RESUMO
Este relato, em comemoração aos 20 anos do Boletim Epidemiológico Paulista (BEPA), apresenta a descrição das legislações estaduais que formalizaram os calendários de vacinações para o estado de São Paulo, obtidas em acervo do Diário Oficial do Estado (DOE) de São Paulo. A primeira publicação ocorreu em 1968, cujo exemplar se encontra na Divisão de Imunização/CVE. As publicações seguintes, de 1975, 1979 e 1984, são relacionadas a Deliberações do Secretário de Saúde e Conselho Técnico Administrativo (SS-CTA). A partir de 1988, as publicações são relacionadas como Resoluções do Secretário de Saúde (SS), com apoio técnico da Comissão Permanente de Assessoramento em Imunizações CPAI (criada em 1987, atuante até hoje). A trajetória oficializada mantém a importância de homogeneizar esquemas vacinais nos diferentes territórios para reduzir de forma sustentável e equitativa a morbidade e mortalidade dos agravos imunopreveníveis...(AU)
This report, in commemoration of the 20th anniversary of the São Paulo Epidemiological Bulletin (BEPA), presents a description of the state legislation that formalized the vaccination calendars for the state of São Paulo, obtained from the Official State Gazette (DOE) of São Paulo. The first publication occurred in 1968, a copy of which is in the Immunization Division/CVE, the following publications in 1975, 1979 and 1984 are related to Deliberations of the Secretary of Health and Administrative Technical Council (SS-CTA). From 1988 onwards, the publications are listed as Resolutions of the Secretary of Health (SS) with technical support from the Permanent Advisory Committee on Immunizations CPAI (created in 1987, still active today). The official trajectory maintains the importance of homogenizing vaccination schedules in different territories to sustainably and equitably reduce morbidity and mortality from vaccine-preventable diseases...(AU)
Assuntos
Brasil , Vacinação , Programas de Imunização , Legislação , SoroRESUMO
Background The state of São Paulo reports the highest number of tuberculosis cases in Brazil. We aimed to analyze the SARS-CoV-2 pandemic's impact on tuberculosis notifications and identify factors associated with reduced notifications and tuberculosis deaths in 20202021. Methods This retrospective cross-sectional study analyzed data from 126,649 patients with tuberculosis notified in São Paulo from 2016 to 2021. Interrupted time series analysis assessed the pandemic's impact on notifications. Descriptive statistics and logistic regressions identified factors associated with decreased tuberculosis notifications and deaths during the pandemic (20202021) compared to the pre-pandemic period (2019). Findings Tuberculosis notifications decreased by 10% and 8% in 2020 and 2021, espectively, with declines 23 times higher among individuals with no education or deprived of liberty. Contrastingly, tuberculosis notifications increased 68% among corrections workers in 2021. Diagnostics and contact tracing were compromised. Individuals with HIV, drug addiction, or deprived of liberty had lower odds of notification during the pandemic. Black and Pardo individuals or those with diabetes, treatment interruption history, or treatment changes post-adverse events had higher odds of notification. However, adverse events and tuberculosis-diabetes cases have been increasing since 2016. During the pandemic, tuberculosis-related deaths rose 5.0%12.7%. Risk factors for mortality remained similar to 2019, with Pardo ethnicity, drug addiction and re-treatment post-adverse events emerging as risk factors in 2020/2021. Interpretation The pandemic affected tuberculosis notifications and deaths differently among populations, exacerbating inequalities. Treatment interruption, loss of follow-up, and challenges in accessing healthcare led to increased mortality. (AU)