Participação em dias nacionais de vacinação contra poliomielite: resultados de inquérito de cobertura vacinal em crianças nas 27 capitais brasileiras

Abstract

In Brazil, National Immunization Days (NIDs) are held twice a year to maintain the elimination of poliomyelitis and to provide routine immunization for children younger than five years of age. Few studies have examined factors associated with participation in National Immunization Days among Brazilian children, or the contribution of immunization days to the coverage of recommended vaccines. Methods: We conducted a household cluster survey in 26 state capitals and the Federal District among children aged 19 to 35 months. Vaccination histories, including dates of vaccination, participation in the most recent NID or reasons for non-participation were obtained. Survey estimates were compared with official estimates based on doses administered. Results: Among the 17,749 children surveyed, 16,213 (91%) participated in the most recent NID. Children who received vaccination in the private sector had the lowest participation (84%) in NIDs. In 13 capitals, official coverage estimates were higher than those from the survey. The main reasons given for non-participation the most recent NID included parent's decision not to participate, doctor's advice, child's illness, and factors associated with the organization of the NID. Overall, 15% of the children surveyed had received at least one immunization in addition to oral polio vaccine in the most recent NID, including yellow fever, hepatitis B, measles-mumps-rubella (MMR) and combined diphtheria-tetanus-pertussisHaemophilus influenzae type b vaccines. Conclusions: In Brazilian capitals, National Immunization Days continue to enjoy high levels of acceptance by the population and offer opportunities to complete recommended immunization schedules. Reasons for non-participation suggest the need for different communication strategies to reach parents who do not bring their children for vaccination on NIDs. Keywords:Poliomyelitis. Healthcare surveys. Mass vaccination. Immunization programs. IntroductionNational Immunization Days (NIDs) are considered essential strategies for polio eradication, to reach children who are not covered by routine vaccination programs, as well as to maintain the necessary visibility and political commitment for eradication. [1,2] In 1980, Brazil implemented National Immunization Days against infantile paralysis as part of the long-term strategy to eliminate poliomyelitis [3]. The initial objective was to achieve high coverage to interrupt transmission of poliovirus, with an established target of vaccinating 95% of children younger than five years with oral poliovirus vaccine. Following the identification of the last confirmed case of poliomyelitis in Brazil in 1989 and the certification of elimination of poliomyelitis from the Americas in 1994, [4] two NIDs per year were maintained to ensure high levels of protection against poliomyelitis while polioviruses circulated in other parts of the world. Currently, with high coverage in the routine immunization program and many years without cases of infantile paralysis, the National Immunization Progra...

Socioeconomic inequalities and vaccination coverage: results of an immunisation coverage survey in 27 Brazilian capitals, 2007–2008

“…Children who do not participate in national immunisation days may miss opportunities to receive vaccines besides OPV offered on these days. 24 Paradoxically, parents in Brazilian capitals with the economic means to provide their children with vaccines not included in the national immunisation programme may feel that their children receive too many injections already or that exposure to too many antigens at once may weaken the immune system, attitudes that have been reported from the USA. 21 Higher birth order and less maternal education have been associated with not receiving recommended immunisations in other countries.…”

Profile of the adults registered in a microarea of the Family Health Strategy/Perfil vacinal de adultos cadastrados em uma microárea da Estratégia Saúde da Família/Perfil de la vacuna de los adultos registrados en una zona micro de la Estrategia de Salud

“…No entanto, atitudes como conhecimentos inadequados, boatos, não indicação dos profissionais da saúde, reações adversas, dentre outros, estão entre os principais vilões que impedem a imunização dos usuários (15) . (1,16) . As demais vacinas também estão disponíveis de forma gratuita, porém os resultados quanto à adesão não oferecem tanto impacto quanto aquelas divulgadas em campanhas.…”

Panorama da cobertura vacinal brasileira com enfoque no município de Jataí, Goiás entre 2011 e 2015

“…Neste quesito, a CV pelo Sistema de Informação (SI) pode revelar falhas, induzindo que a CV seja baixa e não atinge a meta estabelecida. 10 12,13 O PNI possui um importante papel no controle e prevenção das doenças ao adotar medidas de CV como: a vacinação de rotina, as campanhas periódicas e o impacto da vigilância epidemiológica. A CV possui dois aspectos: individuais -produção de reação imunológica protetora ao indivíduo; coletivos -reduzem e eliminam as alterações de doenças na população.…”