Departamento de Saúde Pública, Universidade Federal de Santa Catarina. R. Eng. Agronômico Andrei Cristian Ferreira s/n, Trindade. 88040-900 Florianópolis SC Brasil.
Universidade Federal de Goiás. Goiânia GO Brasil.
Cien Saude Colet. 2024 Aug;29(8):e03952023. doi: 10.1590/1413-81232024298.03952023. Epub 2023 Aug 30.
This study examined the spatial distribution and social inequalities in COVID-19 vaccine coverage among children aged 5-11 in Brazil. First and second dose vaccine coverage was calculated for all Brazilian municipalities and analyzed by geographic region and deciles based on human development index (HDI-M) and expected years of schooling at 18 years of age. Multilevel models were used to determine the variance partition coefficient, and bivariate local Moran's I statistic was used to assess spatial association. Results showed significant differences in vaccine coverage rates among Brazilian municipalities, with lower coverage in the North and Midwest regions. Municipalities with lower HDI and expected years of schooling had consistently lower vaccine coverage rates. Bivariate clustering analysis identified extensive concentrations of municipalities in the Northern and Northeastern regions with low vaccine coverage and low human development, while some clusters of municipalities in the Southeast and South regions with low coverage were located in areas with high HDI-M. These findings highlight the persistent municipal-level inequalities in vaccine coverage among children in Brazil and the need for targeted interventions to improve vaccine access and coverage in underserved areas.
本研究考察了巴西 5-11 岁儿童 COVID-19 疫苗接种的空间分布和社会不平等情况。计算了所有巴西城市的第一剂和第二剂疫苗接种率，并根据人类发展指数 (HDI-M) 和 18 岁时的预期受教育年限，按地理区域和十分位数进行分析。采用多水平模型确定方差分解系数，并用二元局部 Moran's I 统计量评估空间关联。结果表明，巴西城市之间的疫苗接种率存在显著差异，北部和中西部地区的覆盖率较低。HDI 和预期受教育年限较低的城市，疫苗接种率始终较低。二元聚类分析确定了北方和东北部地区存在大量疫苗接种率和人类发展水平较低的城市聚类，而东南部和南部地区一些覆盖范围较低的城市聚类则位于 HDI-M 较高的地区。这些发现突显了巴西儿童疫苗接种率在市级层面上持续存在的不平等现象，需要采取有针对性的干预措施，以改善服务不足地区的疫苗可及性和覆盖率。
