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Factors associated with TC among the socioeconomic variables included VE that was associated with reduced TC both in 2020 (relative change (RC) \u221243%; 95% CI \u221257% to \u201325%) and 2021 (RC \u221246%; 95% CI \u221262% to \u201324%) and employment-to-population ratio that had a positive effect on TC in 2021 (RC 27%; 95% CI 44% to 55%). Socioeconomic variables showed similar patterns for both the established measles\u2013mumps\u2013rubella and the new COVID-19 vaccines. Region-level analyses revealed stark heterogeneity in the associations between socioeconomic variables and TC between the analysed years (2020 vs 2021) and across regions. Region-specific trends showed that in Latin America and Asia\/Oceania, TC was linked to health expenditure in both analysed years (RC\n                      <jats:sub>2020<\/jats:sub>\n                      : 199%; 95% CI 74% to 405%; RC\n                      <jats:sub>2021<\/jats:sub>\n                      : 142%; 95% CI 67% to 24%). VE was associated with decreased TC in the \u2018high-income\u2019, \u2018Central Europe\u2019 and \u2018Sub-Saharan\u2019 regions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Socioeconomic and gender inequalities play a significant role in determining SARS-CoV-2 TC. These inequalities underscore the necessity of ensuring equitable access to health services and targeted public health interventions, particularly in resource-limited settings, to improve health outcomes and pandemic preparedness. Socioeconomic and gender disparities can exacerbate health inequalities and hinder the effectiveness of public health policies in a globally interconnected world.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-090804","type":"journal-article","created":{"date-parts":[[2025,3,3]],"date-time":"2025-03-03T16:55:51Z","timestamp":1741020951000},"page":"e090804","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Socioeconomic determinants potentially underlying differential global SARS-CoV-2 testing capacity: an ecological study"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9224-5157","authenticated-orcid":false,"given":"Andres","family":"Moreira-Soto","sequence":"first","affiliation":[{"name":"Institute of Virology, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt Universit\u00e4t zu Berlin, Berlin, Germany"},{"name":"School of Veterinary Medicine, Universidad Nacional, Heredia, Costa Rica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl","family":"Beuchel","sequence":"additional","affiliation":[{"name":"Institute of Virology, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt Universit\u00e4t zu Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ximena","family":"Tabares","sequence":"additional","affiliation":[{"name":"Institute of Virology, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt Universit\u00e4t zu Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Wulf","sequence":"additional","affiliation":[{"name":"Institute of Virology, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt Universit\u00e4t zu Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils","family":"Gade","sequence":"additional","affiliation":[{"name":"Deutsche Gesellschaft f\u00fcr Internationale Zusammenarbeit GmbH, Bonn, Nordrhein-Westfalen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Fischer","sequence":"additional","affiliation":[{"name":"Institute of Virology, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt Universit\u00e4t zu Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Knipper","sequence":"additional","affiliation":[{"name":"Institute of the History of Medicine, Justus Liebig University, Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"Aigner","sequence":"additional","affiliation":[{"name":"Institute of Biometry and Clinical Epidemiology, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt Universit\u00e4t zu Berlin, Berlin, Germany"},{"name":"Center for Stroke Research Berlin, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt Universit\u00e4t zu Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3509-0232","authenticated-orcid":false,"given":"Jan Felix","family":"Drexler","sequence":"additional","affiliation":[{"name":"Institute of Virology, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt Universit\u00e4t zu Berlin, Berlin, Germany"},{"name":"German Centre for Infection Research (DZIF), Associated Partner Charit\u00e9-Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,3,3]]},"reference":[{"key":"2025081403514166000_15.3.e090804.1","unstructured":"Ritchie H , Mathieu E , Rod\u00e9s-Guirao L , et al . 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