How to overcome the stagnation of the first dose vaccine coverage curve against coronavirus disease 2019 in Brazil?

Guimarães, Raphael Mendonça; Xavier, Diego Ricardo; Saldanha, Raphael de Freitas; Magalhães, Mônica de Avelar Figueiredo Mafra

doi:10.1590/0037-8682-0722-2021

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Revista da Sociedade Brasileira de Medicina Tropical

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Short Communication • Rev. Soc. Bras. Med. Trop. 55 • 2022 • https://doi.org/10.1590/0037-8682-0722-2021 copy

How to overcome the stagnation of the first dose vaccine coverage curve against coronavirus disease 2019 in Brazil?

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Background:

A large percentage of the population has not yet started vaccination, for which the increase in coverage is almost null.

Methods:

We used segmented regression analysis to estimate trends in the first dose coverage curve.

Results:

There has been a slowdown in the application of the first doses in Brazil since epidemiological week 36 (average percent change [APC] 0.83%, 95% confidence interval [CI] 0.75-0.91%), with a trend close to stagnation.

Conclusions:

It is important to develop strategies to increase access to vaccination posts. Furthermore, it is recommended to expand vaccination to children, thereby increasing the eligible population.

Keywords:
Vaccination; COVID-19; Spatial analysis; Health management; Coronavirus infections; Time series analysis

FU^a	Vaccine coverage		Target^b	D1 - D2^c	Joinpoint (1^st dose)
	1^st dose	2^nd dose			Period (EW^d)	APC^e (%)	95% CI^f	P-value
Acre	61.82	45.66	79.67	16.16	3 to 22	0.83	0.77-0.89	<0.001
					22 to 27	3.89	3.26-4.52	<0.001
					27 to 35	2.35	2.17-2.53	<0.001
					37 to 47	0.49	0.33-0.65	<0.001
Alagoas	69.26	52.08	83.23	17.18	3 to 10	0.39	0.08-0.70	0.024
					10 to 23	1.48	1.34-1.62	<0.001
					23 to 39	2.50	2.40-2.60	<0.001
					39 to 47	0.87	0.62-1.12	<0.001
Amazonas	62.82	48.49	79.13	14.33	3 to 22	0.93	0.89-0.97	<0.001
					22 to 27	4.07	3.58-4.56	<0.001
					27 to 37	1.93	1.79-2.07	<0.001
					37 to 47	0.46	0.34-0.58	<0.001
Bahia	71.36	54.14	84.95	17.22	3 to 9	0.44	0.07-0.81	0.029
					9 to 25	1.65	1.55-1.75	<0.001
					25 to 38	2.72	2.58-2.86	<0.001
					38 to 47	0.75	0.55-0.95	<0.001
Amapá	57.37	36.72	79.85	20.65	3 to 11	0.46	0.30-0.62	<0.001
					11 to 24	1.04	0.96-1.12	<0.001
					24 to 36	2.71	2.61-2.81	<0.001
					36 to 47	0.71	0.61-0.81	<0.001
Ceará	73.39	62.57	84.54	10.82	3 to 9	0.57	-0.04-1.18	0.081
					9 to 21	1.23	0.99-1.47	<0.001
					21 to 38	2.78	2.64-2.92	<0.001
					38 to 47	0.85	0.52-1.18	<0.001
Distrito Federal	73.76	63.38	85.94	10.38	3 to 9	1.02	0.90-1.14	<0.001
					9 to 30	2.32	2.10-2.54	<0.001
					30 to 33	7.72	4.88-10.56	<0.001
					33 to 47	0.76	0.62-0.90	<0.001
Espírito Santo	74.73	62.75	84.67	11.98	3 to 10	0.44	0.05-0.83	0.034
					10 to 20	1.85	1.60-2.10	<0.001
					20 to 38	2.65	2.55-2.75	<0.001
					38 to 47	0.60	0.35-0.85	<0.001
Goiás	71.97	55.22	84.14	16.75	3 to 12	0.53	0.37-0.69	<0.001
					12 to 22	1.59	1.43-1.75	<0.001
					22 to 38	2.81	2.73-2.89	<0.001
					38 to 47	0.71	0.55-0.87	<0.001
Maranhão	61.62	46.61	81.99	15.01	3 to 21	0.98	0.88-1.08	<0.001
					21 to 25	3.94	2.51-5.37	<0.001
					25 to 37	1.97	1.79-2.15	<0.001
					37 to 47	0.71	0.49-0.93	<0.001
Mato Grosso	70.75	54.76	82.92	15.99	3 to 11	0.37	0.21-0.53	<0.001
					11 to 23	1.34	1.24-1.44	<0.001
					23 to 36	3.06	2.98-3.14	<0.001
					36 to 47	1.13	1.03-1.23	<0.001
Mato Grosso do Sul	71.24	69.81	83.12	1.43	3 to 11	0.62	0.35-0.89	<0.001
					11 to 31	2.34	2.26-2.42	<0.001
					31 to 34	4.08	1.51-6.65	0.003
					34 to 47	0.43	0.29-0.57	<0.001
Minas Gerais	76.46	63.89	86.39	12.57	3 to 11	0.53	0.37-0.69	<0.001
					11 to 24	1.79	1.71-1.87	<0.001
					24 to 37	3.09	3.01-3.17	<0.001
					37 to 47	0.95	0.83-1.07	<0.001
Pará	60.19	39.89	81.89	20.3	3 to 22	0.98	0.88-1.08	<0.001
					22 to 25	3.68	0.01-7.35	0.057
					25 to 42	1.73	1.59-1.87	<0.001
					42 to 47	0.57	-0.25-1.39	0.186
Paraíba	75.45	58.47	84.86	16.98	3 to 9	0.58	0.19-0.97	0.007
					9 to 25	1.52	1.42-1.62	<0.001
					25 to 36	3.34	3.16-3.52	<0.001
					36 to 47	1.05	0.89-1.21	<0.001
Paraná	77.08	65.79	85.22	11.29	3 to 10	0.46	0.22-0.70	<0.001
					10 to 21	1.61	1.47-1.75	<0.001
					21 to 35	3.18	3.08-3.28	<0.001
					35 to 47	0.97	0.87-1.07	<0.001
Pernambuco	74.00	58.44	84.23	15.56	3 to 9	0.50	0.25-0.75	<0.001
					9 to 21	1.28	1.18-1.38	<0.001
					21 to 37	2.82	2.76-2.88	<0.001
					37 to 47	1.08	0.96-1.20	<0.001
Piauí	74.87	58.40	84.19	16.47	3 to 10	0.46	0.17-0.75	<0.001
					10 to 22	1.36	1.20-1.52	<0.001
					22 to 37	2.75	2.65-2.85	<0.001
					37 to 47	1.50	1.32-1.68	<0.001
Rio de Janeiro	74.15	60.15	86.00	14.00	3 to 11	0.54	0.36-0.72	<0.001
					11 to 20	1.41	1.23-1.59	<0.001
					20 to 38	2.84	2.78-2.90	<0.001
					38 to 47	0.71	0.57-0.85	<0.001
Rio Grande do Norte	72.34	59.97	85.13	12.37	3 to 10	0.46	0.19-0.73	0.003
					10 to 22	1.47	1.31-1.59	<0.001
					22 to 37	2.96	2.86-3.06	<0.001
					37 to 47	0.73	0.57-0.89	<0.001
Rio Grande do Sul	72.27	67.94	86.56	9.33	3 to 11	0.62	0.37-0.87	<0.001
					11 to 24	2.05	1.93-2.17	<0.001
					24 to 33	3.06	2.94-3.18	<0.001
					33 to 47	0.92	0.82-1.02	0.001
Rondônia	66.43	52.90	83.25	13.53	3 to 11	0.47	0.29-0.65	0.002
					11 to 22	1.01	0.87-1.15	<0.001
					22 to 36	3.23	3.15-3.31	<0.001
					36 to 47	0.59	0.47-0.71	<0.001
Roraima	55.61	38.45	80.35	17.16	3 to 22	0.70	0.64-0.76	<0.001
					22 to 30	2.74	2.47-3.01	<0.001
					30 to 38	1.78	1.51-2.05	<0.001
					38 to 47	0.70	0.52-0.88	<0.001
São Paulo	81.41	74.80	85.69	6.61	3 to 13	0.96	0.82-1.10	<0.001
					13 to 22	1.86	1.66-2.06	<0.001
					22 to 35	3.88	3.78-3.98	<0.001
					35 to 47	0.47	0.37-0.57	<0.001
Santa Catarina	78.14	67.39	85.68	10.75	3 to 10	0.47	0.20-0.74	0.001
					10 to 21	1.65	1.49-1.81	<0.001
					21 to 36	3.11	3.01-3.21	<0.001
					36 to 47	0.99	0.85-1.13	<0.001
Sergipe	73.04	60.40	83.96	12.64	3 to 9	0.37	-0.04-0.78	0.09
					9 to 21	1.40	-0.17-2.97	<0.001
					21 to 38	2.89	2.79-2.99	<0.001
					38 to 47	0.54	0.32-0.76	<0.001
Tocantins	65.07	49.47	82.80	15.6	3 to 11	0.48	0.34-0.62	<0.001
					11 to 22	1.23	1.13-1.33	<0.001
					22 to 38	2.70	2.66-2.74	<0.001
					38 to 47	0.54	0.42-0.66	<0.001
Brazil	74.42	62.20	84.86	12.22	3 to 10	0.53	0.37-0.69	<0.001
					10 to 22	1.59	1.51-1.67	<0.001
					22 to 36	3.07	3.01-3.13	<0.001
					36 to 47	0.83	0.75-0.91	<0.001

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[1] Corresponding author: Dr. Raphael Mendonça Guimarães. e-mail: raphael.guimaraes@fiocruz.br