • There is a 55-60% chance of getting vaccinated for diptheria, pertussis, tetanus, polio and MMR for Roma children compared to non-Roma children
  • The groups of children that are considered as vulnerable are: migrant children, children from ethnic minorities, children with low socio-economic status, children from rural communities and undeserved urban areas
  • Based on 2014 data 1/10th of children in the European region were unprotected from vaccine preventable diseases due to lack of the basic sets of vaccination. Barriers in such cases are wealth, parental education level, place of residence and gender
  • Lack of vaccination causes the immunity levels to drop.
  • In 2017 87% of the people that contracted measles were never vaccinated in the EU/EEA area.
  • 37% of the recognised cases were children of five years old and under while 45% of the cases were 15 years old and  over.
  • 65% of children did not vaccinate against MMR
  • 58% of children did not vaccinate against Tetanus
  • As seen by Medecins du Monde International Network only 35% of children belonging to vulnerable groups against MMR while 58% of children had vaccinated against tetanus.
  • Between 2017-2018 measles cases tripled in Europe. Also, there was a 288% increase in suspected measles cases in the first three moths of 2019 in comparison to 2018.

Social Inequalities in vaccination-example

Irregularities regarding the vaccination patterns between whites and racial & ethnic minority groups

Irregularities regarding the vaccination patterns between whites and racial & ethnic minority groups
Minorities-recorded lower numbers of vaccinations among their populations

Reasons for lower vaccination rates:

  1. Lack of access to vaccination due to marginalisation
  2. Lack of knowledge about already-existing vaccines
  3. Lack of knowledge of vaccine benefits
  4. Personal or other types of beliefs that prevent vaccination
  5. Cost of heath care access
  6. Fear of provision of personal information- example: illegal migrants are afraid to give their personal details in fear of being deported

Source: Daniels, N. A., Juarbe, T., Rangel-Lugo, M., Moreno-John, G., & Pérez-Stable, E. J. (2004). Focus group interviews on racial and ethnic attitudes regarding adult vaccinations. Journal of the National Medical Association, 96(11), 1455–1461.

  • Studies conducted in Australia and UK show that minorities have a lower vaccine uptake.
  • However, it was detected that socio-economic status was a greater factor for vaccine hesitancy than ethnicity
  • Socially advantaged groups had more vaccine uptake regardless of their ethnicity
  • In Australia, people living in disadvantaged areas are less likely to get vaccinated.
  • some people expressed that mass COVID-19 vaccination centers do not follow their religious or cultural norms and thus present a barrier for their vaccination.
  • Language can also be another barrier that prevents vaccination uptake
  • Some of the barriers in regard to vaccination consist of religious, ideological, personal or cultural reasons, fear of losing work, economist status, misinformation, low health literacy and practical barriers.

Chapter 1: Summary

In this chapter you should  have learned …

  • What is immunity
  • What is immunization and the types of immunization
  • How you can get immunization
  • How can immunization be increased
  • What is herd immunity  and why it is important
  • How disease outbreaks can take place
  • The social inequalities that take place in vaccinations