{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T23:39:42Z","timestamp":1790638782465,"version":"4.1.0"},"reference-count":41,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","license":[{"start":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T00:00:00Z","timestamp":1698796800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,1]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Combining oral (OPV) and inactivated (IPV) poliovirus vaccines prevents importation of poliovirus and emergence of circulating vaccine-derived poliovirus. We measured the coverage with IPV and third dose of OPV (OPV-3) and identified determinants of coverage inequality in the most at-risk populations in Ethiopia. A national survey representing 10 partly overlapping underserved populations\u2014pastoralists, conflict-affected areas, urban slums, hard-to-reach settings, developing regions, newly formed regions, internally displaced people (IDPs), refugees, and districts neighboring international and interregional boundaries\u2014was conducted among children 12 to 35\u2009months old (<jats:italic>N<\/jats:italic> = 3,646). Socioeconomic inequality was measured using the concentration index (CIX) and decomposed using a regression-based approach. One-third (95% CI: 31.5\u201334.0%) of the children received OPV-3 and IPV. The dual coverage was below 50% in developing regions (19.2%), pastoralists (22.0%), IDPs (22.3%), districts neighboring international (24.1%) and interregional (33.3%) boundaries, refugees (27.0%), conflict-affected areas (29.3%), newly formed regions (33.5%), and hard-to-reach areas (38.9%). Conversely, coverage was better in urban slums (78%). Children from poorest households, living in villages that do not have health posts, and having limited health facility access had increased odds of not receiving the vaccines. Low paternal education, dissatisfaction with vaccination service, fear of vaccine side effects, living in female-headed households, having employed and less empowered mothers were also risk factors. IPV\u2013OPV3 coverage favored the rich (CIX = \u22120.161, <jats:italic>P &lt;<\/jats:italic> 0.001), and causes of inequality were: inaccessibility of health facilities (13.3%), dissatisfaction with vaccination service (12.8%), and maternal (4.9%) and paternal (4.9%) illiteracy. Polio vaccination coverage in the most at-risk populations in Ethiopia is suboptimal, threatening the polio eradication initiative.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0319","type":"journal-article","created":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T11:38:19Z","timestamp":1695641899000},"page":"1148-1156","source":"Crossref","is-referenced-by-count":8,"title":["Oral and Inactivated Polio Vaccine Coverage and Determinants of Coverage Inequality Among the Most At-Risk Populations in Ethiopia"],"prefix":"10.4269","volume":"109","author":[{"given":"Samson","family":"Gebremedhin","sequence":"first","affiliation":[{"name":"School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fisseha","family":"Shiferie","sequence":"additional","affiliation":[{"name":"Project HOPE, Ethiopia Country Office, Addis Ababa, Ethiopia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawit A.","family":"Tsegaye","sequence":"additional","affiliation":[{"name":"Project HOPE, Ethiopia Country Office, Addis Ababa, Ethiopia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wondwossen A.","family":"Alemayehu","sequence":"additional","affiliation":[{"name":"Project HOPE Headquarter, Washington, District of Columbia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamiru","family":"Wondie","sequence":"additional","affiliation":[{"name":"Project HOPE, Ethiopia Country Office, Addis Ababa, Ethiopia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jen","family":"Donofrio","sequence":"additional","affiliation":[{"name":"Bill & Melinda Gates Foundation, Seattle, Washington;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"DelPizzo","sequence":"additional","affiliation":[{"name":"Bill & Melinda Gates Foundation, Seattle, Washington;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kidist","family":"Belete","sequence":"additional","affiliation":[{"name":"USAID Ethiopia, Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gashaw Andarge","family":"Biks","sequence":"additional","affiliation":[{"name":"Project HOPE, Ethiopia Country Office, Addis Ababa, Ethiopia;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","year":"2022"},{"key":"b2"},{"key":"b3"},{"key":"b4","series-title":"Expert Rev Vaccines","first-page":"1113","article-title":"Impact of inactivated poliovirus vaccine on mucosal immunity: implications for the polio eradication endgame","volume":"14","author":"Parker","year":"2015"},{"key":"b5","series-title":"Lancet","first-page":"1163","article-title":"The case for replacing live oral polio vaccine with inactivated vaccine in the 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