The COVID-19 pandemic and vaccination abandonment in children: spatial heterogeneity maps

Rodrigues, Rayssa Nogueira; Nascimento, Gabriela Lourença Martins do; Arroyo, Luiz Henrique; Arcêncio, Ricardo Alexandre; Oliveira, Valéria Conceição de; Guimarães, Eliete Albano de Azevedo

doi:10.1590/1518-8345.6132.3642

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Revista Latino-Americana de Enfermagem

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Original article • Rev. Latino-Am. Enfermagem 30 • 2022 • https://doi.org/10.1590/1518-8345.6132.3642 copy

The COVID-19 pandemic and vaccination abandonment in children: spatial heterogeneity maps

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

to identify spatial clusters corresponding to abandonment of routine vaccines in children.

Method:

an ecological study, according to data from the 853 municipalities of a Brazilian state. The records analyzed were those of the multidose pentavalent, pneumococcal 10-valent, inactivated poliomyelitis and oral human rotavirus vaccines of 781,489 children aged less than one year old. The spatial scan statistics was used to identify spatial clusters and assess the relative risk based on the vaccination abandonment indicator.

Results:

the spatial scan statistics detected the presence of statistically significant clusters for abandonment regarding the four vaccines in all the years analyzed. However, the highest number of clusters with high relative risk estimates was identified in 2020. The Vale do Aço and West, North and West, and Southwest regions stand out for the pentavalent, poliomyelitis and rotavirus vaccines, respectively.

Conclusion:

in an attempt to mitigate the devastating impact of the COVID-19 pandemic, the immunization program experienced setbacks. The presence of clusters points to the need to implement integrated strategies that may involve different sectors for an active search for children and prevent outbreaks of vaccine-preventable diseases in the near future.

Descriptors:
Immunization; Public Health; Child; COVID-19; Spatial Analysis; Ecological Studies

Vaccine	Year	Risk cluster (A)*	Relative Risk	p-value	No. of municipalities	Macro-region
Pentavalent	2018	1	17.875	<0.01	1	3101
		2	2.018	<0.01	41	3101; 3107; 3102
		3	1.238	<0.01	300	3110; 3114; 3106; 3111; 3104; 3103; 3108; 3107
		4	1.662	<0.01	14	3109; 3108
	2019	1	1.831	<0.01	1	3103
		2	1.279	<0.01	21	3102; 3107
		3	1.175	<0.01	71	3109; 3108
	2020	1	21.765	<0.01	1	3114
		2	1.298	<0.01	165	3101; 3102; 3103; 3105; 3107; 3110
		3	13.552	<0.01	1	3106
		4	10.736	<0.01	2	3108
		5	21.412	<0.01	1	3105
		6	1.827	<0.01	24	3101
		7	16.751	<0.01	1	3101
		8	2.442	<0.01	5	3105
		9	1.403	<0.01	56	3108; 3111
		10	2.026	<0.01	11	3108
		11	14.306	<0.01	1	3103
Poliomyelitis	2018	1	21.248	<0.01	1	3101
		2	1.333	<0.01	235	3114; 3106; 3111; 3104; 3108; 3103; 3110
		3	2.018	<0.01	40	3101; 3107; 3102
	2019	1	1.745	<0.01	2	3113
		2	1.590	<0.01	40	3101; 3107; 3102
		3	1.370	<0.01	35	3108; 3109
	2020	1	4.521	<0.01	26	3101; 3102; 3107
		2	3.958	<0.01	19	3106; 3111
		3	25.788	<0.01	1	3108
		4	15.352	<0.01	2	3101
		5	8.007	<0.01	4	3108
		6	37.123	<0.01	1	3105
		7	10.830	<0.01	6	3103
		8	1.442	<0.01	163	3102; 3103; 3107; 3110; 3114
		9	2.928	<0.01	3	3101
		10	2.009	<0.01	29	3104; 3108; 3111
		11	13.876	<0.01	1	3105
		12	8.812	<0.01	1	3105

Vaccine	Year	Risk cluster (A)*	Relative Risk	p-value	No. of municipalities	Macro-region
Pneumococcal 10	2018	1	1.488	<0.01	221	3110; 3101; 3107; 3102; 3103; 3105
	2018	2	1.397	<0.01	265	3114; 3106; 3111; 3104; 3109; 3103; 3108
	2019	1	8.423	<0.01	1	3101
		2	1.391	<0.01	158	3110; 3107; 3102; 3114; 3103
		3	1.354	<0.01	188	3114; 3106; 3111; 3104; 3108; 3103; 3110
		4	1.449	<0.01	49	3109; 3108
		5	2.121	<0.01	5	3109
		6	1.635	<0.01	5	3112; 3101
		7	3.412	<0.01	2	3112
	2020	1	1.353	<0.01	114	3101; 3102; 3103; 3105; 3107; 3110
		2	1.997	<0.01	110	3101
		3	1.776	<0.01	13	3107; 3110
		4	3.801	<0.01	1	3105
Rotavirus	2018	1	1.386	<0.01	359	3110; 3114; 3106; 3111; 3104; 3103; 3108; 3107
		2	9.899	<0.01	1	3101
		3	1.494	<0.01	112	3101; 3107; 3102
		4	2.044	<0.01	11	3112
	2019	1	11.085	<0.01	1	3101
		2	1.377	<0.01	101	3101;3102; 3107
		3	1.253	<0.01	188	3114; 3106; 3111; 3104; 3108; 3103; 3110
		4	1.247	<0.01	91	3113; 3103; 3109; 3112; 3108; 3105
	2020	1	4.343	<0.01	12	3106; 3111
		2	27.472	<0.01	1	3107
		3	3.289	<0.01	24	3101; 3102; 3107
		4	2.079	<0.01	22	3101
		5	1.368	<0.01	1	3103
		6	10.855	<0.01	2	3108
		7	14.274	<0.01	1	3102
		8	4.963	<0.01	6	3101; 3102
		9	3.146	<0.01	6	3102
		10	1.420	<0.01	77	3103; 3104; 3106; 3108; 3111; 3114

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E-mail: rlae@eerp.usp.br

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[1] Corresponding author
Rayssa Nogueira Rodrigues. E-mail: rayssa.machado@ufv.br