Universidade Federal do Maranhão. Departamento de Medicina I. São Luís, MA, Brasil.
Secretaria Municipal de Saúde. São Luís, MA, Brasil.
Rev Saude Publica. 2021 Apr 23;55:12. doi: 10.11606/s1518-8787.2021055003417. eCollection 2021.
To estimate the prevalence and factors associated with hesitancy in getting the vaccine against SARS-CoV-2 in Maranhão, Brazil.
This is a cross-sectional population-based study conducted from October 19 to 30, 2020. The estimates were calculated based on clustering, stratification, and non-response. A three-stage sampling was adopted, considering stratum, census tracts, and domicile. After systematic analysis, thirty sectors were selected in each stratum, totaling 150 sectors. Each sector contained a fixed number of 34 households, thus totaling 5,100 households. One individual within each household (resident for at least six months and aged one year or more) was selected by a simple random sampling. We questioned participants about their vaccination intention. Univariate association between independent variables and the outcome were verified using descriptive analysis (weighted frequencies) and Pearson's chi-square test (p < 0.05). Robust multivariate analysis was performed using a three-level hierarchical model.
We found 17.5% (95%CI 16.1-19.1%) of the 4,630 individuals interviewed to report hesitancy to be vaccinated against covid-19. After final model adjustment, vaccination hesitancy was statistically higher among residents of the cities of Imperatriz (24.0%; RP = 1.48; IC95% 1.09-2.02) and municipalities of the Grande Ilha de São Luís (20.7%; RP = 1.34; 95%CI 1.02-1.76), female individuals (19.8%; RP = 1.44; 95%CI 1.20-1.75), older adults (22.8%; RP = 1.79; IC95% 1.30-2.46), evangelicals (24.1%; RP = 1.49; 95%CI 1.24-1.79), and those without reported symptoms (18.6%; RP = 1.24; 95%CI 1.02-1.51). We found no statistical differences for other socioeconomic and demographic characteristics, as well as variables related to the labor market, behaviors, and health conditions of the interviewees.
The prevalence of vaccine hesitancy in Maranhão and its association with individual, contextual, and clinical factors enable us to identify the groups and contexts of greatest resistance, requiring special attention from public strategies to ensure wide vaccination.
估计巴西马拉尼昂州对 SARS-CoV-2 疫苗接种犹豫不决的流行率和相关因素。
这是一项基于人群的横断面研究，于 2020 年 10 月 19 日至 30 日进行。估计值是基于聚类、分层和无应答进行计算的。采用三阶段抽样，考虑到层次、普查区和住所。经过系统分析，每个层次选择 30 个区域，共计 150 个区域。每个区域包含固定数量的 34 户家庭，共计 5100 户家庭。每个家庭中选择一名（居住至少六个月且年满一岁或以上）个人进行简单随机抽样。我们询问了参与者的疫苗接种意愿。使用描述性分析（加权频率）和 Pearson 卡方检验（p<0.05）对独立变量与结果之间的单变量关联进行验证。使用三级层次模型进行稳健的多变量分析。
我们发现，在接受采访的 4630 人中，有 17.5%（95%CI 16.1-19.1%）报告对接种 covid-19 疫苗犹豫不决。在最终模型调整后，城市居民的疫苗接种犹豫率更高，其中包括伊马塔里斯市（24.0%；RP=1.48；95%CI 1.09-2.02）和大圣路易斯岛市（20.7%；RP=1.34；95%CI 1.02-1.76），女性（19.8%；RP=1.44；95%CI 1.20-1.75），老年人（22.8%；RP=1.79；95%CI 1.30-2.46），福音派（24.1%；RP=1.49；95%CI 1.24-1.79），以及无报告症状者（18.6%；RP=1.24；95%CI 1.02-1.51）。对于其他社会经济和人口统计学特征，以及与受访者劳动力市场、行为和健康状况相关的变量，我们没有发现统计学差异。
在马拉尼昂州，疫苗接种犹豫的流行率及其与个人、环境和临床因素的关联使我们能够确定最具抵抗力的群体和环境，这需要公共策略特别关注，以确保广泛接种疫苗。
