Understanding the gaps in MOV between poor and non-poor in sub-Saharan Africa (SSA) would enable an understanding of factors associated with interventions for improving immunization coverage to achieving universal childhood immunization. We aimed to conduct a multicountry analyses to decompose the gap in MOV between poor and non-poor in SSA. We used cross-sectional data from 35 Demographic and Health Surveys in SSA conducted between 2007 and 2016. Descriptive statistics were used to understand the gap in MOV between the urban poor and non-poor, and across the selected covariates. Out of the 35 countries included in this analysis, 19 countries showed pro-poor inequality, five showed pro-non-poor inequality and remaining 11 countries showed no statistically significant inequality. Among the countries with statistically significant pro-illiterate inequality, the risk difference ranged from 4.2% in Congo DR to 20.1% in Kenya. The important factors responsible for the inequality varied across the countries. In Madagascar, the largest contributions to the inequality in MOV was media access followed by number of under-five children and maternal education. However, Liberia media access narrowed the inequality in MOV between poor and non-poor households.The findings indicate that in most SSA countries, children belonging to poor households are most likely to have MOV and that socio-economic inequality in missed opportunities for vaccination is determined not only by health system functions, but also by factors beyond the scope of health authorities and care delivery system. Suggesting the the importance of addressing the social determinants of health, particularly education
