**5. Conclusions**

Maternal immunity against tetanus, measured as PAB coverage, is a key aspect of MNTE. Findings from this study of 76 countries suggest that substantial inequalities in PAB coverage exist for wealth, maternal age, maternal education, and place of residence, and that these inequalities exist globally across low-, lower-middle-, and upper-middle-income countries. Though global coverage changed little over the time period 2001–2020, several countries had substantial increases in PAB coverage accompanied by decreases in inequality, highlighting the need for continued equity considerations in MNTE efforts.

**Supplementary Materials:** The following supporting information can be accessed at: https://public.t ableau.com/app/profile/katherine.kirkby/viz/Interactivetable-Inequalitiesintetanustoxoidprotect ioncoverage/Interactivetables Interactive Supplemental Table S1: Latest situation of inequality; Interactive Supplemental Table S2: Change in inequality over time. The following supporting information can be downloaded at https://www.mdpi.com/article/10.3390/vaccines11040752/s1: Supplemental Figure S1: Latest situation of inequality in PAB coverage by country MNTE achievement status (DHS/MICS, 2011–2020).

**Author Contributions:** A.R.H. led the conceptualization and execution of the study and interpretation of results; N.E.J. led manuscript development; B.O.C.-P. and N.E.J. led data preparation and analysis; K.K., L.A. and T.M.S. contributed to data preparation and analysis; all authors had full access to the data in the study; B.O.C.-P., L.A., T.M.S. and A.J.D.B. had direct access to and verified the underlying data reported in the manuscript; K.K., N.B., A.R.H., M.C.D.-H., N.Y. and A.J.D.B. provided interpretation, text, and review of findings specific to inequalities and immunization; K.K. produced visuals. All authors have read and agreed to the published version of the manuscript.

**Funding:** This research was funded by Gavi, the Vaccine Alliance. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

**Institutional Review Board Statement:** Not applicable.

**Informed Consent Statement:** Not applicable.

**Data Availability Statement:** All analyses were carried out using publicly available datasets that can be obtained directly from the DHS (dhsprogram.com) and the MICS (mics.unicef.org) websites. Data access is free and publicly available, but requires registration as a data user with the corresponding survey organization and submission of a request to access data for research purposes (https://dhsp rogram.com/data/Access-Instructions.cfm; https://mics.unicef.org/visitors/sign-up). Datasets are continuously sourced and updated by the International Center for Equity in Health (equidade.org) as they are released. Analyses used the latest available dataset versions as of 18 December 2022.

**Conflicts of Interest:** The authors declare that they have no conflict of interest. The authors alone are responsible for the views expressed in this publication and they do not necessarily represent the views, decisions or policies of their institutions.
