Socioeconomic inequalities in vaccination against COVID-19 in Ecuador

Introduction: In January 2021, Ecuador began the administration of vaccination against COVID-19 following a staggered and phased process. It is necessary to identify gaps in vaccination coverage that could be related to the presence of future outbreaks of the disease. General objective Analyze the socioeconomic gaps in relation to vaccination against COVID-19, in the five of the most important cities in Ecuador: Quito, Guayaquil, Cuenca, Ambato and Machala Methodology: Analytical cross-sectional study, based on secondary data from the National Employment, Unemployment and Underemployment Survey (ENEMDU) that included a vaccination component against COVID-19 in 2021. Data from 91,169 surveyed people were included (with factor of proposed expansion 17,917,508 people). Poisson regressions were performed for complex samples, with crude and adjusted analysis. Results: The coverage of the second dose reached percentages from 30.2% to 85.5% in the five cities studied. Significant differences were found in vaccination coverage by area of residence (Prevalence Ratio, PR, 0.51, 95% CI 0.45-0.55 for rural vs. urban areas), ethnicity (indigenous PR 0.21, 95% CI 0.19-0.23=, education (PR 0.05, 95% CI 0.03-0.09 for illiterates compared to higher level), income (PR 0.27, 95% CI 0.17-0.43 for those who earn less than USD 400, compared to those who earn USD 1,600 or more). significance was maintained after the adjusted analysis. Conclusions: There are socioeconomic inequalities in vaccination coverage against COVID-19 in Ecuador. It is necessary to strengthen vaccination in rural and indigenous populations and in sectors with scarce economic resources, as well as establish policies and strategies that ensure timely access to vaccination for the entire population, including more specific strategies for vulnerable populations.