Introduction and objective:
Vaccination remains a cornerstone of global public health, projected to prevent 51 million deaths between 2021–2030. Recent surges in vaccine-preventable diseases, including record measles cases in the USA, a rising number of pertussis outbreaks in Europe and the Americas, increased pneumococcal infections in Australia, signal deteriorating vaccination coverage in high-income countries. These emerging threats highlight the urgent need to examine the socio-economic variables associated with routine childhood immunization. The aim of this scoping review is to identify the socio-economic determinants of childhood vaccine coverage in high-income countries.

Review methods:
Four databases: PubMed, Scopus, Embase and the Web of Science Core Collection were searched for relevant studies published between January 2016 – July 2025.

Brief description of the state of knowledge:
Thirty-nine studies met the inclusion criteria. Childhood vaccination was associated with a variety of socio-economic factors. Key determinants of childhood vaccination coverage were: parental education, geographic location, ethnicity, household size and household income and insurance. While higher education, income, institutional support and living in an urban area were generally associated with higher coverage, hesitancy among educated and affluent groups also appeared. Lower vaccination coverage was associated with larger families, minority status, single parenthood, lack of insurance, deprivation, institutional district, and certain individual factors.

Summary:
The review underscores that vaccination coverage reflects broader societal systems, economic security, healthcare infrastructure, cultural context, and trust in institutions. Structural advantages in high-income countries may mask underlying inequities. Addressing these dimensions is essential for closing immunization gaps.