巴西东南部地区2017年和2018年活产队列中有效剂量的全程疫苗接种覆盖率。
Full vaccination coverage with valid doses among the 2017 and 2018 live birth cohort in the Southeast region of Brazil.
作者信息
França Ana Paula, Barata Rita Barradas, Guibu Ione Aquemi, Moraes José Cássio de, Silva Adriana Ilha da, Ramos Alberto Novaes, França Ana Paula, Oliveira Andrea de Nazaré Marvão, Boing Antonio Fernando, Domingues Carla Magda Allan Santos, Oliveira Consuelo Silva de, Maciel Ethel Leonor Noia, Guibu Ione Aquemi, Mirabal Isabelle Ribeiro Barbosa, Barbosa Jaqueline Caracas, Lima Jaqueline Costa, Moraes José Cássio de, Luhm Karin Regina, Caetano Karlla Antonieta Amorim, Lima Luisa Helena de Oliveira, Antunes Maria Bernadete de Cerqueira, Teixeira Maria da Gloria, Teixeira Maria Denise de Castro, Borges Maria Fernanda de Sousa Oliveira, Queiroz Rejane Christine de Sousa, Gurgel Ricardo Queiroz, Barata Rita Barradas, Azevedo Roberta Nogueira Calandrini de, Oliveira Sandra Maria do Valle Leone de, Teles Sheila Araújo, Gama Silvana Granado Nogueira da, Mengue Sotero Serrate, Simões Taynãna César, Nascimento Valdir, Araújo Wildo Navegantes de
机构信息
Faculdade de Ciências Médicas da Santa Casa de São Paulo, Departamento de Saúde Coletiva, São Paulo, SP, Brazil.
Universidade Federal do Espírito Santo, Vitória, ES, Brazil.
出版信息
Epidemiol Serv Saude. 2024 Dec 16;33(spe2):e2024433. doi: 10.1590/S2237-96222024v33e2024433.especial2.en. eCollection 2024.
OBJECTIVE
To analyze factors associated with full vaccination coverage with valid doses, in children from four state capitals and three other cities in Southeast Brazil.
METHOD
Analysis of a population survey conducted in 2020-2021, with a sample stratified according to socioeconomic levels of children born in 2017-2018, with data collected through photographic records of their vaccination cards. Odds ratios (OR) and 95% confidence intervals (95%CI) for full vaccination coverage were estimated based on the characteristics of the family, mother and child.
RESULTS
Among 8703 children, lowest coverage occurred in strata A and B (OR=0.39; 95%CI 0.23;0.67 and OR=0.38; 95%CI 0.25;0.58); in consumption level A/B (OR=0.38; 95CI% 0.28;0.52); among those with income >BRL8000/month (OR=0.23; 95%CI 0.12;0.42); in children of mothers with higher education (OR=0.47; 95%CI 0.32;0.71); in children not vaccinated exclusively in the public service (OR=0.37; 95%CI 0.26;0.51) and in children with a vaccination delay of up to 6 months (OR=0.28; 95%CI 0.22;0.37).
CONCLUSION
Coverage did not reach the targets for controlling vaccine-preventable diseases and was negatively associated with higher socioeconomic status.
MAIN RESULTS
Vaccination coverage for the full schedule with valid doses was very low, putting the control of vaccine-preventable diseases at risk in the four state capitals and three other cities in the interior region of Southeast Brazil.
IMPLICATIONS FOR SERVICES
Brazilian National Health System managers and workers need to know the factors associated with low vaccination coverage and increased risk of abandoning the schedule, access problems and National Immunization Program difficulties.
PERSPECTIVES
Understanding determinants of low vaccination coverage provides support for the discussion and design of effective public policies to address barriers and qualify health services for vaccination.
目的
分析巴西东南部四个州首府和其他三个城市儿童有效剂量全程疫苗接种覆盖率的相关因素。
方法
对2020 - 2021年进行的一项人口调查进行分析，样本根据2017 - 2018年出生儿童的社会经济水平分层，数据通过其疫苗接种卡的照片记录收集。根据家庭、母亲和儿童的特征估计全程疫苗接种覆盖率的比值比（OR）和95%置信区间（95%CI）。
结果
在8703名儿童中，A层和B层的覆盖率最低（OR = 0.39；95%CI 0.23；0.67和OR = 0.38；95%CI 0.25；0.58）；消费水平A/B层（OR = 0.38；95%CI 0.28；0.52）；月收入>8000雷亚尔的儿童中（OR = 0.23；95%CI 0.12；0.42）；母亲受过高等教育的儿童中（OR = 0.47；95%CI 0.32；0.71）；未仅在公共服务机构接种疫苗的儿童中（OR = 0.37；95%CI 0.26；0.51）以及疫苗接种延迟长达6个月的儿童中（OR = 0.28；95%CI 0.22；0.37）。
结论
覆盖率未达到控制疫苗可预防疾病的目标，且与较高的社会经济地位呈负相关。
主要结果
有效剂量全程疫苗接种覆盖率非常低，使巴西东南部内陆地区四个州首府和其他三个城市的疫苗可预防疾病控制面临风险。
对服务的启示
巴西国家卫生系统管理人员和工作人员需要了解与低疫苗接种覆盖率以及放弃接种计划、获取问题和国家免疫规划困难风险增加相关的因素。
展望
了解低疫苗接种覆盖率的决定因素为讨论和设计有效的公共政策提供支持，以消除障碍并提升疫苗接种卫生服务质量。
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