The emergence of vaccine hesitancy among upper-class Brazilians: Results from four birth cohorts, 1982-2015

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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.authorSILVEIRA, Mariangela F.
dc.contributor.authorBUFFARINI, Romina
dc.contributor.authorBERTOLDI, Andrea D.
dc.contributor.authorSANTOS, Ina S.
dc.contributor.authorBARROS, Aluisio J. D.
dc.contributor.authorMATIJASEVICH, Alicia
dc.contributor.authorMENEZES, Ana Maria B.
dc.contributor.authorGONCALVES, Helen
dc.contributor.authorHORTA, Bernardo L.
dc.contributor.authorBARROS, Fernando C.
dc.contributor.authorBARATA, Rita B.
dc.contributor.authorVICTORA, Cesar G.
dc.date.accessioned2020-03-24T14:51:30Z
dc.date.available2020-03-24T14:51:30Z
dc.date.issued2020
dc.description.abstractVaccine hesitancy has been increasingly reported in Brazil. We describe secular trends and socioeconomic disparities from 1982 to 2015, using data from four population-based birth cohorts carried out in the city of Pelotas. Full immunization coverage (FIC) was defined as having received four basic vaccines (one dose of BCG and measles, and three doses of polio and DTP) scheduled for the first year of life. Information on income was collected through standardized questionnaires, and the slope index of inequality (SII) was calculated to express the difference in percent points between the rich and poor extremes of the income distribution. Full immunization coverage was 80.9% (95% CI 79.8%; 82.0%) in 1982, 97.2% (96.1%; 98.0%) in 1993, 87.8% (86.7%; 88.8%) in 2004 and 77.2% (75.8%; 78.4%) in 2015. In 1982 there was a strong social gradient with higher coverage among children from wealthy families (SII = 25.0, P < 0.001); by 2015, the pattern was inverted with higher coverage among poor children (SII = -6.0; P = 0.01). Vertical immunization programs in the 1980s and creation of the National Health Services in 1980 eliminated the social gradient that had been present up to the 1980s, to reach near universal coverage. The recent decline in coverage is likely associated with the growing complexity of the vaccination schedule and underfunding of the health sector. In addition, the faster decline observed among children from wealthy families is probably due to vaccine hesitancy.eng
dc.description.indexMEDLINEeng
dc.description.sponsorshipWellcome TrustWellcome Trust
dc.description.sponsorshipInternational Development Research Center
dc.description.sponsorshipWorld Health OrganizationWorld Health Organization
dc.description.sponsorshipOverseas Development Administration of the United Kingdom
dc.description.sponsorshipEuropean UnionEuropean Union (EU)
dc.description.sponsorshipBrazilian National Support Program for Centers of Excellence (PRONEX)
dc.description.sponsorshipBrazilian National Council for Scientific and Technological Development (CNPq)National Council for Scientific and Technological Development (CNPq)
dc.description.sponsorshipScience and Technology Department (DECIT) of the Brazilian Ministry of Health
dc.description.sponsorshipResearch Support Foundation of the State of Rio Grande do Sul (FAPERGS)Foundation for Research Support of the State of Rio Grande do Sul (FAPERGS)
dc.description.sponsorshipBrazilian Pastorate of the Child
dc.description.sponsorshipBrazilian Association for Collective Health (ABRASCO)
dc.description.sponsorshipCNPqNational Council for Scientific and Technological Development (CNPq)
dc.description.sponsorshipDepartamento de Ciencia e Tecnologia (DECIT), Brasil
dc.identifier.citationVACCINE, v.38, n.3, p.482-488, 2020
dc.identifier.doi10.1016/j.vaccine.2019.10.070
dc.identifier.eissn1873-2518
dc.identifier.issn0264-410X
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/35497
dc.language.isoeng
dc.publisherELSEVIER SCI LTDeng
dc.relation.ispartofVaccine
dc.rightsrestrictedAccesseng
dc.rights.holderCopyright ELSEVIER SCI LTDeng
dc.subjectImmunization coverageeng
dc.subjectVaccination hesitancyeng
dc.subjectEconomic statuseng
dc.subjectEducational statuseng
dc.subjectSocioeconomic factorseng
dc.subjectPublic healtheng
dc.subjectCohort studieseng
dc.subject.otherelectronic immunization registryeng
dc.subject.otherchild healtheng
dc.subject.otherpelotaseng
dc.subject.otherinequalitieseng
dc.subject.othercoverageeng
dc.subject.othertrendseng
dc.subject.otherprofileeng
dc.subject.othermethodologyeng
dc.subject.othercontexteng
dc.subject.otherstateeng
dc.subject.wosImmunologyeng
dc.subject.wosMedicine, Research & Experimentaleng
dc.titleThe emergence of vaccine hesitancy among upper-class Brazilians: Results from four birth cohorts, 1982-2015eng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.author.externalSILVEIRA, Mariangela F.:Univ Fed Pelotas, Postgrad Program Epidemiol, Pelotas, RS, Brazil
hcfmusp.author.externalBUFFARINI, Romina:Univ Fed Pelotas, Postgrad Program Epidemiol, Pelotas, RS, Brazil
hcfmusp.author.externalBERTOLDI, Andrea D.:Univ Fed Pelotas, Postgrad Program Epidemiol, Pelotas, RS, Brazil
hcfmusp.author.externalSANTOS, Ina S.:Univ Fed Pelotas, Postgrad Program Epidemiol, Pelotas, RS, Brazil
hcfmusp.author.externalBARROS, Aluisio J. D.:Univ Fed Pelotas, Postgrad Program Epidemiol, Pelotas, RS, Brazil
hcfmusp.author.externalMENEZES, Ana Maria B.:Univ Fed Pelotas, Postgrad Program Epidemiol, Pelotas, RS, Brazil
hcfmusp.author.externalGONCALVES, Helen:Univ Fed Pelotas, Postgrad Program Epidemiol, Pelotas, RS, Brazil
hcfmusp.author.externalHORTA, Bernardo L.:Univ Fed Pelotas, Postgrad Program Epidemiol, Pelotas, RS, Brazil
hcfmusp.author.externalBARROS, Fernando C.:Univ Catolica Pelotas, Postgrad Program Hlth & Behav, Pelotas, RS, Brazil
hcfmusp.author.externalBARATA, Rita B.:Santa Casa Sao Paulo FCMSCSP, Dept Collect Hlth, Sch Med Sci, Sao Paulo, SP, Brazil
hcfmusp.author.externalVICTORA, Cesar G.:Univ Fed Pelotas, Postgrad Program Epidemiol, Pelotas, RS, Brazil
hcfmusp.citation.scopus29
hcfmusp.contributor.author-fmusphcALICIA MATIJASEVICH MANITTO
hcfmusp.description.beginpage482
hcfmusp.description.endpage488
hcfmusp.description.issue3
hcfmusp.description.volume38
hcfmusp.origemWOS
hcfmusp.origem.pubmed31718899
hcfmusp.origem.scopus2-s2.0-85075434339
hcfmusp.origem.wosWOS:000509816900009
hcfmusp.publisher.cityOXFORDeng
hcfmusp.publisher.countryENGLANDeng
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