Catholic University of Santos (Universidade Católica de Santos - Programa de Pós- Graduação strictu senso em Saúde Coletiva), Av. Conselheiro Nebias, 300, sala 106; Santos, São Paulo, CEP: 11.015-002, Brazil.
Instituto da Criança, Hospital das Clínicas - Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
BMC Public Health. 2022 Jun 16;22(1):1204. doi: 10.1186/s12889-022-13589-9.
Over time, vaccination has been consolidated as one of the most cost effective and successful public health interventions and a right of every human being. This study aimed to assess the spatial dynamics of the vaccine coverage (VC) rate of children aged < 1 year per municipality in the Brazilian Northeast at 2016 and 2017.
This is a mixed-type ecological study that use a Public domain data Health Information. Vaccine doses were obtained from the Information System of the Brazilian National Immunization Program, and live births from the Brazilian Information System of Live Births of the Brazilian Unified Health System. Descriptive analysis of the coverage of all the vaccines for each year of the study was conducted, and Mann-Whitney U test was used to compare VC between the study years. Chi-squared test was used to evaluate the association between the years and VC, which was stratified into four ranges, very low, low, adequate, and high. Spatial distribution was analyzed according to both each study year and vaccine and presented as thematic maps. Spatial autocorrelation was analyzed using Moran's Global and Local statistics.
Compared with 2017, 2016 showed better VC (p < 0.05), except for Bacillus Calmette-Guérin. In the spatial analysis of the studied vaccines, the Global Moran's Index did not show any spatial autocorrelation (p > 0.05), but the Local Moran's Index showed some municipalities, particularly the Sertão Paraibano region, with high VC, high similarity, and a positive influence on neighboring municipalities (p < 0.05). In contrast, most municipalities with low VC were concentrated in the Mata Paraibano region, negatively influencing their neighbors (p < 0.05).
Uneven geographic regions and clusters of low VC for children aged < 1 year in the State of Paraíba were spatially visualized. Health policy makers and planners need to urgently devise and coordinate an action plan directed at each state's regions to fulfill the vaccination calendar, thereby reversing the vulnerability of this age group, which is at a higher risk of diseases preventable by vaccination.
随着时间的推移，疫苗接种已成为最具成本效益和最成功的公共卫生干预措施之一，也是每个人的权利。本研究旨在评估 2016 年和 2017 年巴西东北部每个市 1 岁以下儿童疫苗接种率（VC）的空间动态。
这是一项混合类型的生态研究，使用公共领域卫生信息数据。疫苗剂量来自巴西国家免疫计划信息系统，活产数据来自巴西统一卫生系统的巴西活产信息系统。对每年所有疫苗的覆盖情况进行描述性分析，并使用曼-惠特尼 U 检验比较研究年份之间的 VC。卡方检验用于评估年份与 VC 之间的关系，VC 分为四个范围，即极低、低、充足和高。根据每年和疫苗对空间分布进行分析，并以专题地图形式呈现。使用 Moran 全局和局部统计分析进行空间自相关分析。
与 2017 年相比，2016 年 VC 更好（p<0.05），卡介苗除外。在所研究疫苗的空间分析中，全局 Moran 指数没有显示任何空间自相关（p>0.05），但局部 Moran 指数显示了一些市，特别是塞特奥帕拉伊巴诺地区，具有较高的 VC、较高的相似性，并对邻近市产生了积极影响（p<0.05）。相比之下，大多数 VC 较低的市集中在帕拉伊巴马塔地区，对其邻居产生了负面影响（p<0.05）。
可视化了帕拉伊巴州 1 岁以下儿童 VC 不均匀的地理区域和低 VC 集群。卫生政策制定者和规划者需要紧急制定和协调针对每个州地区的行动计划，以完成疫苗接种日程，从而扭转该年龄组的脆弱性，该年龄组面临更多可通过疫苗预防的疾病风险。
