Socioeconomic inequalities are still a barrier to full child vaccine coverage in the Brazilian Amazon: a cross-sectional study in Assis Brasil, Acre, Brazil

Abstract

IntroductionVaccines are very important to reduce morbidity and mortality by preventable infectious diseases, especially during childhood. Optimal coverage is not always achieved, for several reasons. Here we assessed vaccine coverage for the first 12 months of age in children between 12 and 59 months old, residing in the urban area of a small Amazonian city, and factors associated with incomplete vaccination.MethodsA census was performed in the urban area of Assis Brasil, in the Brazilian Amazon, in January 2010, with mothers of 282 children aged 12 to 59 months old, using structured interviews and data from vaccination cards. Mixed logistic regression was used to determine factors associated with incomplete vaccination schemes.ResultsOnly 82.6% of all children had a completed the basic vaccine scheme for the first year of life. Vaccine coverage ranged from 52.7% coverage (oral rotavirus vaccine) to 99.7% coverage (for Bacille Calmette-Guérin). The major deficiencies occurred in doses administered after the first six months of life. Incomplete vaccination was associated with not having enough income to buy a house (aOR = 2.12, 95% CI 1.06-4.21), low maternal schooling (aOR = 2.60, 95% CI 1.28 – 5.29) , and time of residence of the child in the urban area of the city (aOR = 0.73, 95% CI 0.55 – 0.95).ConclusionsThis study showed that vaccine coverage in the first twelve months of life in Assis Brasil is similar to other areas in the Amazon and it is below the coverage postulated by the Brazilian Ministry of Health. Low vaccine coverage was associated with socioeconomic inequities that still prevail in the Brazilian Amazon. Short and long-term strategies must be taken to update child vaccines and increase vaccine coverage in the Amazon.

Behavioral determinants of immunization service utilization in Ethiopia: a cross-sectional community-based survey

“…We identified that good level of knowledge was associated with positive behavior of immunization service utilization, which is consistent with studies conducted in Nigeria and Ethiopia [ 11 , 12 ]. Approval and intention were significantly associated with immunization practice and this finding is consistent with some earlier studies conducted in Ethiopia, Brazil and Nigeria [ 11 , 13 , 14 ].…”

Vaccine coverage within the first year of life and associated factors with incomplete immunization in a Brazilian birth cohort

“…Additionally, low socioeconomic status has been found as one of the main factors associated with incomplete vaccination in Brazil [10,12,27] and around the globe [28]. It is worth mentioning that, in our analyses, higher coverage of incomplete immunization was also found among the poorest when compared with the three middle quintiles of family income (Additional file 3).…”

Cobertura vacinal em crianças de até dois anos: o prontuário eletrônico no município do Rio de Janeiro

“…Discussão O presente estudo evidenciou alta cobertura das vacinas de múltiplas doses e do esquema vacinal básico completo nos pacientes de 0 a 2 anos de idade cadastrados no CMS estudado. Quanto às características relacionadas ao atraso, outros estudos apontam que as crianças mais prováveis de completarem o esquema vacinal são aquelas de menor idade, 13,14 o que está em consonância com este trabalho. A não vacinação dos filhos de idade superior pode talvez ser justificada pela ARTIGO condição de concorrência entre irmãos mais velhos em busca do cuidado parental limitado ou pela insuficiência quanto a recursos para abastecer o número de crianças no domicílio.…”