Vaccine Observatory, Stricto Sensu Graduate Program in Collective Health of the Catholic University of Santos, Santos, São Paulo, Brazil.
Children's Institute, University Clinics Hospital, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
PLoS One. 2023 Jul 18;18(7):e0288651. doi: 10.1371/journal.pone.0288651. eCollection 2023.
Immunization is one of the most effective measures in public health, and it is responsible for the reduction of vaccine-preventable diseases. In the present study, vaccine coverage (VC) and the spatial dynamics of homogeneity of VC (HVC) were compared and analyzed in the terms of the immunobiologicals administered to children aged < 1 year in a state in Paraíba, Brazil. This is a mixed ecological study that used public-domain secondary data from the years 2016 and 2017 from the Information System of the Brazilian National Immunization Program (SI-PNI) and the Brazilian National Information System of Live Births (SINASC). VC rates were calculated by dividing the number of administered doses by the number of live births. Then, VC was classified into four categories. The Municipal HVC was considered adequate when the overall VC exceeds 75%. The study included a descriptive analysis and a spatial autocorrelation analysis for HVC using global and local Moran's statistics. The stratified VC analysis revealed a significant number of municipalities in each of the state's mesoregions with low or very low VC rates for all immunobiologicals, with the Mata Paraibana mesoregion having the worst percentages in both years studied. The spatial analysis of HVC revealed several clusters of inadequate homogeneity, with Mata Paraibana being the worst mesoregion in 2016. The analysis of spatial dynamics and spatial statistics techniques allows the precise identification of vulnerable areas, "vaccination pockets," making it possible to develop plans aimed at meeting the targets of the PNI.
免疫接种是公共卫生中最有效的措施之一,它有助于减少可通过疫苗预防的疾病。在本研究中,我们比较和分析了巴西 Paraíba 州为<1 岁儿童接种的各种生物制剂的疫苗接种率(VC)和 VC 同质性(HVC)的空间动态。这是一项混合生态研究,使用了来自 2016 年和 2017 年的公共领域二级数据,数据来源于巴西国家免疫计划信息系统(SI-PNI)和巴西活产国家信息系统(SINASC)。VC 率通过将接种剂量数除以活产数来计算。然后,将 VC 分为四类。当总体 VC 超过 75%时,认为市级 HVC 是足够的。本研究包括描述性分析和使用全局和局部 Moran 统计的 HVC 空间自相关分析。分层 VC 分析显示,在每个州的 mesoregions 中,都有相当数量的城市具有所有生物制剂的低或极低 VC 率,在研究的两年中,Mata Paraibana 地区的百分比最差。HVC 的空间分析显示存在多个不均匀同质聚类,2016 年 Mata Paraibana 是最差的地区。空间动态和空间统计技术的分析可以精确识别脆弱地区,即“疫苗接种点”,从而制定旨在实现 PNI 目标的计划。