National vaccination program compliance in northern Lisbon's primary healthcare: 2022 assessment

Abstract

Abstract Background The National Vaccination Program (NVP) aims to protect all citizens and residents of Portugal from communicable diseases, safeguarding public health. It is coordinated by the Directorate-General of Health and locally implemented by the primary healthcare centers. Currently, a 95% vaccination coverage is set for all vaccines, except for human papillomavirus (HPV) which is 85%. Methods Assess the accomplishment of NVP in 2022, based on the national vaccination platform, for the 15 primary healthcare units of Northern Lisbon. The evaluation included the proportion of users who I) completed vaccination schedule at the recommended age (recommended NVP), and II) completed vaccination schedule, regardless administration date (fulfilled NVP), according to birth cohort. Results The 2021 and 2022 cohorts achieved a 95% vaccination coverage target for the 4 evaluated vaccines; the 2020 cohort only achieved for 3/5 vaccines evaluated, due to a lower vaccination against tetanus (93.42%) and Neisseria meningitidis B (94.58%). Both 2015 and 2016 cohorts missed the vaccination target for tetanus (89.75% and 88.89%, respectively) and measles (92.84% and 91.12%, respectively). The vaccination target for HPV was not achieved in any of the evaluated cohorts, highlighting the low coverage in males (46.26%) and females (52.34%) from 2012. Concerning tetanus, an increasing trend coverage was found along the cohorts from 1956 (54.47%) to 2016 (91.23%). Conclusions Globally, the NVP targets were achieved in several cohorts. However, immunization against HPV and among older cohorts fell short of expectations. Several factors contribute to explain this low coverage, such as vaccine stock-out (for HPV and N. meningitidis B); residing abroad; private health care follow up without proper vaccine registration; vaccine hesitancy. On the other hand, the positive variation in immunization coverage for most of the assessed vaccines reflects some strategies used to increase adherence. Key messages • The accomplishment of vaccination schedules is key to safeguard individuals and communities from vaccine-preventable illnesses. • The continuous assessment of vaccination targets and trend monitoring is critical to implement strategies to increase vaccine coverage and safeguard public health.