de Oliveira Roque E Lima Juliana, Pagotto Valéria, Rocha Bárbara Souza, Scalize Paulo Sérgio, Guimarães Rafael Alves, de Lima Márcio Dias, da Silva Leandro Nascimento, da Silva Oliveira Michele Dias, Moura Winny Éveny Alves, Teles Sheila Araújo, Rosso Claci Fátima Weirich, Caetano Karlla Antonieta Amorim
Faculty of Nursing, Federal University of Goiás, Goiânia 74605-080, GO, Brazil.
School of Civil and Environmental Engineering, Federal University of Goiás, Goiânia 74605-220, GO, Brazil.
Vaccines (Basel). 2023 Apr 13;11(4):838. doi: 10.3390/vaccines11040838.
Discrimination and limited access to healthcare services in remote areas can affect vaccination coverage. Therefore, this study aimed to estimate vaccination coverage for children living in quilombola communities and rural settlements in the central region of Brazil during their first year of life and to analyze the factors associated with incomplete vaccination. An analytical cross-sectional study was conducted on children born between 2015 and 2017. The percentage of children who received all vaccines recommended by the National Immunization Program in Brazil by 11 months and 29 days was used to calculate immunization coverage. Children who received the following vaccines were considered as having a complete basic vaccination schedule: one dose of BCG; three doses of Hepatitis B, of Diphtheria-Tetanus-Pertussis (DPT), of type b (Hib), and of Poliovirus (Polio); two doses of Rotavirus, of 10-valent pneumococcal (PCV10), and of Serogroup C meningococcal conjugate (MenC); and one dose of Yellow Fever (YF). Measles-mumps-rubella (MMR) and other doses recommended at or after 12 months were not included. Consolidated logistic regression was used to identify factors associated with incomplete vaccination coverage. Overall vaccination coverage was 52.8% (95% CI: 45.5-59.9%) and ranged from 70.4% for the Yellow Fever vaccine to 78.3% for the Rotavirus vaccine, with no significant differences between the quilombola and settler groups. Notably, the likelihood of incomplete general vaccination coverage was higher among children who did not receive a visit from a healthcare professional. Urgent strategies are required to achieve and ensure health equity for this unique and traditionally distinct group with low vaccination coverage.
偏远地区存在的歧视现象以及获得医疗服务的机会有限,可能会影响疫苗接种覆盖率。因此,本研究旨在估算巴西中部地区基隆波拉社区和农村定居点儿童一岁以内的疫苗接种覆盖率,并分析与疫苗接种不完全相关的因素。对2015年至2017年出生的儿童进行了一项分析性横断面研究。通过计算11个月零29天时接种巴西国家免疫规划推荐的所有疫苗的儿童百分比来得出免疫覆盖率。接种了以下疫苗的儿童被视为完成了基础疫苗接种程序:一剂卡介苗;三剂乙型肝炎疫苗、白喉-破伤风-百日咳(DPT)疫苗、b型流感嗜血杆菌(Hib)疫苗和脊髓灰质炎病毒(脊灰)疫苗;两剂轮状病毒疫苗、10价肺炎球菌结合疫苗(PCV10)和C群脑膜炎球菌结合疫苗(MenC);以及一剂黄热病(YF)疫苗。不包括12个月及以后推荐接种的麻疹-腮腺炎-风疹(MMR)疫苗和其他剂次疫苗。采用合并逻辑回归来确定与疫苗接种覆盖率不完全相关的因素。总体疫苗接种覆盖率为52.8%(95%置信区间:45.5 - 5⑨9%),范围从黄热病疫苗的70.4%到轮状病毒疫苗的78.3%,基隆波拉群体和定居者群体之间无显著差异。值得注意的是,未接受医护人员访视的儿童疫苗接种覆盖率不完全的可能性更高。需要采取紧急策略,以实现并确保这个疫苗接种覆盖率低的独特且传统上有别于其他群体的健康公平。