The relationship between socio-economic inequity indicators and 4CMenB vaccination rates in infants and adolescents in Spain: An ecological correlation study

Invasive meningococcal disease (IMD) is associated with a high mortality rate and can cause severe long-term sequelae. In Spain, the majority of IMD cases are caused by serogroup B. The four-component meningococcal serogroup B vaccine (4CMenB) is included in the Spanish infant National Immunisation Plan (NIP); however, vaccination of other age groups is not yet publicly funded. This analysis aimed to estimate infant and adolescent 4CMenB vaccination rates across Spanish autonomous regions and municipalities and their correlation with income, higher education and unemployment from 2019 to 2022, prior to inclusion of 4CMenB within the Spanish NIP. Correlation between vaccination rates and income per capita, higher education and employment status was assessed across municipalities using Spearman’s coefficient. In 2022, infant 4CMenB vaccination rates across autonomous regions were highest in Cantabria (61.87%), across municipalities this was Ciudad Real (72.40%), and were lowest in Melilla (12.20%) across both. Adolescent 4CMenB vaccination rates were highest in Galicia (5.14%) across autonomous regions, and Lugo (6.05%) across municipalities, and lowest in Cantabria (0.09%) across both. A significant and positive correlation was observed between infant 4CMenB vaccination rates and income per capita (<i>r</i> = 0.37; <i>p</i> ≤ .01) and higher education rate (<i>r</i> = 0.38; <i>p</i> ≤ .01) across municipalities. There were also significant correlations between adolescent vaccination rates and income per capita (<i>r</i> = 0.55; <i>p</i> ≤ .01), higher education rate (<i>r</i> = 0.5; <i>p</i> ≤ .01) and unemployment (<i>r</i> = −0.47; <i>p</i> ≤ .01). These data suggest that lower socio-economic status may influence 4CMenB vaccination rates in Spain, and inclusion of 4CMenB vaccination into Spain’s NIP for other age groups could reduce inequity in 4CMenB coverage.