Abstract
The Brazilian National Immunization Program (PNI, in Portuguese) is coordinated by the Ministry of Health in cooperation with state and municipal health departments. Since the program's creation in 1973, it has become one of the country's most relevant public health interventions, having produced important results such as certification of Brazil as free of wild poliovirus circulation, the elimination rubella virus circulation, and an important reduction in cases and deaths from vaccine-preventable diseases. Brazil is one of the countries that offers the most vaccines free of cost to the population, with 15 vaccines for children, 9 for adolescents, and 5 for adults and the elderly. The program's expansion and the maintenance of high vaccination coverage rates led to a rapid decrease in vaccine-preventable diseases, completely changing the epidemiological scenario of these diseases in Brazil in the last four decades. The country is currently witnessing an increasing share of the population without adequate vaccination. To the extent that these diseases are no longer circulating, precisely because of the high vaccination coverage rates, especially since the early 2000s, many of them are now unknown to the population. As a result, many people have no notion of the danger these diseases represent. We thus need to understand the multiple factors contributing to this decrease in coverage, which has created the risk of resurgence of serious diseases that had already been controlled or eliminated in Brazil.
Highlights
The Brazilian National Immunization Program (PNI, in Portuguese), coordinated by the Ministry of Health in cooperation with the state and municipal health departments, has become one of the country’s most relevant public health interventions 1
Vaccines are supplied in Special Immunobiological Centers (CRIE, in Portuguese), serving groups with special clinical conditions in addition to the different vaccination schemes for pregnant women, indigenous peoples, and military personnel 4
We assessed the simultaneity of vaccination estimated by the vaccination coverage rates (VCR) with each dose for vaccines with equivalent vaccination schemes in relation to months of life, by the variation in the percentage of coverage, comparing the data from 2015 and 2018
Summary
The Brazilian National Immunization Program (PNI, in Portuguese), coordinated by the Ministry of Health in cooperation with the state and municipal health departments, has become one of the country’s most relevant public health interventions 1. 2011: Expansion of hepatitis B vaccine to the population up to 24 years of age Expansion of the influenza vaccine to children from 6 months to 2 years of age, indigenous people, pregnant women, and health workers. Expansion of the hepatitis B vaccine to the population up to 29 years of age. 2013: Expansion of influenza vaccine to postpartum women and groups with comorbidities Expansion of hepatitis B vaccine to the population up to 49 years of age Introduction of quadrivalent viral vaccine (measles, mumps, rubella, varicella) at 15 months, replacing 2nd dose of triple viral at 4 years of age. Introduction of DTaP vaccine for pregnant women and health workers Introduction of HPV vaccine for girls 11 to 13 years of age Expansion of influenza vaccine to include prison inmates and prison staff.
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