Multilevel approaches to immunization equity

Over the last 2 years, immunization disparities have surged due to a pandemic, violent conflicts, economic crises, and their disrupting effects on health care systems. This review provides a multilevel framework for understanding vaccination disparities and provides examples of work addressing disparities risk factors and building immunization equity. Readers will review the World Health Organization’s 2023 priorities for vaccination equity, learn about vaccination campaigns in conflict zones like Ukraine, identify key components to a successful COVID-19 response in Ghana, and understand Brazilian efforts to minimize stigma and champion community members to build trust in mpox vaccines and health services. These efforts will improve equity and foster flourishing among vulnerable populations. •From 2020 to 2022, global immunization progress stalled, and disparities surged.•Multilevel factors interact to create and sustain immunization disparities.•Interventions at all levels exist to build immunization equity.