Understanding patterns of COVID-19 vaccination uptake is essential to identify and address inequities in vaccine access. Socioeconomic status has been identified as a key determinant of vaccine uptake in Nigeria, and differences in uptake may reflect broader social and structural inequalities that influence access to preventive services. This further analysis uses nationally representative survey data to quantify socioeconomic inequality in COVID-19 vaccination among women of reproductive age and to identify the factors that contribute to that inequality.
The analysis used data from the 2024 Nigeria Demographic and Health Survey (NDHS). The analytic sample comprised 36,555 women aged 15–49 years. The outcome variable was self-reported COVID-19 vaccination uptake. To examine how uptake varied across the socioeconomic gradient, the study applied a socioeconomic decomposition approach and used concentration indices/curves to quantify and illustrate inequality.
The decomposition analysis identified which socioeconomic and demographic variables contributed positively or negatively to the observed inequality in vaccination uptake. Variables specifically named in the results include educational attainment (secondary and higher education), exposure to mass media, employment status, health insurance coverage, age groups (notably age 30 years and above), and geopolitical zone of residence. The abstract summarizes the approach and key drivers but does not report the detailed decomposition coefficients or the full set of covariates in the written abstract.
Vaccination coverage among reproductive-age women in Nigeria was low overall and patterned by socioeconomic disadvantage. Reported uptake rates by disadvantage level were:
The concentration index curve indicated that COVID-19 vaccination uptake was significantly concentrated among the least disadvantaged women. In other words, higher socioeconomic groups had greater vaccine uptake than lower socioeconomic groups.
The decomposition identified several positive contributors to the observed socioeconomic inequality in uptake. These included:
The abstract reports the direction and presence of these contributors but does not present the numeric share of inequality attributable to each factor in the abstract text.
The analysis found a low overall level of COVID-19 vaccination among Nigerian women of reproductive age, with clear socioeconomic gradients: 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. The pattern indicates that achieving equitable vaccination coverage will require deliberate, targeted strategies that prioritize disadvantaged women.
Recommended policy and program implications, as framed by the study conclusions, include the need for context-specific policies and interventions designed to reduce socioeconomic barriers to access. Interventions that could reasonably be inferred from the identified contributors include efforts to improve access among less-educated and uninsured women, using mass media and outreach channels to reach disadvantaged groups, and geographically targeted strategies in underperforming zones. The abstract emphasizes that concerted efforts are required to address the structural and social determinants that underlie the observed inequality.
Conflict of interest and data availability notes
The author declared no competing interests. The study is a secondary analysis of the 2024 NDHS and is published open access in PLoS One. The abstract provides summary findings and identifies major contributing factors to inequality but does not include full methodological detail or the numerical decomposition outputs within the abstract text.