Socioeconomic inequalities and vaccination coverage: results of an immunisation coverage survey in 27 Brazilian capitals, 2007-2008

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorBARATA, Rita Barradas
dc.contributor.authorRIBEIRO, Manoel Carlos Sampaio de Almeida
dc.contributor.authorMORAES, Jose Cassio de
dc.contributor.authorFLANNERY, Brendan
dc.contributor.groupauthorVaccine Coverage Survey 2007 Grp
dc.contributor.groupauthorLUNA, Expedito
dc.date.accessioned2019-08-20T14:57:38Z
dc.date.available2019-08-20T14:57:38Z
dc.date.issued2012
dc.description.abstractBackground Since 1988, Brazil's Unified Health System has sought to provide universal and equal access to immunisations. Inequalities in immunisation may be examined by contrasting vaccination coverage among children in the highest versus the lowest socioeconomic strata. The authors examined coverage with routine infant immunisations from a survey of Brazilian children according to socioeconomic stratum of residence census tract. Methods The authors conducted a household cluster survey in census tracts systematically selected from five socioeconomic strata, according to average household income and head of household education, in 26 Brazilian capitals and the federal district. The authors calculated coverage with recommended vaccinations among children until 18 months of age, according to socioeconomic quintile of residence census tract, and examined factors associated with incomplete vaccination. Results Among 17 295 children with immunisation cards, 14 538 (82.6%) had received all recommended vaccinations by 18 months of age. Among children residing in census tracts in the highest socioeconomic stratum, 77.2% were completely immunised by 18 months of age versus 81.2%-86.2% of children residing in the four census tract quintiles with lower socioeconomic indicators (p < 0.01). Census tracts in the highest socioeconomic quintile had significantly lower coverage for bacille Calmette-Guerin, oral polio and hepatitis B vaccines than those with lower socioeconomic indicators. In multivariable analysis, higher birth order and residing in the highest socioeconomic quintile were associated with incomplete vaccination. After adjusting for interaction between socioeconomic strata of residence census tract and household wealth index, only birth order remained significant. Conclusions Evidence from Brazilian capitals shows success in achieving high immunisation coverage among poorer children. Strategies are needed to reach children in wealthier areas.eng
dc.description.indexMEDLINEeng
dc.description.sponsorshipBrazilian Ministry of Health
dc.identifier.citationJOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, v.66, n.10, p.934-941, 2012
dc.identifier.doi10.1136/jech-2011-200341
dc.identifier.issn0143-005X
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/33349
dc.language.isoeng
dc.publisherBMJ PUBLISHING GROUPeng
dc.relation.ispartofJournal of Epidemiology and Community Health
dc.rightsopenAccesseng
dc.rights.holderCopyright BMJ PUBLISHING GROUPeng
dc.subject.otherunited-stateseng
dc.subject.otherchildreneng
dc.subject.othervaccineseng
dc.subject.othermeasleseng
dc.subject.otherhealtheng
dc.subject.otherassociationeng
dc.subject.otherreasonseng
dc.subject.otherrubellaeng
dc.subject.othersafetyeng
dc.subject.othermumpseng
dc.subject.wosPublic, Environmental & Occupational Healtheng
dc.titleSocioeconomic inequalities and vaccination coverage: results of an immunisation coverage survey in 27 Brazilian capitals, 2007-2008eng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.author.externalBARATA, Rita Barradas:Sch Med Sci Santa Casa, Dept Social Med, BR-01221020 Sao Paulo, Brazil
hcfmusp.author.externalRIBEIRO, Manoel Carlos Sampaio de Almeida:Sch Med Sci Santa Casa, Dept Social Med, BR-01221020 Sao Paulo, Brazil
hcfmusp.author.externalMORAES, Jose Cassio de:Sch Med Sci Santa Casa, Dept Social Med, BR-01221020 Sao Paulo, Brazil
hcfmusp.author.externalFLANNERY, Brendan:Pan Amer Hlth Org, Brasilia, DF, Brazil
hcfmusp.citation.scopus89
hcfmusp.description.beginpage934
hcfmusp.description.endpage941
hcfmusp.description.issue10
hcfmusp.description.volume66
hcfmusp.origemWOS
hcfmusp.origem.pubmed22268129
hcfmusp.origem.scopus2-s2.0-84866050667
hcfmusp.origem.wosWOS:000308456400015
hcfmusp.publisher.cityLONDONeng
hcfmusp.publisher.countryENGLANDeng
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