Inequalities in COVID-19 vaccination coverage in Peru: An ecological study

Ali Al-Kassab-Córdova; Carolina Mendez-Guerra; Claudia Silva-Perez; Percy Herrera-Añazco; Vicente A Benites-Zapata

doi:10.1016/j.puhip.2023.100384

Inequalities in COVID-19 vaccination coverage in Peru: An ecological study

Public Health Pract (Oxf). 2023 Jun:5:100384. doi: 10.1016/j.puhip.2023.100384. Epub 2023 Apr 6.

Authors

Ali Al-Kassab-Córdova¹, Carolina Mendez-Guerra², Claudia Silva-Perez², Percy Herrera-Añazco^{3

4}, Vicente A Benites-Zapata⁵

Affiliations

¹ Centro de Excelencia en Estudios Económicos y Sociales en Salud, Universidad San Ignacio de Loyola, Lima, 15024, Peru.
² Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, 15067, Peru.
³ Universidad Privada del Norte, Trujillo, 13001, Peru.
⁴ Red Peruana de Salud Colectiva, Lima, Peru.
⁵ Maestría de Epidemiología Clínica y Bioestadística, Universidad Científica del Sur, Lima, 15067, Peru.

Abstract

Objective: To assess the correlation between COVID-19 vaccination coverage and the Human Development Index (HDI) at the provincial level in Peru.

Study design: Ecological study.

Methods: We conducted a cross-sectional ecological study based on secondary data analysis. Coverages of the first, second^, and third doses of the vaccine against COVID-19 and the HDI were evaluated. The magnitude of the correlations was assessed using Spearman's rank correlation coefficients with their corresponding bootstrapped 95% confidence intervals (95% CI). Scatter plots were also constructed.

Results: A total of 196 provinces were included. There was a moderate correlation between the first dose of the COVID-19 vaccine and the HDI (r = 0.3807 [95% CI 0.2585-0.5030], p < 0.0001). The same direction was found for the second (r = 0.4064 [95% CI 0.2853-0.5276], p < 0.0001) and third dose (r = 0.4435 [95% CI 0.3201-0.5669], p < 0.0001).

Conclusions: A positive correlation was found between COVID-19 vaccination coverage and the HDI, suggesting the presence of inequalities in access to vaccines. Individualised strategies are needed in lower HDI regions to tackle inequalities.

Keywords: COVID-19; Peru; Socioeconomic inequalities; Vaccination.