Vaccination in Low- and Middle-Income Countries

Vaccines are one of the largest public health successes of the last century, and are among the most cost-effective public health interventions available. Vaccination remains central to preventing childhood diseases, and the burden of vaccine-preventable diseases has decreased significantly especially in high-income countries. However, distinctive challenges remain in low- and middle-income countries (LMICs). LMICs have a disproportionate burden of vaccine-preventable diseases and often have lower vaccination coverage than high income countries. Lower coverage is associated with complex factors including demographics, religion, culture, politics, war, and economics. Other LMICs have highly functioning immunization programs, but their populace may have changing attitudes towards vaccines and perceptions of vaccine-preventable diseases. The differing characteristics of populations and programs in high-income countries versus LMICs and across LMICs could be responsible for varying vaccine coverage, immune responses, and cost-effectiveness of vaccinations.

In this Research Topic, we welcome a series of Original Research articles and Review Articles discussing numerous questions and problems associated with vaccination in LMICs. The goal is to highlight pivotal studies related to vaccination in LMICs.

The scope of the Research Topic includes:
• Cross-sectional and longitudinal studies assessing the seroprevalence of immunity towards vaccine-preventable infections or the burden of vaccine-preventable diseases in LMICs;
• Studies or trials of vaccine efficacy or effectiveness; research into vaccination coverage and the assessment of associated factors in LMICs; studies of vaccine decision-making in LMICs;
• Perceptions of existing or hypothetical vaccines in LMICs; strategies that will increase and sustain the uptake of vaccines in LMICs;
• Characteristics of vaccine hesitancy in resource-limited settings; the economics of vaccination;
• Ethical issues surrounding vaccination in LMICs; and
• Cost-effectiveness studies.

Studies examining vulnerable populations within LMICs, including migrants or refugees, individuals of lower socioeconomic status, pregnant women, or older adults are particularly welcomed.