Subpopulações com maior risco de agravamento da COVID-19 e adesão ao esquema vacinal completo: estudo transversal e investigativo das associações existentes

Abstract

INTRODUCTION: The COVID-19 pandemic had significant impacts, highlighting a high prevalence of comorbidities in deaths in Brazil. Additionally, individuals aged 60 years and older, those with permanent disabilities, institutionalized individuals, healthcare professionals, pregnant women, and postpartum women showed higher fatality rates. Despite efforts to promote vaccination, persistent challenges such as limited access and vaccine hesitancy persist. OBJECTIVE: To compare adherence to the complete COVID-19 vaccination schedule (EVCR) among the population considered at higher risk of disease severity and those who do not fit this profile. METHODOLOGY: A cross-sectional study involving Brazilian residents from all regions, including traditional communities (quilombolas, indigenous, and riverside populations), aged 18 years or older. This study is a subset of a master's thesis, using a digital questionnaire (ADHERE) to identify barriers and facilitators to adherence to preventive measures and control of respiratory infectious diseases - ADHERE. Before this questionnaire, participants answered twenty-five questions covering personal, socioeconomic, demographic, health conditions, and vaccination schedule characteristics. These questions allowed sample characterization and assessed the sample's adherence to the recommended complete COVID-19 vaccination schedule. For the analyses, participants were grouped into five categories: the group at higher risk of COVID-19 severity (GER) and the group outside the risk of COVID-19 severity (GFR) (Risk analysis); the group with comorbidities (GC) and the group without comorbidities (GSC) (Comorbidities and C2 analyses); the special health group (GES) and the group not belonging to a special health condition (NPGES) (Special and E2 analyses). Statistical analysis used the chi-square test (χ2) in the Jamovi software (Version 2.3). RESULTS: A total of 1731 respondents participated in the study, aged 18 to 94 years (Md: 33 years; IQ25-75%: 25-44), predominantly women (74.41%) with higher education (80.40%), from the northeast region (52.11%). There was a significant association between GER and adherence to EVCR in the Risk analysis (p=0.044). In the Comorbidities and C2 analyses, no association between variables was evidenced. In the Special analysis, GES revealed a significant association with EVCR adherence (p=0.003), while E2 indicated low adherence among immunocompromised individuals and those living in long-term care facilities (ILPs). CONCLUSION: Being part of the risk group or special health group may be associated with vaccination schedule adherence. These results support the need for more targeted and sensitive vaccination policies tailored to the unique characteristics of certain groups, such as immunocompromised individuals and those living in long-term care facilities.