Please use this identifier to cite or link to this item:
https://www.arca.fiocruz.br/handle/icict/62395
Type
ArticleCopyright
Open access
Sustainable Development Goals
03 Saúde e Bem-EstarCollections
Metadata
Show full item record
MUNICIPALITY-LEVEL MEASLES, MUMPS, AND RUBELLA (MMR) VACCINE COVERAGE AND DEPRIVATION IN BRAZIL: A NATIONWIDE ECOLOGICAL STUDY, 2006 TO 2020
Author
Affilliation
Health Equity Action Lab. Department of Infectious Disease Epidemiology. London School of Hygiene &Tropical Medicine. London, United Kingdom.
Health Equity Action Lab. Department of Infectious Disease Epidemiology. London School of Hygiene &Tropical Medicine. London, United Kingdom.
Health Equity Action Lab. Department of Infectious Disease Epidemiology. London School of Hygiene &Tropical Medicine. London, United Kingdom.
Health Equity Action Lab. Department of Infectious Disease Epidemiology. London School of Hygiene &Tropical Medicine. London, United Kingdom.
Fundação Oswaldo Cruz. Instituto Gonçalo Muniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil
Universidade de São Paulo. Faculdade de Saúde Pública. São Paulo, SP, Brasil.
Department of Non-communicable Disease Epidemiology. London School of Hygiene & Tropical Medicine. London, United Kingdom.
Fundação Oswaldo Cruz. Instituto Gonçalo Muniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.
Health Equity Action Lab. Department of Infectious Disease Epidemiology. London School of Hygiene &Tropical Medicine. London, United Kingdom.
Health Equity Action Lab. Department of Infectious Disease Epidemiology. London School of Hygiene &Tropical Medicine. London, United Kingdom.
Health Equity Action Lab. Department of Infectious Disease Epidemiology. London School of Hygiene &Tropical Medicine. London, United Kingdom.
Health Equity Action Lab. Department of Infectious Disease Epidemiology. London School of Hygiene &Tropical Medicine. London, United Kingdom.
Fundação Oswaldo Cruz. Instituto Gonçalo Muniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil
Universidade de São Paulo. Faculdade de Saúde Pública. São Paulo, SP, Brasil.
Department of Non-communicable Disease Epidemiology. London School of Hygiene & Tropical Medicine. London, United Kingdom.
Fundação Oswaldo Cruz. Instituto Gonçalo Muniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.
Health Equity Action Lab. Department of Infectious Disease Epidemiology. London School of Hygiene &Tropical Medicine. London, United Kingdom.
Abstract
To better understand the declining rates of routine childhood vaccination in Brazil, we investigated the association between measles, mumps, and rubella (MMR) first dose vaccine coverage and deprivation at the municipality level. Using routinely collected data from 5565 Brazilian municipalities from 2006 to 2020, we investigated the association between municipality-level MMR vaccine first dose coverage (i.e., as a continuous variable and as a percentage of municipalities attaining the 95% target coverage) in relation to quintiles of municipality-level deprivation, measured by the Brazilian Deprivation Index (Índice Brasileiro de Privação, IBP), and geographic regions. From 2006 to 2020, the mean municipality-level MMR vaccine coverage declined across all deprivation quintiles and regions of Brazil, by an average of 1.2% per year. The most deprived quintile of municipalities had higher coverage on average, but also the steepest declines in coverage (i.e., an annual decline of 1.64% versus 0.61% in the least deprived quintile) in the period of 2006–2020, and the largest drop in coverage at the beginning of the COVID-19 pandemic (2019–2020). Across all deprivation quintiles and regions (except for the Southeast region), less than 50% of municipalities in Brazil met the 95% MMR coverage target in 2020.The decrease in MMR first dose vaccine coverage in Brazil is widespread, but steeper declines have been observed in the most deprived municipalities. To promote vaccine equity and prevent future outbreaks, further research is urgently needed to understand the causal mechanisms underlying the observed associations between municipality-level MMR vaccine coverage and deprivation.
Share