Cobertura vacinal e adesão aos esquemas recomendados da vacina pneumocócica conjugada 10 valente logo após sua introdução no calendário básico em Goiânia, GO: estudo transversal.
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2014-11-03
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Universidade Federal de Goiás
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Background: Pneumococcal 10-valent conjugate vaccine (PCV10) was introduced to the routine immunization in Brazil in 2010. During PCV10 introduction year three schedules were used: (i) children aged ≤6 months: 3 doses + 1 booster; (ii) children aged 7-11 months: 2 doses + 1 booster (2p + 1), and (iii) children 12-15 months: single dose. The aim of this study was to assess vaccination coverage and compliance with recommended schedules after the introduction of PCV10 and to identify the factors associated with greater coverage and compliance.
Methods: A household survey was conducted between December 2010 and February 2011 in Goiania, GO, where the PCV10 vaccination started on June, 2010. Systematic sampling was used to recruit 1,237 children. A sociodemographic questionnaire was applied during the home visits; dates of vaccination were obtained from the vaccination card. The child's age at vaccine introduction was calculated for July 14th, 2010 (30 days after the introduction of the vaccine on routine immunization) and the child was retrospectively classified into one of three age groups: ≤6 months, 7-11 months; 12-15 months. Vaccination coverage (percentage of children who received the number of recommended doses) and compliance with schedules (percentage of children who received all valid doses at the recommended time interval) were calculated for all children and for each of the three age groups; prevalence ratios were compared by chi-square test. Log binomial regression (prevalence ratio / PR) was used to identify variables independently associated with vaccination coverage and compliance with recommended schedules.
Results: The overall vaccination coverage was 53.4% (95% CI: 50.8-56.2%), varying from 88.3% (12-15 months / single dose) to 39.3% (7-11 months / 2 doses). Compliance to vaccination schedules was 16.6% (95% CI: 14.5 to 18.7%), ranging from 35.6% (≥12 months / single dose) to 6.0% (7-11 months / 2 doses). Having a private health insurance was independently associated with both vaccination coverage (PR = 1.22; 95% CI: 1.04-1.43, p=0.013) and compliance with the vaccination schedule (PR = 1.08; 95% CI: 1.01-1.15, p=0.019).
Conclusions: Vaccination coverage achieved high percentages before the first year of introduction of PCV10 on routine immunization. Compliance with PCV10 recommended schedules was low, being important gap in the program. Having private health insurance was associated with compliance and vaccination coverage, which may reflect an attitude of seeking health care frequently and not only on emergencies. Initiatives to increase rates of vaccination coverage and compliance should be pursued targeting children aged 7-11 months, who are under the highest risk of acquiring pneumococcal disease.
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SARAIVA, F. O. Cobertura vacinal e adesão aos esquemas recomendados da vacina pneumocócica conjugada 10 valente logo após sua introdução no calendário básico em Goiânia, GO: estudo transversal.. 2014. 98 f. Dissertação (Mestrado em Medicina Tropical e Saúde Publica) - Universidade Federal de Goiás, Goiânia, 2014.