Faria Letícia Bezerra, França Ana Paula, Moraes José Cássio de, Donalisio Maria Rita
Faculty of Medical Sciences of the University of Campinas, Campinas 13083-887, Brazil.
Faculty of Medical Sciences of the Santa Casa de São Paulo, São Paulo 01224-001, Brazil.
Vaccines (Basel). 2025 May 13;13(5):516. doi: 10.3390/vaccines13050516.
BACKGROUND/OBJECTIVES: In recent years, Brazil has experienced declining vaccination coverage, raising concerns about vaccine hesitancy and barriers to access. This research analyzes the reasons for non-vaccination among children born in 2017 and 2018 in a metropolitan area of the state of São Paulo in 2020 and 2021.
Data were obtained from a retrospective cohort of children born in 2017 and 2018, living in Campinas, monitored during the first 24 months by vaccination records. A stratified and clustered sample by census sector was performed according to socioeconomic conditions. The reasons for non-vaccination were obtained from interviews with the children's guardians.
A total of 1775 caregivers were interviewed, and 63.1% of children had complete vaccination coverage, with lower socioeconomic groups presenting the highest rates for non-vaccination. The study identified three main groups for non-vaccination: vaccine hesitancy (e.g., fear of side effects, misinformation) in 1.7% of respondents, access difficulties (e.g., service location, financial constraints) in 7.9%, and missed opportunities (e.g., lack of vaccines, administrative barriers) in 16.4%.
The findings indicate that the main reported barriers to childhood vaccination are missed opportunities in healthcare services, often due to vaccine shortages or administrative issues, along with social vulnerabilities. Vaccine hesitancy stems from misinformation and fear of side effects. Despite these challenges, families persist in seeking vaccination. However, coverage remains below the national targets, particularly in the second year of life. Targeted public health interventions are urgently needed to improve vaccine confidence, accessibility, and healthcare system efficiency.
背景/目的：近年来，巴西的疫苗接种覆盖率不断下降，引发了对疫苗犹豫和接种障碍的担忧。本研究分析了2020年和2021年在圣保罗州一个大都市地区出生的2017年和2018年出生儿童未接种疫苗的原因。
数据来自对2017年和2018年出生、居住在坎皮纳斯的儿童的回顾性队列研究，通过疫苗接种记录在头24个月进行监测。根据社会经济状况按普查区进行分层和聚类抽样。未接种疫苗的原因通过与儿童监护人的访谈获得。
共采访了1775名照料者，63.1%的儿童接种疫苗完整，社会经济地位较低的群体未接种率最高。该研究确定了未接种疫苗的三个主要群体：1.7%的受访者存在疫苗犹豫（例如，害怕副作用、错误信息），7.9%存在接种困难（例如，服务地点、经济限制），16.4%存在错过接种机会（例如，疫苗短缺、行政障碍）。
研究结果表明，报告的儿童疫苗接种主要障碍是医疗服务中错过接种机会，这通常是由于疫苗短缺或行政问题以及社会脆弱性导致的。疫苗犹豫源于错误信息和对副作用的恐惧。尽管存在这些挑战，家庭仍坚持寻求接种疫苗。然而，接种覆盖率仍低于国家目标，尤其是在儿童出生后的第二年。迫切需要有针对性的公共卫生干预措施，以提高疫苗信心、可及性和医疗系统效率。
