Publication date: Dec 20, 2024

Equity in COVID-19 vaccine uptake is the heart of managing the ongoing pandemic of COVID-19 disease. However, the evidence of inequality in COVID-19 vaccination in Ethiopia is limited. Therefore, this study investigated the trends of socioeconomic and geographic inequality of COVID-19 vaccine uptake in Ethiopia. This study used the Global COVID-19 trends and impact survey as part of the WHO Health Equity Assessment Toolkit software 2021 version. The trends of socioeconomic and geographic inequalities in COVID-19 vaccine uptake between surveys were calculated with a 95% confidence interval (CI). A 95% CI was calculated along with measures of inequality in COVID-19 vaccine uptake and statistical significance was declared if the 95% CI of absolute and relative measures of inequalities does not include 0 and 1 respectively. The COVID-19 vaccine uptake in the 45-65 age group significantly increased from 40. 04%, 95% CI (32. 49, 48. 1) to 72. 7%, 95%CI (63. 7, 80. 2) in 05/2021 to 03/2022 respectively. The absolute inequality of COVID-19 vaccine uptake among male vs female respondents was 3. 6%, 95% CI (3. 9, 11. 2) in 08/2021 which was obtained by subtraction of the respecting proportion of vaccines uptakes 32. 9% for males minus 29. 28% for females and there was a significant more prevalence of vaccine uptake in males than in females. The absolute inequality in COVID-19 vaccine uptake among health workers vs non-health workers was 28. 5%, 95% CI (17. 8, 37. 2), 03/2022 and there was a significantly higher prevalence of vaccine uptake in health workers than non-health workers in each survey. The relative measures of inequality in the ratios of COVID-19 vaccine uptake among urban vs rural was 0. 85, 95%CI (0. 7, 0. 994) in 08/2021 which was obtained by dividing the respecting proportion of vaccine uptakes of urban by rural residents. The study showed that the proportion of COVID-19 vaccine uptake in Ethiopia significantly increased from 2021 to 2022 with distinct inequality. The study indicated there is significant absolute and relative inequality in COVID-19 vaccine uptake between health workers and non-health workers, male and female, and urban and rural residents in Ethiopia. Therefore, the effort should be geared towards reducing health workers vs non-health workers, urban vs rural, and gender inequalities in COVID-19 vaccine uptake through health literacy and recommend geographic and equity-oriented policies, to ensure effective pandemic management of COVID-19.

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