Exposure of Zero-Dose Children to Multiple Deprivation: Analyses of Data from 80 Low- and Middle-Income Countries

Wendt, Andrea; Santos, Thiago M.; Cata-Preta, Bianca O.; Arroyave, Luisa; Hogan, Daniel R.; Mengistu, Tewodaj; Barros, Aluisio J. D.; Victora, Cesar G.

doi:10.3390/vaccines10091568

Cited by 30Vaccine Coverage and HesitancyChild Nutrition and Water AccessGlobal Maternal and Child Health

Exposure of Zero-Dose Children to Multiple Deprivation: Analyses of Data from 80 Low- and Middle-Income Countries

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Wendt, Andrea, Santos, Thiago M., Cata-Preta, Bianca O., Arroyave, Luisa, Hogan, Daniel R., Mengistu, Tewodaj, Barros, Aluisio J. D., Victora, Cesar G.·2022·Vaccines

DOI 10.3390/vaccines10091568PMC PMC9502633

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Abstract

The concept of multiple deprivation recognizes that the same individuals, households, and communities are often exposed to several forms of scarcity. We assessed whether lack of immunization is also associated with nutritional, environmental, and educational outcomes. We analyzed data from nationally representative surveys from 80 low- and middle-income countries with information on no-DPT (children aged 12-23 months without any doses of a diphtheria, pertussis and tetanus containing vaccine), stunting, wasting, maternal education and use of contraception, improved water and sanitation, and long-lasting insecticidal nets. Analyses of how these characteristics overlap were performed at individual and ecological levels. Principal component analyses (PCA) provided additional information on indicator clustering. In virtually all analyses, no-DPT children were significantly more likely to be exposed to the other markers for deprivation. The strongest, most consistent associations were found with maternal education, water, and sanitation, while the weakest associations were found for wasting and bed nets. No-DPT prevalence reached 46.1% in the most deprived quintile from first PCA component derived from deprivation indicators. All children were immunized in the two least deprived quintiles of the component. Our analyses provide strong support for the hypothesis that unimmunized children are also affected by other forms of deprivation.

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Zero-dose children are more likely to miss out on subsequent vaccinations and experience other types of deprivation.
“Zero-dose children are more likely to miss out on subsequent vaccinations30 and experience other types of deprivation17”
From Global, regional, and national trends in routine childhood vaccination coverage from 1980 to 2023 with forecasts to 2030: a systematic analysis for the Global Burden of Disease Study 2023 (2025) · cites this paper as [17]

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Authors: Wendt, A., Santos, T. M., Cata-Preta, B. O., Arroyave, L., Hogan, D. R., Mengistu, T., Barros, A. J. D., & Victora, C. G.
Affiliations: Universidade Federal de Pelotas (BR)
Gavi (CH)
International Center for Equity in Health, Federal University of Pelotas, Rua Marechal Deodoro 1160, Pelotas 96020-220, RS, Brazil
Corresponding author: Santos, Thiago M.
ORCID: Wendt, Andrea
Santos, Thiago M.
Cata-Preta, Bianca O.
Arroyave, Luisa
Hogan, Daniel R.
Mengistu, Tewodaj
Barros, Aluisio J. D.
Victora, Cesar G.
Venue: Vaccines
Publisher: MDPI AG
Published: 2022-09-19
Volume: 10
Issue: 9
Pages: 1568
ISSN: 2076-393X (ISSN-L)
DOI: 10.3390/vaccines10091568
PMC: PMC9502633
OpenAlex: W4296755075
Cited by: 30
References: 15
Citations by year: 2026: 5 · 2025: 9 · 2024: 10 · 2023: 6
FWCI: 4.80
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (vor)
Locations: Vaccines (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders: Bill & Melinda Gates Foundation (OPP1199234, 101815/Z/13/Z)
Gavi, the Vaccine Alliance, Wellcome Trust (OPP1199234, 101815/Z/13/Z)
Associação Brasileira de Saúde Coletiva (OPP1199234, 101815/Z/13/Z)
Topics: Social Sciences › Health › Vaccine Coverage and Hesitancy
Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
Keywords: multiple deprivation, childhood immunization, stunting, wasting, maternal education, water and sanitation, long-lasting insecticidal nets, contraceptive use, child malnutrition, low- and middle-income countries

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Exposure of Zero-Dose Children to Multiple Deprivation: Analyses of Data from 80 Low- and Middle-Income Countries

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