Avaliação da cobertura vacinal no Brasil: um estudo de série temporal de 2000 a 2022

Abstract

The mission of the National Immunization Program is based on the control and eradication of preventable diseases. Insufficient campaigns and declining vaccination coverage can increase the burden of endemic infectious diseases and the risk of resurgence of eliminated pathogens. In view of this, this study aims to assess vaccination coverage in Brazil, based on the time series from 2000 to 2022. This is a national population-based ecological study of a quantitative nature with a temporal component. We used the vaccination coverage of the immunobiological available in the National Immunization Calendar, of people aged 0 to over 60 in Brazil and its regions, from 2000 to 2022. The data was obtained from the Department of Informatics of the Unified Health System of the Ministry of Health, collected from February to May 2023. The dependent variables used were vaccination coverage and immunobiological, while the independent variables were Brazilian regions, states, years and age group under one year. The data was analyzed using Excel 2016 for Windows, Joinpoint Regression Program and Power Business Intelligence. The results show that overall vaccination coverage of the Brazilian population was above 80% in 2001, 2004, 2011, 2014 and 2015, and that there has been a considerable decline since 2016, with the lowest rates recorded in 2016 and 2021. In the temporal analysis, the states of the North, Northeast and Southeast have the lowest overall average vaccination coverage rates for the period. In addition, the linear regression showed four temporal variations with line segments to explain the autocorrelation, showing equivalent breakpoints in the periods 2013-2016, 2016-2019 and 2019-2022, following a decreasing, increasing, and decreasing order. The Northern region shows a statistically significant negative variation in the 2019-2022 segment, confirming the downward trend. About immunobiological for children under two years of age, in the aggregate of the period evaluated, there is a profile below 80% of vaccination coverage in relation to rotavirus, meningococcal C, hepatitis A, triple viral second dose and vaccine against mumps, measles, rubella and varicella. The highest coverage rates were for Tuberculosis, Polio and against mumps, masles and rubella vaccines. However, the other immunizations analyzed also show a pattern of low coverage (less than 90%), failing to meet the targets recommended by the Ministry of Health. States in the North lead the way with the lowest immunization rates for children under two years of age. In the regions of Brazil, high rates of vaccination coverage were identified in 2015 in the Northeast, especially in the states of Ceara and Pernambuco. The importance of the strategy of systematic updating of health professionals, training in information systems, as well as the microplanning of high-quality vaccination activities of the routine program, intensification and campaigns is essential for all stages of vaccination to be carried out properly and safely.