Vaccine uptake and associated factors in an irregular urban settlement in northeastern Brazil: a cross-sectional study

Abstract

<jats:title>Abstract</jats:title> <jats:p><jats:bold><jats:italic>Background: </jats:italic></jats:bold>Globally, childhood immunization saves the lives of 2-3 million children annually by protecting them against vaccine-preventable diseases. In 2017, 116.2 million children were vaccinated worldwide according to the World Health Organization. Nevertheless, figures suggest that 19.5 million children around the world fail to receive the benefits of complete immunization.<jats:bold><jats:italic>Methods:</jats:italic></jats:bold> This cross-sectional study analyzed vaccine uptake and the factors associated with incomplete vaccination schedule in children of up to 36 months of age assisted by the family health strategy in an irregular settlement located in a state capital city in northeastern Brazil. This study was nested within a larger study entitled “Health, nutrition and healthcare services in an urban slum population in Recife, Pernambuco”, conducted in 2015. A census included 309 children, with vaccination data obtained, exclusively, from their vaccination cards records. An <jats:italic>ad hoc </jats:italic>database was constructed with variables of interest. Absolute and relative values were calculated for the socioeconomic, demographic, obstetric and biological data. To identify possible factors associated with incomplete vaccination schedule, crude and multivariable Poisson regression analyses were performed, and conducted in accordance with the forward selection method with robust variance and the adjusted prevalence ratio was calculated with the 95% CI. Variables with p-values &lt;0.20 in the unadjusted stage were included in the multivariable analysis. The statistical significance of each variable was evaluated using the Wald test, with p-values &lt;0.05. <jats:bold><jats:italic>Results:</jats:italic></jats:bold> Just half of the children (52,1%) was classified as complete vaccination schedule. In the final model, the factors associated with incomplete vaccination schedule were age 12-36 months and the mother who did not complete high school.<jats:bold><jats:italic>Conclusion:</jats:italic></jats:bold> The percentage of vaccine uptake found was far below the recommendation of the National Childhood Immunization Schedule and was associated with child’s age and mother’s education level. Based on these findings, the family healthcare teams may elaborate vaccination strategies aimed at reaching the coverage rates established by the national immunization program. Optimizing coverage will ultimately prevent the resurgence, at epidemic level, of infectious diseases that are already under control in this country.</jats:p>

Estudos sobre a Caderneta da Criança no Brasil: uma revisão de escopo

“…The main scenario of the studies is PHC (58.2%; n = 71) 7 , 11 , 12 , 16 , 17 , 20 , 22 . About one-third of the studies were carried out in UBS (32.5%; n= 38) 20 , 22 , 23 , 25 , 26 , 28 , 29 , 36 , 42 , 46 , 50 , 57 , 62 , 68 , 75 ( Table 2 ).…”

“…O principal cenário dos estudos é a APS (58,2%; n = 71) 7 , 11 , 12 , 16 , 17 , 20 , 22 . Cerca de 1/3 dos estudos foram realizados em UBS (32,5%; n = 38) 20 , 22 , 23 , 25 , 26 , 28 , 29 , 36 , 42 , 46 , 50 , 57 , 62 , 68 , 75 ( Tabela 2 ).…”

“…Thirty-seven studies (28.7%) 20,26,30,31,[37][38][39][40][41][42][43]47,48,56,58,64,69,70,[73][74][75]100,102,[104][105][106][107]110,111,[114][115][116]120,123,124,126,134 used the terminologies "vaccine card", "vaccination card", "vaccination handbook", "vaccine handbook", and "vaccination record", while those adopted by the MoH were "Child Card", "CHH" or "CH" (Table 2). In 41.9% (n = 54) 20,26,30-32,37-43,45,47-49,52,55,56,58,61,64,66,69-72,74-76, 78,102-108,110,111,114-121, 123-126,134,136 of the cases, the authors did explicitly state that the instrument used referred to the MoH's CH (Table 2).…”

“…The main scenario of the studies is PHC (58.2%; n = 71) 7,11,12,16,17,20,[22][23][24][25][26][27][28][29][30][33][34][35][36]40,42,44,46,50,53,57,[60][61][62][63]65,68,73,[75][76][77][78]80,81,[83][84][85][87][88][89][90][91][92][93][94][96][97][98]…”

Vaccination coverage in children under one year of age and associated socioeconomic factors: maps of spatial heterogeneity

“…Low vaccination coverage is often related to geographic conditions and a population's socioeconomic status (1,(15)(16)(38)(39) ; structural conditions and supply and access to health services (6,16,18,38) ; lack of knowledge of strategies recommended by the immunization program (38,(40)(41) ; fake news about vaccines (5) ; vaccine hesitancy (5,18) ; and more recently the COVID-19 pandemic (19)(20)31) . The latter has exacerbated pre-existing health inequalities, exposing social inequalities, discrimination and health gradients in human populations between and within countries (12,31,42) .…”