Foto: Fernando Frazão/Agência Brasil

Article published on October 4, 2020

According to data from the National Immunization Program (PNI), none of the nine mandatory vaccines for children up to one year of age managed to reach the vaccination target in Brazil in 2019. Research commissioned and funded by the Ministry of Health can help to understand the reasons the drop in vaccination coverage in recent years. The study is coordinated by the Institute of Collective Health of the Federal University of Bahia (ISC / UFBA) in Salvador and three other capitals: São Paulo, Goiânia and Manaus.

The research “Studies on Vaccine Coverage of Children born in 2017 in Brazilian Capitals  assesses the coverage of all childhood vaccines that are part of the National Vaccination Calendar. In Salvador, the goal is to collect data from 2,000 children within 60 days. To date, about 200 families have participated in the study.

“The irregularity of vaccination coverage has shown the resurgence of some immunopreventable diseases in our country, such as measles, in addition to increasing the risk for other diseases such as polio (childhood paralysis), rubella and diphtheria”, warns Professor Glória Teixeira, who coordinates the study by ISC.

Researchers use protective equipment during interviews

The household survey covers several neighborhoods in the capital of Bahia and is carried out by a specialized company under the supervision of the Institute. During the interviews, the parents / guardians answer a questionnaire about the vaccines already applied to the child and the reason for the absence of those that have not yet been carried out. Interviewers also photograph the Vaccination Card to record the data collected.

The study started in March this year, before the Covid-19 pandemic, and resumed last week, with the adoption of protective measures for the professionals and people interviewed. During home visits, all interviewers use masks, facial protectors and follow the sanitary hygiene protocol.

Concerning data

In 2019, 85.1% of Brazilian children received a dose of BCG, a vaccine that protects newborns against tuberculosis. It was the first time in 25 years that adherence to the vaccine was below the 90% target in Brazil. The data collected are from the National Immunization Program (PNI) of the Ministry of Health.

“The drop in vaccination coverage may be related to several factors, such as difficulty in accessing vaccination rooms, the impossibility of parents or caregivers to seek health services on weekdays, or even the refusal of those responsible for the child to vaccinate them. ”, Observes Professor Glória Teixeira.

The survey also points out that 75.7% of Bahian children received the vaccine last year, also below the target of 90%. In ten years, BCG’s coverage drop was 29% in Bahia (2009-2019). In Salvador, only 69.1% of children received the dose in 2019. In the last ten years, the drop in BCG coverage in the municipality reaches 40% (2009-2019).

The goals were also not achieved in any of the other vaccines in the basic calendar (Rotavirus, Meningococcal C, Pentavalent, Pneumococcal, Poliomyelitis, Yellow Fever, Triple Viral and Hepatitis A). In Bahia and Salvador, the lowest adherence was registered in relation to Yellow Fever: 64.8% of children received the vaccine in the state; in the municipality, 60.75%. However, the target for this vaccine is 100% according to the Ministry of Health.

“Until 2015, the average coverage of the main vaccines indicated to children was above the target. In the following years, this percentage has been decreasing gradually throughout the country, including in the state of Bahia and in the municipality of Salvador ”, highlights Ramon Saavedra, researcher at ISC / UFBA.

According to him, the rates of vaccination coverage reflect, directly or indirectly, the population’s adherence to the regular vaccination program, the existence of people living at risk of preventable diseases, in addition to the effectiveness of the services.

“This monitoring represents an important planning, analysis and evaluation instrument, and it must be implemented on an ongoing basis in order to instrumentalize decision making at different levels of management”, he concludes.