Socioeconomic and geographical inequalities in polio immunisation coverage among two-year-olds in Sierra Leone, 2008–2019

The initial increase in coverage followed by a decline underscores the need for sustained efforts to maintain and improve immunization rates, particularly in the Western, Northwestern, and Northern provinces, where significant subnational inequalities exist. The absence of disparities related to maternal age, child sex, and education suggests that traditional demographic factors may not be the primary barriers to immunization; instead, geographic and socioeconomic contexts play a more pivotal role. This indicates that targeted interventions should focus on improving access to vaccination services in underserved areas, potentially through community outreach and mobile vaccination units. Additionally, the better coverage among children of poorer mothers and those in rural areas highlights the importance of understanding local dynamics and leveraging community strengths to enhance immunization uptake.