Temporal trend of the dropout rate and vaccination coverage of the triple viral vaccine in Brazil, 2014-2021

Abstract

Objective: to analyze the temporal trend of coverage and dropout rate for triple viral vaccine in Brazil, according to the country’s Federative Units and Macro-Regions, between 2014 and 2021. Methods: this was an ecological time series study, using data from the National Immunization Program Information System and the Live Birth Information System; joinpoint regression models were used. Results: in Brazil as a whole annual vaccination coverage was below 95% and ranged from 92.3% (2015) to 54.4% (2021); the second dose of the vaccine showed a decreasing temporal trend in the period (average change over the period = -5.8; 95%CI -10.5;-0.8); the temporal trends were stationary and decreasing in the country’s Federative Units; the dropout rate ranged from 22.2% (2014) to 37.4% (2021). Conclusion: there was a downward trend in vaccination coverage and an increase in the dropout rate in Brazil as a whole and in the country’s Federative Units.

Vaccination coverage and abandonment among children under two years old in Brazil: a time-series study

“…In this sense, a recent study that analyzed the MMR vaccine abandonment rate in Brazil according to regions of the country, from 2014 to 2021, corroborated the results found in the current research since, during the period investigated, the abandonment rate varied among the Federation Units that make up the Brazilian regions, ranging from 22.20% in 2014 to 37.40% in 2021. 7 Therefore, the abandonment rate is considered average, and investments are required to reduce it in the country. 6…”

“…In this sense, a recent study that analyzed the MMR vaccine abandonment rate in Brazil according to regions of the country, from 2014 to 2021, corroborated the results found in the current research since, during the period investigated, the abandonment rate varied among the Federation Units that make up the Brazilian regions, ranging from 22.20% in 2014 37.40% in 2021. 7 Therefore, the abandonment rate is considered average, and investments are required to reduce it in the country. 6 Some studies have pointed out the factors that contribute to the decrease in VC and the increase in the abandonment rate, such as fear of a post-vaccination reaction, lack of knowledge on the part of parents about the importance of vaccination and about the severity of vaccine-preventable diseases, the socioeconomic conditions and geographic characteristics of the population, the working conditions of the nursing professionals who work in vaccination rooms, dissemination of fake news about vaccines, an increase in anti-vaccination movements and false contraindications.…”

“… 4 , 5 Thus, the VC indicators, which show the number of doses administered and the abandonment rate, which estimates the population's adherence when considering the number of individuals that started and did not complete the regime, represent important instruments for monitoring diseases that are of interest for public health. 6 , 7 …”

“…4,5 Thus, the VC indicators, which show the number of doses administered and the abandonment rate, which estimates the population's adherence when considering the number of individuals that started and did not complete the regime, represent important instruments for monitoring diseases that are of interest for public health. 6,7 Nonetheless, in recent years, several countries presented reductions in infant VC rates, such as Mexico, Colombia, Paraguay, Venezuela, Jordan and also Brazil, which may directly reflect on the increase in morbidity and mortality, as children's vulnerability is increased, especially in those under two years old. [7][8][9][10][11][12][13][14] The decrease in vaccination coverage is a process that preceded the COVID-19 pandemic, but has intensified during this period throughout the country.…”

“…6,7 Nonetheless, in recent years, several countries presented reductions in infant VC rates, such as Mexico, Colombia, Paraguay, Venezuela, Jordan and also Brazil, which may directly reflect on the increase in morbidity and mortality, as children's vulnerability is increased, especially in those under two years old. [7][8][9][10][11][12][13][14] The decrease in vaccination coverage is a process that preceded the COVID-19 pandemic, but has intensified during this period throughout the country. However, it is also influenced by access to vaccination services and by availability of products.…”