RESUMO
OBJECTIVE: The national vaccination coverage survey on full vaccination at 12 and 24 months of age was carried out to investigate drops in coverage as of 2016. METHODS: A sample of 37,836 live births from the 2017 or 2018 cohorts living in capital cities, the Federal District, and 12 inner cities with 100 thousand inhabitants were followed for the first 24 months through vaccine record cards. Census tracts stratified according to socioeconomic levels had the same number of children included in each stratum. Coverage for each vaccine, full vaccination at 12 and 24 months and number of doses administered, valid and timely, were calculated. Family, maternal and child factors associated with coverage were surveyed. The reasons for not vaccinating analyzed were: medical contraindications, access difficulties, problems with the program, and vaccine hesitancy. RESULTS: Preliminary results showed that less than 1% of children were not vaccinated, full coverage was less than 75% at all capitals and the Federal District, vaccines requiring more than one dose progressively lost coverage, and there were inequalities among socioeconomic strata, favorable to the highest level in some cities and to the lowest in others. CONCLUSION: There was an actual reduction in full vaccination in all capitals and the Federal District for children born in 2017 and 2018, showing a deteriorating implementation of the National Immunization Program from 2017 to 2019. The survey did not measure the impacts of the COVID-19 pandemic, which may have further reduced vaccination coverage.
Assuntos
COVID-19 , Cobertura Vacinal , Vacinas , Criança , Humanos , Lactente , Brasil , Pandemias , VacinaçãoRESUMO
Objetivo: estimar as chances de adoecimento por coqueluche segundo número de doses de vacinas Pertussis administradas e idade, no Brasil. Métodos: estudo de caso-controle utilizando dados do Sistema de Informação de Agravos de Notificação (Sinan) no período 2007-2011; considerou-se como casos aqueles notificados com coqueluche confirmada, e como controles, aqueles descartados; foram calculadas as odds ratio (OR) e respectivos intervalos de confiança de 95 por cento (IC95 por cento). Resultados: foram incluídos 5.389 casos e 10.689 controles; entre 7-12 meses de idade, a chance de adoecimento foi maior com 1 dose administrada [OR:2,1(IC95 por cento:1,3-3,4)], comparativamente às 3 doses esperadas; entre 1-3 anos, essa chance foi maior sem reforço vacinal [OR 1 dose: 2,4(IC95 por cento:1,6-3,8); OR 2 doses:3,6(IC95 por cento:2,2-6,1); OR 3 doses:1,6(IC95 por cento:1,3-2,2); OR Ø dose:2,8(IC95 por cento:1,7-4,8)], quando este era esperado; entre 7-15 anos, foi maior com 1 reforço [OR:1,6(IC95 por cento:1,2-2,3)], quando 2 eram esperados. Conclusão: o esquema vacinal incompleto aumenta as chances de adoecimento por coqueluche em todas as idades estudadas.
Objective: estimate the likelihood of pertussis according to number of vaccine doses received and age. Methods: Case-control study using 2007-2011 SINAN data. "Cases" were considered to be confirmed reported pertussis cases. "Controls" were the discarded cases. Results: 5,389 cases and 10,689 controls were included. In those aged 7-12 months, cases were twice as likely [OR:2.1 (95 per cent CI: 1.3-3.4)] when only 1 instead of 3 doses had been administered. In 1-3 year--olds, likelihood was greater in those not having boosters (1 booster expected) [OR 1 dose: 2.4 (95 per cent CI:1.6-3.8); OR 2 doses: 3.6 (95 per cent CI: 2.2-6.1); OR 3 doses: 1.6 (95 per cent CI:1.3-2.2); OR Ø dose: 2.8 (95 per cent CI:1.7-4.8)]. In 7-15 year-olds, cases were 60 per cent more likely in those having had 1 booster instead of 2 [OR:1.6 (95 per cent CI:1.2-2.3)]. Conclusion: incomplete immunization increases likelihood of contracting pertussis in all age groups studied, mainly 7-15 years.
