Data insight

Less urbanized means less vaccinated

Countries with low urban population shares tend to be more poorly vaccinated
Countries with low urbanization rates are more likely to be poorly vaccinated. The visualization establishes that positive relationship at 95% confidence by correlating the urban population share with the share of the total population that is fully vaccinated. The chart controls for population size (the area of the bubbles) and groups countries by World Bank income classification (color).
The positive slope is not unexpected. We know that urbanization is a reflection of development. As countries become more prosperous and move up the country income ladder, they undergo structural transformation, which includes a rise in the urban population share. We can see this pattern clearly, with urbanization rates generally rising as the color code in the chart shifts from low to high income. 
But there is more to this. Low vaccination rates are not only associated with low levels of urbanization simply because countries are poorer. We would also expect that countries with a larger share of the population living in rural areas may face greater logistical difficulties in reaching the unvaccinated. That provides another channel for the positive association between urbanization and vaccination. 

Let’s examine now the relationship a little more deeply by weighting the smoothing function by total population size as in the above chart. In plain language, India and Ireland no longer carry the same weight when calculating the trajectory of the solid line. Countries with smaller populations are penalized in favor of countries with larger populations.

The weighted estimates between urbanization and vaccination still exhibit a positive relationship but it is no longer monotonously positive. This is largely due to effect of China and India. These are both very large countries, who have despite their large populations managed to outperform their per capita income peers on measures of vaccination).  It should be noted here that China and India are themselves major producers of vaccines, which tends to contribute to vaccination performance. 

In sum, urbanization and vaccination are strongly positively associated. 

  • This reflects the common influence of the level of development, which tends to raise both urbanization and vaccination. It also reflects the lesser logistical difficulties to vaccinate everyone in more urban settings.
  • There are however two important outliers – China and India – which have overperformed in terms of vaccine coverage relative to their peers and urbanization levels. This, in part, reflects their vaccine manufacturer status as there is an important home bias element in vaccination progress among manufacturers.