Immunization Coverage, Equity, and Access for Children with Disabilities: A Scoping Review of Challenges, Strategies, and Lessons Learned to Reduce the Number of Zero-Dose Children
<b>Background</b>: Children with disabilities, particularly in low- and middle-income countries (LMICs), face heightened risks of vaccine-preventable diseases due to a range of systemic and social barriers. Although immunization is a fundamental human right and a proven public health int...
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| Format: | Article |
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MDPI AG
2025-03-01
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| Series: | Vaccines |
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| Online Access: | https://www.mdpi.com/2076-393X/13/4/377 |
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| author | Godfrey Musuka Diego F. Cuadros F. DeWolfe Miller Zindoga Mukandavire Tapiwa Dhliwayo Patrick Gad Iradukunda Oscar Mano Tafadzwa Dzinamarira |
| author_facet | Godfrey Musuka Diego F. Cuadros F. DeWolfe Miller Zindoga Mukandavire Tapiwa Dhliwayo Patrick Gad Iradukunda Oscar Mano Tafadzwa Dzinamarira |
| author_sort | Godfrey Musuka |
| collection | DOAJ |
| description | <b>Background</b>: Children with disabilities, particularly in low- and middle-income countries (LMICs), face heightened risks of vaccine-preventable diseases due to a range of systemic and social barriers. Although immunization is a fundamental human right and a proven public health intervention, this vulnerable group is often overlooked in policy and practice. Understanding the factors compromising vaccine equity for these children is critical to reducing zero-dose prevalence and improving health outcomes. <b>Methods</b>: This scoping review examined peer-reviewed, gray literature from 2010 to 2024. Searches were conducted in PubMed, Google Scholar, and relevant organizational reports (WHO, UNICEF). Studies addressing children with disabilities and focusing on immunization barriers, interventions, or lessons learned were selected. English-language publications were screened in title/abstract and full-text stages. Key data extracted included population, barriers, and immunization outcomes. Since this review focused on articles in English, this is a key limitation. Results were synthesized thematically to identify recurring patterns and to guide improved interventions and policies. <b>Results</b>: Twelve articles met the inclusion criteria. Key barriers identified were inadequate healthcare infrastructure, insufficient provider training, limited follow-up services in rural regions, societal stigma, and pervasive misconceptions around both disability and vaccines. Factors such as maternal education, logistical support for caregivers, and using low-sensory, inclusive vaccination settings were consistently linked with better outcomes. Effective strategies included mobile vaccination units, tailored interventions (e.g., distraction or sedation techniques), school-based immunization programs, and robust community engagement to address stigma. Lessons learned underscored the importance of flexible, individualized care plans and empowering families through transparent communication. <b>Conclusions</b>: Children with disabilities continue to experience significant gaps in immunization coverage, driven by intersecting barriers at the individual, health system, and societal levels. Scaling tailored interventions, inclusive policies, strengthened infrastructure, and ongoing research can help ensure these children receive equitable access to life-saving vaccinations. |
| format | Article |
| id | doaj-art-e65b7fa0239b4777824a5883ef160bb4 |
| institution | OA Journals |
| issn | 2076-393X |
| language | English |
| publishDate | 2025-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Vaccines |
| spelling | doaj-art-e65b7fa0239b4777824a5883ef160bb42025-08-20T02:18:21ZengMDPI AGVaccines2076-393X2025-03-0113437710.3390/vaccines13040377Immunization Coverage, Equity, and Access for Children with Disabilities: A Scoping Review of Challenges, Strategies, and Lessons Learned to Reduce the Number of Zero-Dose ChildrenGodfrey Musuka0Diego F. Cuadros1F. DeWolfe Miller2Zindoga Mukandavire3Tapiwa Dhliwayo4Patrick Gad Iradukunda5Oscar Mano6Tafadzwa Dzinamarira7International Initiative for Impact Evaluation, Harare P.O. Box 0002, ZimbabweDigital Epidemiology Laboratory, Digital Futures, University of Cincinnati, Cincinnati, OH 45221, USADepartment of Tropical Medicine and Medical Microbiology and Pharmacology, University of Hawaii at Manoa, Honolulu, HI 96822, USAInstitute of Applied Research and Technology, Emirates Aviation University, Dubai P.O. Box 53044, United Arab EmiratesDepartment of Community Medicine, Midlands State University, Gweru P.O. Box 9055, ZimbabweRwanda Food and Drug Authority, Kigali P.O. Box 3243, RwandaDepartment of Public Health, University of the Western Cape, Robert Sobukwe Road, Bellville 7535, South AfricaSchool of Health Systems and Public Health, University of Pretoria, Pretoria 0002, South Africa<b>Background</b>: Children with disabilities, particularly in low- and middle-income countries (LMICs), face heightened risks of vaccine-preventable diseases due to a range of systemic and social barriers. Although immunization is a fundamental human right and a proven public health intervention, this vulnerable group is often overlooked in policy and practice. Understanding the factors compromising vaccine equity for these children is critical to reducing zero-dose prevalence and improving health outcomes. <b>Methods</b>: This scoping review examined peer-reviewed, gray literature from 2010 to 2024. Searches were conducted in PubMed, Google Scholar, and relevant organizational reports (WHO, UNICEF). Studies addressing children with disabilities and focusing on immunization barriers, interventions, or lessons learned were selected. English-language publications were screened in title/abstract and full-text stages. Key data extracted included population, barriers, and immunization outcomes. Since this review focused on articles in English, this is a key limitation. Results were synthesized thematically to identify recurring patterns and to guide improved interventions and policies. <b>Results</b>: Twelve articles met the inclusion criteria. Key barriers identified were inadequate healthcare infrastructure, insufficient provider training, limited follow-up services in rural regions, societal stigma, and pervasive misconceptions around both disability and vaccines. Factors such as maternal education, logistical support for caregivers, and using low-sensory, inclusive vaccination settings were consistently linked with better outcomes. Effective strategies included mobile vaccination units, tailored interventions (e.g., distraction or sedation techniques), school-based immunization programs, and robust community engagement to address stigma. Lessons learned underscored the importance of flexible, individualized care plans and empowering families through transparent communication. <b>Conclusions</b>: Children with disabilities continue to experience significant gaps in immunization coverage, driven by intersecting barriers at the individual, health system, and societal levels. Scaling tailored interventions, inclusive policies, strengthened infrastructure, and ongoing research can help ensure these children receive equitable access to life-saving vaccinations.https://www.mdpi.com/2076-393X/13/4/377immunization equitychildren with disabilitieslow- and middle-income countriesvaccine barriersvaccination strategiesinclusive healthcare |
| spellingShingle | Godfrey Musuka Diego F. Cuadros F. DeWolfe Miller Zindoga Mukandavire Tapiwa Dhliwayo Patrick Gad Iradukunda Oscar Mano Tafadzwa Dzinamarira Immunization Coverage, Equity, and Access for Children with Disabilities: A Scoping Review of Challenges, Strategies, and Lessons Learned to Reduce the Number of Zero-Dose Children Vaccines immunization equity children with disabilities low- and middle-income countries vaccine barriers vaccination strategies inclusive healthcare |
| title | Immunization Coverage, Equity, and Access for Children with Disabilities: A Scoping Review of Challenges, Strategies, and Lessons Learned to Reduce the Number of Zero-Dose Children |
| title_full | Immunization Coverage, Equity, and Access for Children with Disabilities: A Scoping Review of Challenges, Strategies, and Lessons Learned to Reduce the Number of Zero-Dose Children |
| title_fullStr | Immunization Coverage, Equity, and Access for Children with Disabilities: A Scoping Review of Challenges, Strategies, and Lessons Learned to Reduce the Number of Zero-Dose Children |
| title_full_unstemmed | Immunization Coverage, Equity, and Access for Children with Disabilities: A Scoping Review of Challenges, Strategies, and Lessons Learned to Reduce the Number of Zero-Dose Children |
| title_short | Immunization Coverage, Equity, and Access for Children with Disabilities: A Scoping Review of Challenges, Strategies, and Lessons Learned to Reduce the Number of Zero-Dose Children |
| title_sort | immunization coverage equity and access for children with disabilities a scoping review of challenges strategies and lessons learned to reduce the number of zero dose children |
| topic | immunization equity children with disabilities low- and middle-income countries vaccine barriers vaccination strategies inclusive healthcare |
| url | https://www.mdpi.com/2076-393X/13/4/377 |
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