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. 2023 Feb;28(2):337.
doi: 10.1590/1413-81232023282.17842022. Epub 2022 Nov 19.

Vaccination against poliomyelitis in Brazil from 2011 to 2021: successes, setbacks, and challenges ahead

[Article in Portuguese, English]
Maria Rita Donalisio  1 , Alexandra Crispim Boing  2 , Ana Paula Sayuri Sato  3 , Edson Zangiacomi Martinez  4 , Mariana Otero Xavier  5 , Rosa Livia Freitas de Almeida  6 , Rafael da Silveira Moreira  7 , Rejane Christine de Sousa Queiroz  8 , Alicia Matijasevich  5
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Free article

Vaccination against poliomyelitis in Brazil from 2011 to 2021: successes, setbacks, and challenges ahead

[Article in Portuguese, English]
Maria Rita Donalisio et al. Cien Saude Colet. 2023 Feb.
Free article

Abstract
in English, Portuguese

The drop in childhood vaccination coverage (VC), including poliomyelitis, has become a health concern. The objective was to analyze the temporal trend of coverage of the three doses of the polio vaccine in the first 12 months of life between 2011 and 2021, in addition to mapping vaccination coverage in Brazil, including the COVID-19 pandemic period. An ecological study was carried out using interrupted time series (STI) techniques and spatial analysis, with data from the National Immunization Program Information System. The VC trend was adjusted by the Newey-West variance estimator according to the federated units and the Brazilian Deprivation Index. The VC distribution was estimated by Bayesian models and the spatial clusters by the global and local Moran index, identifying areas of lower coverage in the health regions. There was a reduction in the VC over the period in all regions, being more pronounced in the North and Northeast regions and during the Covid-19 pandemic. The biggest drops were identified in states and health regions with greater social vulnerability after 2019. The drop in VC shows that the risk of reintroduction of the wild virus is imminent and the challenges need to be faced with the strengthening of the Brazilian Health System (SUS).

A queda de coberturas vacinais (CV) na infância, entre elas a da poliomielite, vem se tornando uma preocupação sanitária. O objetivo foi analisar a tendência temporal das coberturas das três doses da vacina contra a poliomielite nos primeiros 12 meses de vida entre 2011 e 2021, com destaque na pandemia de COVID-19, além de mapear as CV no Brasil. Foi realizado um estudo ecológico com técnicas de série temporal interrompida (STI) e análise espacial, a partir dos dados do Sistema de Informação do Programa Nacional de Imunização. A tendência da CV foi ajustada pelo estimador de variância de Newey-West, segundo as unidades federadas e o Índice de Privação Brasileiro. A distribuição da CV foi estimada por modelos bayesianos e os aglomerados espaciais pelos índices de Moran global e local, identificando áreas de menor cobertura nas Regiões de Saúde. Observa-se perda da CV ao longo do período em todas as regiões do país, sendo maiores no Norte e no Nordeste e se acentuando durante a pandemia. As maiores quedas foram identificadas em estados e regiões de saúde com maior vulnerabilidade social. A queda na CV mostra que o risco de reintrodução do vírus selvagem é iminente e os desafios precisam ser enfrentados com o fortalecimento do Sistema Único de Saúde.

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