Neves Rosália Garcia, Saes Mirelle de Oliveira, Machado Karla Pereira, Duro Suele Manjourany Silva, Facchini Luiz Augusto
Secretaria Estadual de Saúde do Rio Grande do Sul, Porto Alegre, Brasil.
Universidade Federal do Rio Grande, Rio Grande, Brasil.
Cad Saude Publica. 2022 May 9;38(4):PT135621. doi: 10.1590/0102-311XPT135621. eCollection 2022.
The objective was to analyze the trend in the availability of vaccines in Brazil and its various regions and states from 2012 to 2018. This cross-sectional study used data from basic units assessed in cycles I (2012), II (2014), and III (2018) of the Brazilian National Program for Improvement of Access and Quality of Basic Care (PMAQ-AB). We assessed the availability of the dT, hepatitis B, meningococcal C, polio, pneumococcal 10-valent, MMR, DPT, tetravalent/pentavalent, and human rotavirus vaccines. Identification of trend was performed with weighted least squares regression to estimate annual percent changes. We also verified the relative and absolute differences in prevalence of vaccines. The sample consisted of 13,842 basic health units in Cycle I, 19,752 in Cycle II, and 25,152 in Cycle III. An upward trend was seen in the prevalence of availability of all vaccines investigated during the period, with an increase of 16 percentage points from 2012 to 2018, reaching nearly 70% in 2018. The regions with the largest upward trend were the North (2.9p.p.), Central-West (2.1p.p.), and Northeast (2.0p.p.). There was a visible downward trend in both the availability (-3.3p.p.) and absolute and relative difference (-20p.p.; 0.68) in Rio de Janeiro State. The prevalence of availability of vaccines was low in Brazil, with disparities between regions that become even more pronounced when assessing specific states.
目的是分析2012年至2018年巴西及其各地区和州疫苗可及性的趋势。这项横断面研究使用了巴西国家基本医疗服务可及性与质量改善计划（PMAQ-AB）第一周期（2012年）、第二周期（2014年）和第三周期（2018年）评估的基层单位数据。我们评估了白百破疫苗、乙肝疫苗、C群脑膜炎球菌疫苗、脊髓灰质炎疫苗、10价肺炎球菌疫苗、麻腮风疫苗、白百破疫苗、四价/五价疫苗和人轮状病毒疫苗的可及性。采用加权最小二乘法回归进行趋势识别，以估计年度百分比变化。我们还验证了疫苗流行率的相对和绝对差异。样本包括第一周期的13842个基层卫生单位、第二周期的19752个和第三周期的25152个。在此期间，所有调查疫苗的可及性流行率呈上升趋势，从2012年到2018年增加了16个百分点，2018年达到近70%。上升趋势最大的地区是北部（2.9个百分点）、中西部（2.1个百分点）和东北部（2.0个百分点）。里约热内卢州的可及性（-3.3个百分点）以及绝对和相对差异（-20个百分点；0.68）均呈现明显下降趋势。巴西疫苗的可及性流行率较低，各地区之间存在差异，在评估特定州时差异更为明显。
