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

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art_SILVEIRA_Theemergence_of_vaccine_hesitancy_among_upperclass_Brazilians_2020.PDF.pdf (376.26 KB)
Citações na Scopus
28
Tipo de produção
article
Data de publicação
2020
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
ELSEVIER SCI LTD
Autores
SILVEIRA, Mariangela F.
BUFFARINI, Romina
BERTOLDI, Andrea D.
SANTOS, Ina S.
BARROS, Aluisio J. D.
MENEZES, Ana Maria B.
GONCALVES, Helen
HORTA, Bernardo L.
BARROS, Fernando C.
Citação
VACCINE, v.38, n.3, p.482-488, 2020
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Vaccine 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.
Palavras-chave
Immunization coverage, Vaccination hesitancy, Economic status, Educational status, Socioeconomic factors, Public health, Cohort studies
URI
https://observatorio.fm.usp.br/handle/OPI/35497
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MPR
Artigos e Materiais de Revistas Científicas - LIM/39
Artigos e Materiais de Revistas Científicas - ODS/03
Artigos e Materiais de Revistas Científicas - ODS/10