Rural–Urban Disparities in Adult Immunisation: Evidence from the Longitudinal Ageing Study in India (2017–2018)

Abstract

Adult immunisation reduces the risk of vaccine-preventable diseases (VPDs) and prevents early mortality, reduces other health risks and healthcare costs. The study aims to explore the status of adult immunisation and the rural–urban difference in adult immunisation in India. The study used data from 68,463 young (18–44 years), middle-aged (45–59 years) and older adults (60 years and above) from the Longitudinal Ageing Study in India (LASI)—wave 1 (2017–2018). Immunisation coverage was measured based on influenza vaccine, pneumococcal vaccine, hepatitis B vaccine, diphtheria and tetanus (dT) and any other vaccines. A set of socio-economic, demographic, social capital and health-related variables were considered to explore the determinants of adult immunisation. Bivariate analysis and logistic regression models were applied. Decomposition analysis was performed to investigate the rural–urban difference in adult immunisation. The results revealed that the adult immunisation coverage was lower in India, irrespective of rural and urban areas. Even with this lower coverage, rural areas had a statistically significant poor coverage in comparison to urban areas (6.56% vs 6.89%). Difference in educational attainment of the adult population and economic growth and development of the region [measured using state gross domestic product (GSDP) per capita data] were the major contributors to the rural–urban difference in adult immunisation. The study urges providing adult immunisation awareness programmes to the population and expanding the healthcare system, especially in rural areas, to improve adult immunisation coverage.