Objective: To estimate vaccination coverage and analyze sociodemographic factors associated with non-vaccination in children born in 2017 and 2018 in the state capitals of Northeast Brazil.
Methods: A household survey using cluster sampling was conducted from 2020-2022 to estimate vaccination coverage and hesitancy. Factors associated with non-vaccination were analyzed using logistic regression to calculate Odds Ratios (OR) and their Confidence Intervals (95%CI).
Results: Natal was the capital with the lowest vaccination coverage, below 75.0% for most immunizers. Teresina had rates equal to or greater than 90.0% for all vaccines. Among those interviewed, 99.1% (95%CI 98.9;99.3) believe that vaccines are important for health; 95.4% (95%CI 95.0;95.8) trust immunobiologicals and 79.6% (95%CI% 78.8;80.3) are not afraid of reactions. Belonging to the highest socioeconomic stratum (adjusted OR: 1.34 - 95%CI 1.20;1.50) was as a factor associated with non-vaccination.
Conclusion: Low coverage highlights the need for a better understanding of regional specificities and social inequalities.
Objetivo: Estimar cobertura vacunal, analizar factores sociodemográficos asociados a la no vacunación en niños nacidos vivos en 2017/2018 en capitales del noreste de Brasil.
Métodos: Se realizó encuesta de hogares con muestreo por conglomerados, entre 2020/ 2022, para estimar cobertura y reticencias a vacunarse. Factores asociados a bajas coberturas de vacunación se analizaron mediante regresión logística calculando los odds ratios (OR) y sus intervalos de confianza (IC del 95%).
Resultados: La capital con menor cobertura de vacunación: Natal, con < 75,0% para la mayoría de inmunizadores; Teresina presentó cobertura ≥ 90,0% en todos inmunizadores. 99,1% (IC95% 98,9%;99,3%) cree que vacunas son importantes para la salud; 95,4% (IC95% 95,0%;95,8%) confía en los inmunobiológicos distribuidos por gobierno y 79,6% (IC95% 78,8%;80,3%) no teme reacciones. Ser residente en zona de mayor estrato socioeconómico (Orajustado:1,34 - IC95% 1,20;1,50) se identificó como factor asociado a no vacunación.
Conclusión: Bajas coberturas destacan la necesidad de comprender mejor las especificidades regionales y desigualdades sociales.
Main results: Three northeastern capitals achieved targets for just two or three vaccines. The majority of interviewees expressed favorable opinions regarding the National Immunization Program. However, a third of those interviewed reported that they had sought vaccination but had been unable to vaccinate their children.
Implications for services: Rethinking immunization strategies in the Brazilian National Health System, to adapt them to regional contexts. Operational obstacles related to the supply of vaccines require special attention, in addition to integrated health communication and education actions.
Perspectives: Understanding the regional specificities presented will support the National Immunization Program in implementing strategies contextualized to territories, via microplanning of vaccination actions, to recover vaccination coverage.