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

Andrea Maugeri, Martina Barchitta, Syed Muhammad Zaffar and Antonella Agodi ()
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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

IJERPH, 2025, vol. 22, issue 6, 1-17

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.

Keywords: vaccine; immunization; childhood; development; socio-economic factors (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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