Vaccination Coverage at Birth in Brazil: Spatial and Temporal Trends in the Impact of COVID-19 on Uptake of BCG and Hepatitis B Vaccines
Yan Mathias Alves,
Thaís Zamboni Berra,
Reginaldo Bazon Vaz Tavares,
Nathalia Zini,
Quézia Rosa Ferreira,
Licia Kellen de Almeida Andrade,
Ariela Fehr Tártaro,
Maria Eduarda Pagano Pelodan,
Beatriz Fornaziero Vigato,
Beatriz Kuroda Silveira,
Ana Luiza Brasileiro Nato Marques Assumpção,
Marcela Antunes Paschoal Popolin,
Patricia Abrahão Curvo,
Simone Protti-Zanatta,
Maria Del Pilar Serrano-Gallardo,
Ricardo Alexandre Arcêncio,
Pedro Fredemir Palha,
Jaqueline Garcia de Almeida Ballestero
Affiliations
Yan Mathias Alves
Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, São Paulo, Brazil
Thaís Zamboni Berra
Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, São Paulo, Brazil
Reginaldo Bazon Vaz Tavares
Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, São Paulo, Brazil
Nathalia Zini
Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, São Paulo, Brazil
Quézia Rosa Ferreira
Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, São Paulo, Brazil
Licia Kellen de Almeida Andrade
Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, São Paulo, Brazil
Ariela Fehr Tártaro
Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, São Paulo, Brazil
Maria Eduarda Pagano Pelodan
Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, São Paulo, Brazil
Beatriz Fornaziero Vigato
Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, São Paulo, Brazil
Beatriz Kuroda Silveira
Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, São Paulo, Brazil
Ana Luiza Brasileiro Nato Marques Assumpção
Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, São Paulo, Brazil
Marcela Antunes Paschoal Popolin
Nursing Department, Federal University of Tocantins, Palmas 77001-090, Tocantins, Brazil
Patricia Abrahão Curvo
Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, São Paulo, Brazil
Simone Protti-Zanatta
Nursing Department, Federal University of São Carlos, São Carlos 13565-905, São Paulo, Brazil
Maria Del Pilar Serrano-Gallardo
Nursing Department, Faculty of Medicine, Autonomous University of Madrid, 28029 Madrid, Spain
Ricardo Alexandre Arcêncio
Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, São Paulo, Brazil
Pedro Fredemir Palha
Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, São Paulo, Brazil
Jaqueline Garcia de Almeida Ballestero
Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, São Paulo, Brazil
Introduction: Vaccines are a significant public health achievement, which are crucial for child survival and disease control globally. In Brazil, the National Immunization Program (PNI) manages vaccination schedules, including essential vaccines like BCG and Hepatitis B, administered at birth. Despite achieving over 95% coverage for years, vaccination rates have declined since 2016, a trend exacerbated by the COVID-19 pandemic. This study aims to analyze spatial and temporal trends in BCG and Hepatitis B vaccination coverage at birth, identify areas with spatial variation in these trends, classify the identified trends, and investigate the pandemic’s impact on vaccination adherence. Methods: This is an ecological study with real-world data from Brazil, focusing on vaccination coverage from 2014 to 2023. Utilizing the Spatial Variation in Temporal Trends (SVTT) technique, the study identifies municipalities’ vaccination trends. It also employs time series analysis and Interrupted Time Series methods to evaluate the pandemic’s impact on vaccination rates, using data from the PNI and the Information System on Live Births (SINASC). Results: Between January 2014 and December 2023, Brazil administered 25,902,207 doses of the BCG vaccine to children at birth, with 3911 municipalities (70.24%) showing declining trends, particularly in Florianópolis. Similarly, 22,962,434 doses of the Hepatitis B vaccine were administered, with 3284 municipalities also experiencing declines. Conclusions: It is crucial that public health policies be reevaluated to address regional disparities in vaccination coverage, particularly in more vulnerable areas. Focused interventions, such as awareness campaigns, improved access to vaccination services, and strengthened monitoring, are fundamental to reversing this trend.