Global pattern and determinants of coronavirus disease 2019 (COVID-19) vaccine coverage and progression: a global ecological study.

ABSTRACT

Background: Understanding and minimizing existing global coronavirus disease 2019 (COVID-19) vaccination disparities is critical to global population health and eliminating health inequities. The study aims to investigate the disparities of vaccination coverage and progression and the associated economic and educational determinants to inform global COVID-19 vaccination strategies. Methods: COVID-19 vaccination coverage data from 206 countries used in the study were derived from "Our World in Data" website. After obtaining the vaccination coverage indicators, we fitted the progression indicators for vaccination. Correlation and multiple linear regression analysis were used to examine the effects of gross domestic product (GDP) per capita, Gini index, education, and their interactions on the coverage and progression of the COVID-19 vaccination. Results: The coverage of COVID-19 vaccination ranged from less than 30 doses to more than 150 doses per hundred people, from less than 15% to more than 75% for proportion of people vaccinated, from less than 15% to more than 60% for proportion of people fully vaccinated. Similarly, the progression of vaccination ranged from less than 0.1 to more than 0.6 for progression of total number of doses, from less than 0.1 to more than 0.3 for progression of proportion of people vaccinated, and from less than 0.1 to more than 0.4 for progression of proportion of people fully vaccinated. GDP per capita and education were positively associated with the coverage and progression, while Gini index was negatively associated with the coverage and progression. Negative interaction between GDP per capita and education was also observed for coverage (ß = -0.012 to -0.011, P < 0.05) and progression (ß = -0.012 to -0.011, P < 0.05). Conclusions: Substantial geographic disparities existed for the coverage and progression of COVID-19 vaccination. Economy and education are two important factors contributing to the disparities. Different countries may adopt varied strategies to promote the national distribution and vaccination of COVID-19 vaccines.