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

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.

Cobertura de doses da vacina contra HPV e variação por nível de privação material dos municípios brasileiros, 2012 a 2018

“…Condições socioeconômicas e demográficas impactam diretamente na adesão e cobertura vacinal, com municípios com melhores indicadores sociais apresentando maiores coberturas (Queiroz et al, 2021). Os achados do presente estudo reforçam esta evidência, uma vez que os quintis de privação dos municípios observados, apresentaram uma média de doses aplicadas mais prevalentes em unidades federativas mais desenvolvidas em comparação àquelas em situação de vulnerabilidade social.…”

Spatial behavior of hepatitis A, MMR, and varicella vaccination coverage in the state of Minas Gerais, 2020

“…Regional coverage variations are also found in Brazil and other countries. Such differences result from significant geographic, social, and cultural discrepancies between and within regions 16,[46][47][48][49][50] . Brazil and Minas Gerais, for example, have large territories with unequal socioeconomic effects among their population groups 51 .…”

Comportamento espacial da cobertura vacinal de hepatite A, tríplice viral e varicela no estado de Minas Gerais, 2020

“…Variações regionais nas coberturas também são observadas no Brasil e em outros países, e tais diferenças se devem às grandes discrepâncias geográficas, sociais e culturais entre e dentro das regiões 16,[46][47][48][49][50] . O Brasil e o estado de Minas Gerais, por exemplo, compreendem grandes dimensões territoriais que têm efeitos socioeconômicos desiguais entre os grupos populacionais 51 .…”