Desigualdades raciales en la vacunación infantil y obstáculos para la vacunación en Brazil entre nacidos vivos en 2017 y 2018: análisis de uma cohorte retrospectiva de los dos primeros años de vida

Boing, Antonio Fernando; Boing, Alexandra Crispim; França, Ana Paula; Moraes, José Cássio de; ,; Silva, Adriana Ilha da; Ramos Jr., Alberto Novaes; França, Ana Paula; Oliveira, Andrea de Nazaré Marvão; Boing, Antonio Fernando; Domingues, Carla Magda Allan Santos; Oliveira, Consuelo Silva de; Maciel, Ethel Leonor Noia; Guibu, Ione Aquemi; Mirabal, Isabelle Ribeiro Barbosa; Barbosa, Jaqueline Caracas; Lima, Jaqueline Costa; Moraes, José Cássio de; Luhm, Karin Regina; Caetano, Karlla Antonieta Amorim; Lima, Luisa Helena de Oliveira; Antunes, Maria Bernadete de Cerqueira; Teixeira, Maria da Gloria; Teixeira, Maria Denise de Castro; Borges, Maria Fernanda de Sousa Oliveira; Queiroz, Rejane Christine de Sousa; Gurgel, Ricardo Queiroz; Barata, Rita Barradas; Azevedo, Roberta Nogueira Calandrini de; Oliveira, Sandra Maria do Valle Leone de; Teles, Sheila Araújo; Gama, Silvana Granado Nogueira da; Mengue, Sotero Serrate; Simões, Taynãna César; Nascimento, Valdir; Araújo, Wildo Navegantes de

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Sumário

ORIGINAL ARTICLE • Epidemiol. Serv. Saúde 33 (spe2) • 2024 • https://doi.org/10.1590/S2237-96222024v33e20231216.especial2.en copiar

Desigualdades raciales en la vacunación infantil y obstáculos para la vacunación en Brazil entre nacidos vivos en 2017 y 2018: análisis de uma cohorte retrospectiva de los dos primeros años de vida

Autoría Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo

Describir completitud vacunal a tiempo en los primeros 24 meses de vida en Brasil y obstáculos para vacunar, evaluando asociaciones con etnicidad materna.

Métodos

Análisis de datos de nacidos en 2017 y 2018, participantes de la Encuesta Nacional de Cobertura Vacunal a lo largo de sus primeros 24 meses de vida. Verificación de prevalencia y los intervalos de confianza 95% de obstáculos vacunales y completitud a los cinco meses, primer y segundo año por color/raza materna. Se utilizó regresión logística para el análisis de asociaciones.

Resultados

Datos de 37.801 niños analizados. El 7,2% (IC₉₅% 6,3;8,2) enfrentó dificultades para vacunarse y el 23,4% (IC₉₅% 21,7; 25,1) no se vacunó incluso llevados. Estas cifras fueron 75% (IC₉₅% 1,25;2,45) y 97% (IC₉₅% 1,57;2,48) más altas entre madres negras. El 49,9% (IC₉₅% 47,8;51,9) y 61,1% (IC₉₅% 59,2;63,0) experimentaron retrasos vacunales a los cinco meses y al año, respectivamente, con tasas superiores en pardos/negros.

Conclusión

Desigualdades raciales en obstáculos y vacunación en Brasil.

Palabras clave
Cobertura de Vacunación; Niño; Inequidades en Salud; Encuestas Epidemiológicas; Brasil

	Sample	Faced difficulty in taking child to vaccination center	Child not vaccinated, despite having been taken to vaccination center	Delay in scheduled vaccination at up to 5 months old	Vaccine schedule not completed on time at 1st year of life	Vaccine schedule not completed on time at 2nd year of life
	N	% (95%CI)
All	37,801	7.2 (6.3;8.2)	23.4 (21.7;25.1)	49.9 (47.8;51.9)	61.1 (59.2;63.0)	86.1 (84.9;87.2)
Mother’s race/skin color (n = 36,341)
White	15,227	5.1 (4.1;6.5)	17.3 (15.5;19.2)	43.6 (40.8;46.4)	54.6 (51.8;57.4)	86.5 (84.5;88.4)
Mixed race	16,859	8.6 (7.5;9.8)	28.9 (26.8;31.2)	53.2 (48.2;58.2)	66.2 (63.9;68.4)	86.2 (84.6;87.6)
Black	4,255	8.7 (6.9;10.9)	29.2 (25.2;33.5)	54.9 (52.5;57.5)	65.4 (60.9;69.7)	83.1 (79.8;85.9)
Mother’s schooling ( years of study) (n = 37,748)
Up to 8	3,280	11.2 (8.6;14.3)	23.2 (19.5;27.4)	68.0 (62.8;72.8)	75.4 (70.2;80.0)	85.3 (81.3;88.6)
9-12	5,494	10.2 (7.6;13.7)	23.8 (20.2;27.8)	55.8 (51.0;60.5)	64.3 (59.5;68.8)	83.8 (79.7;87.2)
13 or over	27,974	6.1 (5.3;7.0)	25.6 (23.4;29.9)	49.5 (46.6;52.3)	60.7 (58.1;63.2)	84.1 (82.3;85.7)
Mother worked in the last month (n = 36,866)
No	16,420	8.0 (6.7;9.7)	25.3 (23.0;27.7)	51.7 (49.1;54.3)	61.6 (59.1;64.0)	84.1 (82.3;85.7)
Yes	20,446	6.4 (5.6;7.5)	22.2 (20.4;24.1)	47.9 (45.4;50.4)	60.1 (57.7;62.5)	87.6 (86.0;89.0)
Mother’s age (years) (n = 37,619)
Up to 21	2,627	10.7 (7.7;14.6)	25.6 (21.0;30.8)	59.4 (53.2;65.2)	69.4 (64.4;74.0)	87.2 (83.7;90.0)
22-29	11,565	8.8 (7.0;11.1)	26.8 (24.2;29.5)	55.7 (52.7;58.6)	66.6 (63.8;69.3)	86.5 (84.8;88.1)
30-39	17,472	6.3 (5.3;7.5)	22.6 (20.7;24.6)	46.8 (44.1;49.4)	58.6 (56.1;61.1)	86.3 (84.6;87.9)
40 or over	5,955	5.6 (4.2;7.4)	19.3 (16.3;22.8)	44.3 (39.8;49.0)	55.3 (50.9;59.7)	84.3 (80.5;87.4)

	Faced difficulty in taking child to vaccination center		Child not vaccinated, despite having been taken to vaccination center
	Crude OR	Adjusted OR	Crude OR	Adjusted OR
Race/skin color
White	1.00	1.00	1.00	1.00
Mixed race	1.73 (1.30;2.29)	1.54 (1.13;2.10)	1.95 (1.69;2.25)	1.92 (1.66;2.23)
Black	1.75 (1.25;2.45)	1.54 (1.10;2.16)	1.97 (1.57;2.48)	1.96 (1.56;2.45)
Mother’s schooling (years of study)
Up to 8	1.00	1.00	1.00	1.00
9-12	0.91 (0.60;1.38)	0.83 (0.58;1.18)	1.03 (0.79;1.34)	0.98 (0.77;1.24)
13 or over	0.52 (0.38;0.61)	0.61 (0.45;0.84)	1.02 (0.82;1.29)	1.24 (0.99;1.55)
Mother worked in the last month
No	1.00	1.00	1.00	1.00
Yes	0.79 (0.62;1.00)	0.98 (0.80;1.20)	0.84 (0.74;0.96)	0.92 (0.80;1.04)
Mother’s age (years)
Up to 21	1.00	1.00	1.00	1.00
22-29	0.81 (0.54;1.20)	0.86 (0.58;1.26)	1.06 (0.81;1.40)	0.97 (0.73;1.28)
30-39	0.56 (0.38;0.84)	0.71 (0.45;1.11)	0.85 (0.65;1.11)	0.87 (0.66;1.15)
40 or over	0.49 (0.31;0.79)	0.63 (0.37;1.07)	0.70 (0.51;0.96)	0.73 (0.52;1.01)

	Delay in scheduled vaccination at up to 5 months old		Incomplete vaccination schedule on time in 1^st year of life		Incomplete vaccination schedule on time in 2^nd year of life
	Crude OR	Adjusted OR	Crude OR	Adjusted OR	Crude OR	Adjusted OR
Race/skin color
White	1.00	1.00	1.00		1.00	1.00
Mixed race	1.57 (1.36;1.82)	1.40 (1.21;1.62)	1.62 (1.40;1.88)	1.48 (1.28;1.72)	0.97 (0.79;1.19)	1.01 (0.81;1.26)
Black	1.47 (1.18;1.84)	1.29 (1.03;1.61)	1.57 (1.27;1.94)	1.40 (1.13;1.73)	0.76 (0.58;1.01)	0.79 (0.59;1.06)
Mother’s schooling (years of study )
Up to 8	1.00	1.00	1.00	1.00	1.00	1.00
9-12	0.59 (0.45;0.78)	0.55 (0.42;0.71)	0.59 (0.42;0.81)	0.55 (0.40;0.75)	0.89 (0.60;1.31)	0.86 (0.58;1.26)
13 or over	0.40 (0.32;0.51)	0.44 (0.34;0.56)	0.46 (0.35;0.60)	0.50 (0.38;0.66)	1.11 (0.82;1.50)	1.04 (0.75;1.43)
Mother worked in the last month
No	1.00	1.00	1.00	1.00	1.00	1.00
Yes	0.86 (0.76;0.97)	1.04 (0.91;1.19)	0.94 (0.82;1.07)	1.12 (0.98;1.29)	1.33 (1.11;1.59)	1.34 (1.10;1.64)
Mother’s age (years)
Up to 21	1.00	1.00	1.00	1.00	1.00	1.00
22-29	0.86 (0.66;1.12)	0.97 (0.74;1.26)	0.88 (0.69;1.12)	0.96 (0.75;1.24)	0.95 (0.69;1.30)	0.83 (0.59;1.15)
30-39	0.60 (0.47;0.77)	0.75 (0.58;0.97)	0.62 (0.49;0.79)	0.75 (0.58;0.96)	0.93 (0.68;1.23)	0.76 (0.55;1.07)
40 or over	0.54 (0.40;0.75)	0.68 (0.49;0.94)	0.54 (0.41;0.73)	0.64 (0.47;0.87)	0.79 (0.53;1.17)	0.63 (0.41;0.96)

Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil SRTVN Quadra 701, Via W5 Norte, Lote D, Edifício P0700, CEP: 70719-040, +55 (61) 3315-3464 - Brasília - DF - Brazil
E-mail: revista.saude@saude.gov.br

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[1] Correspondence:
Antonio Fernando Boing | antonio.boing@ufsc.br