Vaccination services and incomplete vaccine coverage for children: a comparative spatial analysis of the BRISA cohorts, São Luís (Maranhão State) and Ribeirão Preto (São Paulo State), Brazil.

Rafaelle Cristina Cruz Da Silva Queiroz,Isaias Pereira Da Silva,Rejane Christine De Sousa Queiroz,Francelena De Sousa Silva,Núbia Cristina Da Silva,Thiago Augusto Hernandes Rocha,Antônio Augusto Moura Da Silva,Marco Antônio Barbieri,Maria Da Conceição Pereira Saraiva,Izani Gonçalves Dos Santos

doi:10.1590/0102-311x00037020

Abstract

We analyzed the spatial relation between incomplete vaccine coverage for children and the distance from vaccination services. This was a cross-sectional study of children from 13 to 35 months of age from the cities of São Luís (Maranhão State) and Ribeirão Preto (São Paulo State), Brazil, and from basic health units (UBS, in Portuguese). The sample consisted of 2,744 children from São Luís and 3,325 from Ribeirão Preto. Data about incomplete vaccine coverage for children were obtained from the BRISA birth cohorts. Data about the quality of UBS vaccination services were obtained from the first cycle of the Brazilian National Program for Improvement of Access and Quality of Basic Care (PMAQ-AB, in Portuguese). For the spatial analysis, we determined the distance between the residence of the children (with and without a complete vaccine calendar) and the vaccination services of the UBS (classified according to number of structural items). Incomplete vaccine coverage was more pronounced in São Luís, with greater percentages for human rotavirus and triple viral vaccines, with the latter being the least available. In Ribeirão Preto, incomplete BCG vaccine coverage was more pronounced, with the tetravalent vaccine being the least available. Children from the two cities showed similarities: most of them had adult mothers with 9 to 11 years of schooling and did not reside with siblings in the household. They also showed differences: in São Luís, most mothers belonged to the economic class C, while in Ribeirão Preto they belong to the A and B classes. In the two cities with different socioeconomic conditions, complete vaccine coverage seemed not to depend on the location or quality of the vaccination service. Although São Luís showed a better structure of the services, incomplete vaccine coverage was higher compared to Ribeirão Preto.

Highlights

Among the more effective public health strategies for the control of transmissible diseases are the immunizations, considered to represent one of the greatest public health conquests of the 20th century and one of the three most important milestones for the prevention of these diseases, representing one of the safest and most cost-effective measures for the health system 1
3 VACCINATION SERVICES AND CHILDREN’S INCOMPLETE VACCINE COVERAGE. This was a cross-sectional study nested within two population cohorts of liveborn delivered in 2010 in the cities of São Luís and Ribeirão Preto called BRISA (Brazilian Ribeirão Preto and São Luís Birth Cohort Studies)
The municipality of Ribeirão Preto is located in the State of São Paulo, Southeast region of the country

Summary

Introduction

Among the more effective public health strategies for the control of transmissible diseases are the immunizations, considered to represent one of the greatest public health conquests of the 20th century and one of the three most important milestones for the prevention of these diseases, representing one of the safest and most cost-effective measures for the health system 1. Brazil was a pioneer in the incorporation of various vaccines into the calendar of the Brazilian Unified National Health System (SUS, in Portuguese) and it is one of the few countries in the world to offer an extensive and comprehensive spectrum of immunobiological agents in a universal and free manner. The decline of coverage in the main vaccines offered to the population at no cost started in 2016 and continued over the two subsequent years. This scenario shows that, in 2017, the coverage of the PNI was one of the worst since the year 2000 regarding the main vaccines on the calendar 4

Methods

Results

Conclusion