placestats

DTP3 immunisation vs. Fertility rate

Fades after adjusting for income

Across 186 countries, DTP3 immunisation and Fertility rate rise and fall together at r = -0.51 (on a scale from −1 to +1, where 0 means no link). Comparing only countries with similar income (GDP per person) shrinks it to -0.17, which could easily be chance (q = 0.38, allowing for the many pairs tested, and allowing for countries in the same region being alike). So the first figure mostly shows richer countries differing from poorer ones, not a link between these two things. Caution: direction is not consistent across regions.

Comparing countries across the middle half of fertility rate, 1.46 to 3.2 births per woman, dtp3 immunisation is worse by 9.17% of children aged 12-23 months at the top of that range than the bottom. Comparing only countries with similar national income, the gap is 4.65% of children aged 12-23 months.

Link before adjusting (r)-0.509p = 1.2e-13 · 186 countries
After adjusting for national income-0.171p = 0.020 · likely range [-0.31, -0.03]
p, allowing for regions0.239standard error 0.131 · 7 regions
Check for luck (q)0.379across 12,497 pairs

How to read these.r runs from −1 (one goes up as the other goes down) to +1 (they rise together), and 0 means no link. Adjusting for national income means comparing countries with the same GDP per person, so differences in wealth can’t explain the link. Income is used in percentage terms, since an extra $1,000 means more to a poor country than to a rich one. p is how likely a link this strong would be if there were really none. Below 0.05 means it is unlikely to be chance. Very small values are written in short form: 1.1e-32 means a decimal point followed by 31 zeros and then 11, so very close to zero. The likely range is where the true figure probably lies, and a range that crosses zero means the link could easily be chance. Countries in the same region tend to resemble each other, so the third figure allows for that, which gives a fairer p. The standard error is the typical size of the error in r. Finally, testing this many pairs means some will look strong by luck alone. A q below 0.05 means this link is unlikely to be one of those.

DTP3 immunisation · % of children aged 12-23 monthslink with income +0.53 · moderate
Fertility rate · births per womanlink with income -0.81 · proxy

“Link with income” is how closely each measure tracks GDP per person across countries, from −1 to +1.

Every country as a dot

DTP3 immunisation · % of children aged 12-23 months →Fertility rate · births per woman →39%99%0.7486.03Afghanistan: 59% of children aged 12-23 months, 4.76 births per womanAngola: 64% of children aged 12-23 months, 5.05 births per womanAlbania: 97% of children aged 12-23 months, 1.34 births per womanAndorra: 98% of children aged 12-23 months, 1.09 births per womanUnited Arab Emirates: 96% of children aged 12-23 months, 1.21 births per womanArgentina: 75% of children aged 12-23 months, 1.5 births per womanArmenia: 94% of children aged 12-23 months, 1.7 births per womanAntigua and Barbuda: 99% of children aged 12-23 months, 1.58 births per womanAustralia: 93% of children aged 12-23 months, 1.48 births per womanAustria: 85% of children aged 12-23 months, 1.31 births per womanAzerbaijan: 51% of children aged 12-23 months, 1.43 births per womanBurundi: 89% of children aged 12-23 months, 4.79 births per womanBelgium: 97% of children aged 12-23 months, 1.44 births per womanBenin: 63% of children aged 12-23 months, 4.48 births per womanBurkina Faso: 91% of children aged 12-23 months, 4.11 births per womanBangladesh: 97% of children aged 12-23 months, 2.14 births per womanBulgaria: 94% of children aged 12-23 months, 1.72 births per womanBahrain: 96% of children aged 12-23 months, 1.8 births per womanBahamas, The: 90% of children aged 12-23 months, 1.37 births per womanBosnia and Herzegovina: 79% of children aged 12-23 months, 1.49 births per womanBelarus: 98% of children aged 12-23 months, 1.22 births per womanBelize: 88% of children aged 12-23 months, 2.02 births per womanBolivia: 59% of children aged 12-23 months, 2.52 births per womanBrazil: 91% of children aged 12-23 months, 1.61 births per womanBarbados: 94% of children aged 12-23 months, 1.71 births per womanBrunei Darussalam: 99% of children aged 12-23 months, 1.73 births per womanBhutan: 98% of children aged 12-23 months, 1.45 births per womanBotswana: 95% of children aged 12-23 months, 2.7 births per womanCentral African Republic: 42% of children aged 12-23 months, 5.95 births per womanCanada: 92% of children aged 12-23 months, 1.25 births per womanSwitzerland: 96% of children aged 12-23 months, 1.29 births per womanChile: 95% of children aged 12-23 months, 1.14 births per womanChina: 97% of children aged 12-23 months, 1.01 births per womanCote d'Ivoire: 77% of children aged 12-23 months, 4.23 births per womanCameroon: 77% of children aged 12-23 months, 4.26 births per womanCongo, Dem. Rep.: 65% of children aged 12-23 months, 5.98 births per womanCongo, Rep.: 78% of children aged 12-23 months, 4.11 births per womanColombia: 89% of children aged 12-23 months, 1.63 births per womanComoros: 75% of children aged 12-23 months, 3.82 births per womanCabo Verde: 93% of children aged 12-23 months, 1.51 births per womanCosta Rica: 99% of children aged 12-23 months, 1.32 births per womanCyprus: 94% of children aged 12-23 months, 1.38 births per womanCzechia: 86% of children aged 12-23 months, 1.36 births per womanGermany: 89% of children aged 12-23 months, 1.36 births per womanDjibouti: 77% of children aged 12-23 months, 2.62 births per womanDominica: 90% of children aged 12-23 months, 1.48 births per womanDenmark: 96% of children aged 12-23 months, 1.47 births per womanDominican Republic: 87% of children aged 12-23 months, 2.22 births per womanAlgeria: 92% of children aged 12-23 months, 2.72 births per womanEcuador: 70% of children aged 12-23 months, 1.81 births per womanEgypt, Arab Rep.: 97% of children aged 12-23 months, 2.73 births per womanSpain: 94% of children aged 12-23 months, 1.1 births per womanEstonia: 81% of children aged 12-23 months, 1.18 births per womanEthiopia: 73% of children aged 12-23 months, 3.91 births per womanFinland: 91% of children aged 12-23 months, 1.25 births per womanFiji: 94% of children aged 12-23 months, 2.27 births per womanFrance: 96% of children aged 12-23 months, 1.61 births per womanMicronesia, Fed. Sts.: 76% of children aged 12-23 months, 2.74 births per womanGabon: 61% of children aged 12-23 months, 3.59 births per womanUnited Kingdom: 92% of children aged 12-23 months, 1.55 births per womanGeorgia: 86% of children aged 12-23 months, 1.8 births per womanGhana: 95% of children aged 12-23 months, 3.34 births per womanGuinea: 63% of children aged 12-23 months, 4.13 births per womanGambia, The: 80% of children aged 12-23 months, 3.91 births per womanGuinea-Bissau: 68% of children aged 12-23 months, 3.76 births per womanEquatorial Guinea: 68% of children aged 12-23 months, 4.12 births per womanGreece: 95% of children aged 12-23 months, 1.24 births per womanGrenada: 93% of children aged 12-23 months, 1.47 births per womanGuatemala: 81% of children aged 12-23 months, 2.29 births per womanGuyana: 98% of children aged 12-23 months, 2.4 births per womanHonduras: 75% of children aged 12-23 months, 2.48 births per womanCroatia: 92% of children aged 12-23 months, 1.46 births per womanHaiti: 60% of children aged 12-23 months, 2.63 births per womanHungary: 99% of children aged 12-23 months, 1.41 births per womanIndonesia: 78% of children aged 12-23 months, 2.12 births per womanIndia: 94% of children aged 12-23 months, 1.96 births per womanIreland: 92% of children aged 12-23 months, 1.47 births per womanIran, Islamic Rep.: 98% of children aged 12-23 months, 1.68 births per womanIraq: 90% of children aged 12-23 months, 3.22 births per womanIceland: 94% of children aged 12-23 months, 1.56 births per womanIsrael: 98% of children aged 12-23 months, 2.87 births per womanItaly: 94% of children aged 12-23 months, 1.18 births per womanJamaica: 99% of children aged 12-23 months, 1.35 births per womanJordan: 96% of children aged 12-23 months, 2.6 births per womanJapan: 99% of children aged 12-23 months, 1.15 births per womanKazakhstan: 98% of children aged 12-23 months, 2.98 births per womanKenya: 91% of children aged 12-23 months, 3.17 births per womanKyrgyz Republic: 85% of children aged 12-23 months, 2.6 births per womanCambodia: 83% of children aged 12-23 months, 2.55 births per womanKiribati: 94% of children aged 12-23 months, 3.12 births per womanSt. Kitts and Nevis: 97% of children aged 12-23 months, 1.53 births per womanKorea, Rep.: 97% of children aged 12-23 months, 0.748 births per womanKuwait: 99% of children aged 12-23 months, 1.56 births per womanLao PDR: 67% of children aged 12-23 months, 2.4 births per womanLebanon: 49% of children aged 12-23 months, 2.23 births per womanLiberia: 83% of children aged 12-23 months, 3.86 births per womanLibya: 86% of children aged 12-23 months, 2.3 births per womanSt. Lucia: 99% of children aged 12-23 months, 1.39 births per womanSri Lanka: 97% of children aged 12-23 months, 1.95 births per womanLesotho: 86% of children aged 12-23 months, 2.66 births per womanLithuania: 89% of children aged 12-23 months, 1.11 births per womanLuxembourg: 99% of children aged 12-23 months, 1.25 births per womanLatvia: 97% of children aged 12-23 months, 1.24 births per womanMorocco: 96% of children aged 12-23 months, 2.21 births per womanMoldova: 86% of children aged 12-23 months, 1.73 births per womanMadagascar: 60% of children aged 12-23 months, 3.91 births per womanMaldives: 99% of children aged 12-23 months, 1.56 births per womanMexico: 78% of children aged 12-23 months, 1.89 births per womanMarshall Islands: 85% of children aged 12-23 months, 2.86 births per womanNorth Macedonia: 89% of children aged 12-23 months, 1.4 births per womanMali: 82% of children aged 12-23 months, 5.51 births per womanMalta: 97% of children aged 12-23 months, 1.01 births per womanMyanmar: 71% of children aged 12-23 months, 2.1 births per womanMontenegro: 81% of children aged 12-23 months, 1.8 births per womanMongolia: 96% of children aged 12-23 months, 2.5 births per womanMozambique: 70% of children aged 12-23 months, 4.69 births per womanMauritania: 86% of children aged 12-23 months, 4.63 births per womanMauritius: 93% of children aged 12-23 months, 1.44 births per womanMalawi: 91% of children aged 12-23 months, 3.59 births per womanMalaysia: 93% of children aged 12-23 months, 1.54 births per womanNamibia: 74% of children aged 12-23 months, 3.21 births per womanNiger: 86% of children aged 12-23 months, 5.93 births per womanNigeria: 67% of children aged 12-23 months, 4.38 births per womanNicaragua: 89% of children aged 12-23 months, 2.21 births per womanNetherlands: 91% of children aged 12-23 months, 1.43 births per womanNorway: 97% of children aged 12-23 months, 1.45 births per womanNepal: 97% of children aged 12-23 months, 1.96 births per womanNaoero: 99% of children aged 12-23 months, 3.29 births per womanNew Zealand: 89% of children aged 12-23 months, 1.57 births per womanOman: 99% of children aged 12-23 months, 2.51 births per womanPakistan: 87% of children aged 12-23 months, 3.55 births per womanPanama: 72% of children aged 12-23 months, 2.11 births per womanPeru: 80% of children aged 12-23 months, 1.97 births per womanPhilippines: 71% of children aged 12-23 months, 1.89 births per womanPalau: 97% of children aged 12-23 months, 1.88 births per womanPapua New Guinea: 42% of children aged 12-23 months, 3.07 births per womanPoland: 94% of children aged 12-23 months, 1.14 births per womanPortugal: 99% of children aged 12-23 months, 1.41 births per womanParaguay: 80% of children aged 12-23 months, 2.42 births per womanWest Bank and Gaza: 88% of children aged 12-23 months, 3.25 births per womanQatar: 96% of children aged 12-23 months, 1.72 births per womanRomania: 79% of children aged 12-23 months, 1.39 births per womanRussian Federation: 97% of children aged 12-23 months, 1.42 births per womanRwanda: 98% of children aged 12-23 months, 3.65 births per womanSaudi Arabia: 97% of children aged 12-23 months, 2.31 births per womanSudan: 39% of children aged 12-23 months, 4.26 births per womanSenegal: 91% of children aged 12-23 months, 3.77 births per womanSingapore: 97% of children aged 12-23 months, 0.97 births per womanSolomon Islands: 87% of children aged 12-23 months, 3.51 births per womanSierra Leone: 91% of children aged 12-23 months, 3.7 births per womanEl Salvador: 95% of children aged 12-23 months, 1.77 births per womanSan Marino: 88% of children aged 12-23 months, 1.16 births per womanSomalia, Fed. Rep.: 70% of children aged 12-23 months, 6.01 births per womanSerbia: 95% of children aged 12-23 months, 1.64 births per womanSao Tome and Principe: 87% of children aged 12-23 months, 3.6 births per womanSuriname: 69% of children aged 12-23 months, 2.23 births per womanSlovak Republic: 96% of children aged 12-23 months, 1.46 births per womanSlovenia: 90% of children aged 12-23 months, 1.52 births per womanSweden: 96% of children aged 12-23 months, 1.43 births per womanEswatini: 84% of children aged 12-23 months, 2.72 births per womanSeychelles: 94% of children aged 12-23 months, 1.85 births per womanSyrian Arab Republic: 73% of children aged 12-23 months, 2.7 births per womanChad: 68% of children aged 12-23 months, 6.03 births per womanTogo: 90% of children aged 12-23 months, 4.12 births per womanThailand: 92% of children aged 12-23 months, 1.2 births per womanTajikistan: 97% of children aged 12-23 months, 3.04 births per womanTurkmenistan: 98% of children aged 12-23 months, 2.66 births per womanTimor-Leste: 83% of children aged 12-23 months, 2.63 births per womanTonga: 99% of children aged 12-23 months, 3.1 births per womanTrinidad and Tobago: 92% of children aged 12-23 months, 1.54 births per womanTunisia: 97% of children aged 12-23 months, 1.82 births per womanTurkiye: 99% of children aged 12-23 months, 1.48 births per womanTuvalu: 94% of children aged 12-23 months, 3.17 births per womanTanzania: 83% of children aged 12-23 months, 4.54 births per womanUganda: 91% of children aged 12-23 months, 4.17 births per womanUkraine: 88% of children aged 12-23 months, 0.988 births per womanUruguay: 94% of children aged 12-23 months, 1.4 births per womanUnited States: 94% of children aged 12-23 months, 1.63 births per womanUzbekistan: 90% of children aged 12-23 months, 3.49 births per womanSt. Vincent and the Grenadines: 99% of children aged 12-23 months, 1.76 births per womanViet Nam: 97% of children aged 12-23 months, 1.9 births per womanVanuatu: 71% of children aged 12-23 months, 3.57 births per womanSamoa: 85% of children aged 12-23 months, 3.8 births per womanSouth Africa: 74% of children aged 12-23 months, 2.21 births per womanZambia: 91% of children aged 12-23 months, 4.04 births per womanZimbabwe: 91% of children aged 12-23 months, 3.67 births per womanAZEBDICAFCODJPNKORLBNMLINERPNGSDNSGP

best-fit line line after adjusting

Four ways to measure the link

MethodrpCountries
Standard (Pearson), not adjusted-0.5091.2e-13186
By rank (Spearman), not adjusted-0.4929.5e-13186
Standard (Pearson), adjusted for national income-0.1710.020186
By rank (Spearman), adjusted for national income-0.1220.097186

The rank version uses only each country’s place in line, from lowest to highest, so a few extreme countries count for less. The adjusted and unadjusted versions use the same 186 countries: those that report both measures and GDP per person. So the gap between them comes from the adjustment, not from a change in which countries are counted. Drop in the size of r after adjusting: +0.338 (a minus sign means it grew).

How solid is it?

Leaving out one country at a time, r ranges from -0.196 (without AZE) to -0.145 (without AGO). The bar above shows that range on a scale from −1 to +1, with the solid line at the full result. The single country that moves r most: AGO (+0.026).

Fragile: this link may not hold up.
  • direction is not consistent across regions

Within each region

Countries are not separate, unrelated cases, and neighbors share a lot. A link that holds inside each region is far more believable than one that shows up only when comparing regions.

nr
East Asia & Pacific29+0.17
Europe & Central Asia50+0.24
Latin America & Caribbean31-0.57
Middle East, North Africa, Afghanistan & Pakistan22-0.03
Sub-Saharan Africa46-0.40

By income third

If the link shows up only in the richest third of countries, it is a feature of rich countries, not a general pattern.

nr
Poorest third62-0.19
Middle third62-0.22
Richest third62+0.11

By largest religious group

Countries grouped by a label they share, such as main religion, rather than by a number. Groups of fewer than twelve countries are not shown. These groups differ in income, region and history all at once. So a gap between them is a place to start asking questions, not an answer.

nr
Christians108-0.29
Muslims49+0.03

By last european coloniser

Countries grouped by a label they share, such as main religion, rather than by a number. Groups of fewer than twelve countries are not shown. These groups differ in income, region and history all at once. So a gap between them is a place to start asking questions, not an answer.

nr
France25+0.05
Never a European colony21-0.05
Spain20-0.50
United Kingdom63-0.18

Without outliers (countries far outside the middle half of countries on either measure, by more than one and a half times the width of that middle half): r = -0.206 after dropping 9 countries.

Two series, one country

Both measures over the years for one country you pick. The two charts are stacked so they share only the years along the bottom.

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Over time, within countries

Everything above compares countries with each other at one moment. This section compares each country only with itself over 35years. So a link here can’t come from anything about a country that stays the same, such as its history, geography, institutions or culture.

The link shows up within countries over time (r = -0.222) but mostly disappears in year-to-year changes (r = -0.007). That points to slow trends particular to each country, not the two measures moving together from year to year.

Across countries (adjusted)-0.171for comparison
Within countries-0.394each country vs itself
…and vs the same year elsewhere-0.222q = 1.0e-5 · 193 countries
Year-on-year changes-0.007q = 0.714
Read with care.
  • The association is much weaker in year-on-year changes than in levels, which points to shared country-specific trends.

6,624 country-years (one country in one year), 193 countries, 1990–2024, about 34 years each on average. Share of the variation that happens within countries over time: 12% for DTP3 immunisation, 32% for Fertility rate. The margins of error allow for each country appearing many times, and for each year’s value being close to the year before.

Year-to-year changes are a cautious test, not a final answer. Looking only at changes from one year to the next removes each country’s own trends. But it also makes measurement mistakes louder, which pulls the results toward zero. A near-zero result here is weak evidence of no link, not proof.

With one measure years behind the other

0.30−0.3-100+10years Fertility rate trails DTP3 immunisation →lag -10: r = -0.030 (n = 4,805)lag -9: r = -0.054 (n = 4,995)lag -8: r = -0.077 (n = 5,183)lag -7: r = -0.100 (n = 5,371)lag -6: r = -0.123 (n = 5,558)lag -5: r = -0.146 (n = 5,745)lag -4: r = -0.169 (n = 5,932)lag -3: r = -0.188 (n = 6,118)lag -2: r = -0.204 (n = 6,299)lag -1: r = -0.220 (n = 6,462)lag +0: r = -0.222 (n = 6,624)lag +1: r = -0.235 (n = 6,432)lag +2: r = -0.246 (n = 6,239)lag +3: r = -0.254 (n = 6,046)lag +4: r = -0.263 (n = 5,853)lag +5: r = -0.268 (n = 5,660)lag +6: r = -0.267 (n = 5,467)lag +7: r = -0.260 (n = 5,274)lag +8: r = -0.251 (n = 5,081)lag +9: r = -0.245 (n = 4,888)lag +10: r = -0.241 (n = 4,691)

Same year (lag 0): -0.222. A peak away from zero does not show which comes first. These series change slowly — this year’s value is close to last year’s. That makes the curve smooth and nearly symmetric, whatever produced the data. Even a sharp peak at one lag (a gap of some years) would not prove that one measure changes the other.

The data


% of children aged 12-23 months

births per woman
Years
St. Vincent and the Grenadines VCT99%1.762024
Turkiye TUR99%1.482024
Tonga TON99%3.12024
Portugal PRT99%1.412024
Oman OMN99%2.512024
Naoero NRU99%3.292024
Maldives MDV99%1.562024
Luxembourg LUX99%1.252024
St. Lucia LCA99%1.392024
Kuwait KWT99%1.562024
Japan JPN99%1.152024
Jamaica JAM99%1.352024
Hungary HUN99%1.412024
Costa Rica CRI99%1.322024
Brunei Darussalam BRN99%1.732024

World Bank, World Development Indicators
World Bank, World Development Indicators

Sources

DTP3 immunisation

Immunization, DPT (% of children ages 12-23 months)

WHO and UNICEF · CC BY 4.0 · updated quarterly

Three doses of the diphtheria, tetanus and whooping cough (pertussis) vaccine, the standard measure of a routine vaccination system. Measles coverage is published the same way and moves with it almost exactly, so only one of the two is here.

Fertility rate

Fertility rate, total (births per woman)

World Bank · CC BY 4.0 · updated quarterly

How this was computed

Data used: most recent value in 2010-2025; values come from 2023–2024. To adjust for income, each measure is first predicted from GDP per person (in percentage terms, on a log scale) with a straight-line fit. Only what is left over is then compared. This is called a partial correlation. The line is drawn the standard way (ordinary least squares), which picks the line that comes closest to all the countries at once. The error margins allow for countries in the same region resembling each other, using 7 World Bank regions. The q-value corrects for testing all 12,497 pairs at once, using the Benjamini–Hochberg method. Underlying data last updated DYB 2024. How the country data works · explore DTP3 immunisation and Fertility rate

This page shows that two measures go together. It does not show that DTP3 immunisation changes Fertility rate, or the reverse. These figures also describe countries, not individual people. See the ecological fallacy.

More links with DTP3 immunisation or Fertility rate