Vaccination Equity

Vaccination Equity: Reaching Every Child, Every Community

Safe and effective vaccines exist — yet significant inequities in vaccination uptake and protection persist across populations and settings. Children and families experiencing poverty, social exclusion, marginalization, and limited access to services continue to be left behind, with consequences that extend across the life course. At the Excellence in Pediatrics Institute, we are committed to understanding the systemic drivers of these inequities and working with partners across health, policy, and civil society to close the gap.

Survey Insights
Understanding Barriers

Why Vaccination Inequities Persist

Vaccination inequity is too often framed as a problem of individual choice or "vaccine hesitancy." The evidence is clear: inequities are predictable, patterned, and preventable outcomes of how systems are designed, measured, and experienced. Families are not failing to vaccinate — in many cases, systems are failing families.

Data Blind Spots: Aggregate national coverage figures mask deep inequalities between socioeconomic groups and geographies. Systems can appear high-performing while clusters of vulnerability go undetected.
Structural and Socioeconomic Barriers: Poverty, housing instability, inflexible clinic hours, and complex appointment systems all limit access — even when vaccines are free.
Trust Rooted in Lived Experience: Mistrust in vaccination often reflects mistrust in institutions. Where services are inconsistent or inaccessible, scepticism is a rational response.
Community Decision-Making: Vaccination decisions are shaped by shared values, social networks, and moral frameworks. Effective programs must engage with how communities actually make decisions.
Survey Insights

The LifeCourse Prevention Summit on Vaccination Equity

In 2025, the Excellence in Pediatrics Institute convened the Vaccination Equity session of the LifeCourse Prevention Summit, bringing together experts in public health, clinical practice, social science, civil society, and policy. The meeting examined why vaccination equity remains unresolved and how systems can be redesigned to deliver more equitable outcomes.

The discussion moved beyond individual-level explanations to focus on systemic drivers — including how data is collected, how services are structured, how trust is built or eroded, and how communities are engaged. It produced a concrete set of shared commitments and an Action Framework to guide implementation across seven areas: measurement, resource targeting, trust, program design, engagement, coordination, and ongoing accountability.

Meeting Report

A deep dive into real-world challenges and ideas for targeted public health strategies.

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Resources

Campaign Resources

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Equity Gap

From Evidence to Action

The Summit produced a set of shared commitments that form the basis of an action-oriented agenda:

Embed equity as a core performance objective in vaccination policy, delivery, and accountability frameworks.
Reform vaccination data systems to make inequities visible through disaggregated, equity-sensitive indicators.
Ensure equity is designed in from the outset of new vaccine programs — not retrofitted after gaps emerge.
Address structural barriers to access, recognizing that free vaccines do not guarantee equitable access across all communities.
Rebuild trust through transparency, consistent communication, and responsive service experience.
Embed community engagement and co-design as core vaccination infrastructure, supported by sustained investment.
Strengthen coordination and shared responsibility across public authorities, health services, community organizations, and information providers.
Vaccination Equity – Campaign Supporters

Supported by Our Partners in Care

This program aims to identify and provide solutions to help remove barriers to routine pediatric immunization through data-driven research, education, and advocacy with support from Pfizer.