Inquérito de cobertura vacinal e fatores associados à situação vacinal em Rondonópolis – Mato Grosso

Abstract

Introduction: Vaccination represents one of the most cost-effective public health interventions for the prevention and control of infectious diseases. Objective: To analyze vaccination status up to 12 and up to 15 months of age and associated factors of children born in 2015, in the city of Rondonópolis-MT. Method: This is a retrospective cohort of live births in 2015 and a population-based survey, August/2017 to February/2018, which used the cluster sampling method proposed by the World Health Organization to collect information about the compliance with the routine vaccination schedule. The study population consisted of a cohort of live births in 2015, whose parents or guardians are residents of Rondonópolis. A structured questionnaire was applied and vaccination books were photographed. Univariate analysis was performed and the factors associated with p<0.20 entered the multiple analysis. Logistic regression was performed to analyze the factors associated with the incomplete timely vaccination schedule up to 12 months, based on the recommendations of the National Immunization Program of the Ministry of Health (NIP/MH). Poisson regression was used to analyze factors associated with the incomplete timely vaccination schedule for rotavirus. Vaccine coverage (VC) was also estimated for the complete regimen up to 12 and up to 15 months of age and for isolated vaccine, by applied and timely dose. For comparison between proportions of administrative and timely VC, a Wald test was performed, considering significant p<0.05. Results: The sample involved 440 children, six were excluded because they had been vaccinated in the private network, totaling 434. The timely VC reached the recommended only for BCG (91.2%) and HB (95.4%). Timely CV for the complete scheme up to 12 months was lower, 17.9%, compared to applied VC, 41.0%. Up to 15 months, the opportune VC for the complete scheme was 6.9% and for applied CV 66.6%. There was a significant difference between administrative and timely VC for all vaccines, except MeningoC-booster dose and HB. In the final model, they remained independently associated: “having a brother or more at home” (OR: 3.18, 95%CI: 1.75; 5.76) and “not receiving a visit from a community health agent in the last 30 days” (OR: 1.93, 95%CI: 1.04; 3.57). In the incomplete vaccination schedule with a more rigid application interval, rotavirus vaccine, the associated factors were: incomplete routine consultation of the child (PR 2.20; 95%CI: 1.17; 4.13); hospitalization in the first year of life (PR 1.62; 95%CI 1.01; 2.60); having at least one sibling (PR 1.98; 95%CI: 1.13; 3.48) and being taken to medical service by people other than their parents (PR 1.77; 95%CI: 1.09; 2.87). Conclusions: The survey enabled a more accurate estimate of vaccination coverage. It allowed to compare administrative VC with the opportune VC or applied by vaccine. The timely low VC of the vaccination schedule up to 12 months (17.9%) and up to 15 months (6.9%) of age, indicates the need for early intervention in the vaccination delay in the first year of life. Regarding the factors associated with the incomplete scheme, there is a need to implement an active search for children with vaccination delay in relation to the recommended interval for each vaccine, in addition to the need to establish and/or strengthen the bond between health professionals in the family health strategy and child caregivers.