Socioeconomic Status, Health Inequalities, and Solidarity Trends in a Mass Vaccination Campaign

In July 2013, Israel was swept with fear of a polio outbreak. This study analyzes the vaccination uptake rates resulting from the mass polio vaccination campaign on the basis of health inequality parameters of socioeconomic status (SES), principles of solidarity, and the Gini inequality index. The research explores understanding the value of the Gini inequality index within the context of SES and solidarity. The study is based on data gathered from the Israeli Ministry of Health’s administrative records from mother-and-child clinics across Israel. The research population is comprised of resident infants and children whom the Ministry of Health defined as eligible for the OPV between August and December 2013 (the "campaign period"). The higher the SES level of the area where the mother-and-child clinic is located, the lower the OPV vaccination uptake is. The greater the income inequality is in the municipality where the mother-and-child clinic is situated, the lower the vaccination uptake. As time passed in the vaccination campaign, vaccination uptake increased regardless of the location of the mother-and-child clinics. The highest vaccination uptake rate was found among populations of low SES and low Gini inequality index. The lowest vaccination uptake rate was found among high SES/high Gini inequality index. This study provides further support for the “paradox” that recent scholarship (Binyaminy et al., 2016) has shown in regard to vaccination uptake and health inequalities. Despite higher health inequalities present in areas of low SES, vaccination rates were higher than populations with lower health inequalities and high SES. Additionally, this study identifies a negative correlation between the Gini inequality index in regard to vaccination uptake. Results stress the need for contextualization and for policy makers to account for SES and solidarity in implementing vaccination policy, particularly how to maximize vaccination uptake under unique circumstances.