Vaccination coverage, vaccine hesitancy and factors associated with incomplete vaccination: a household survey conducted with children born between 2017 and 2018 in the inland municipalities of Northeastern Brazil

Epidemiol Serv Saude. 2025 Jan 10;33(spe2):e20231224. doi: 10.1590/S2237-96222024v33e20231224.especial2.en. eCollection 2025.
[Article in English, Portuguese]

Abstract

Objective: To analyze vaccination coverage and factors associated with incomplete vaccination in inland municipalities of Northeastern Brazil.

Methods: This was a household survey using cluster sampling conducted in Vitória da Conquista, Bahia state, Caruaru, Pernambuco state, Sobral, Ceará state and Imperatriz, Maranhão state between 2020 and 2022. Vaccination coverage by valid doses and vaccine hesitancy were analyzed, with the odds ratio (OR) estimated and adjusted using logistic regression.

Results: Among 1,847 children, complete vaccination coverage was 49.2% (95%CI 43.9;54.5). Factors associated with incomplete vaccination included: higher income (OR 1.53; 95%CI 1.02;2.31), residence in Sobral (OR 4.35; 95%CI 3.04; 6.21) and >1 child (OR 1.20; 95%CI 1.11;1.32). Parental decision not to vaccinate and difficulties in traveling to vaccination centers contributed to vaccine hesitancy.

Conclusion: Low vaccination coverage and incomplete vaccination were associated with social issues in the socioeconomic strata analyzed.

MeSH terms

  • Adult
  • Brazil
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • Humans
  • Infant
  • Logistic Models
  • Male
  • Parents* / psychology
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Vaccination Coverage* / statistics & numerical data
  • Vaccination Hesitancy* / psychology
  • Vaccination Hesitancy* / statistics & numerical data
  • Vaccination* / psychology
  • Vaccination* / statistics & numerical data