Inequalities in measles immunization coverage among two-year-olds in Sierra Leone, 2008–2019

The observed fluctuations in national measles immunization coverage for children under two underscore the need for sustained efforts in vaccination programs. While improvements in access based on age, socioeconomic status, education level, and place of residence suggest progress in reducing inequalities, the persistent provincial disparities, with a significant gap in 2019, highlight ongoing challenges that must be addressed to ensure equitable health outcomes. Additionally, the increase in inequalities based on the child's sex during the study period raises concerns about targeted interventions that may inadvertently neglect specific groups. These findings imply that policymakers must prioritize strategies that maintain high vaccination rates and focus on closing the geographical and sex-based gaps, particularly in underserved provinces and among vulnerable populations.