HPV immunization in Brazil and proposals to increase adherence to vaccination campaigns

Santos, Wagner Mesojedovas; Santos, Debora Mesojedovas; Fernandes, Márcia Santana

doi:10.11606/s1518-8787.2023057005410

Acessibilidade / Reportar erro

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Review • Rev. Saúde Pública 57 • 2023 • https://doi.org/10.11606/s1518-8787.2023057005410 copy

HPV immunization in Brazil and proposals to increase adherence to vaccination campaigns

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVES

To identify the possible causes of low adherence to vaccination campaigns in Brazil, find and analyze campaigns regarding human papillomavirus (HPV) in Brazil and abroad, and apply quality tools to prepare proposals to increase vaccination coverage (VC) and prevent HPV in the country.

METHOD

This is a qualitative and deductive-hypothetical research. A narrative review of the literature (especially on the narratives and formats applied in vaccination campaigns in Brazil) was the technique used to develop our method.

RESULTS

Brazil had a 49.6% VC in 2019, unlike countries such as Australia (80.2% in 2017), Mexico (97.5% in 2019), and Peru (91% in 2019). This study found evidence of the use of social marketing strategies to engage communities as good practices in the vaccination campaigns of these countries.

CONCLUSION

With the retrieved information, three quality tools (Ishikawa diagram, Pareto graph, and 5W2H) classified and quantified the causes of low VC in Brazil and enabled proposals that can direct its Ministry of Health to take more effective strategies to achieve the HPV VC goal recommended by the WHO.

Human papillomavirus; Uterine Cervical Neoplasms; Social Marketing; Immunization; Immunization Programs

Gender	Target population	D1(%)	D2 (%)	Mean (%)
Girls	9–14 years	82.1	54.5	68.3
Boys	9–14 years	38.6	23.5	31
Total average		60.3	39	49.6

Country	Product	Promotion		Place	Price
Country	Product	Population	Campaigns	Place	Price
Brazil	Quadrivalent HPV	Girls (9–14 years)	Materials in primary healthcare units	Primary healthcare units	Free
Brazil	Quadrivalent HPV	Boys (11–14 years)	Materials in primary healthcare units	Primary healthcare units	Free
Mexico	Nonavalent vaccine	Girls (9–12 years) who are in the fifth grade of primary school	Campaigns on TV and radio and printed materials	Schools and primary healthcare units	Free
Australia	Nonavalent vaccine	Boys and girls (9–13 years)	Campaigns on TV and radio and printed materials. National registry for follow-ups, websites, and a telephone line	Schools and primary healthcare units	Free for individuals aged from 11 to 13 years
Peru	Nonavalent vaccine	Girls (9–13 years) who are in the fifth grade of primary school	Campaigns on TV and radio and printed materials	Schools	Free
Barretos Study	Quadrivalent HPV	Girls (10–16 years)	Campaigns on TV and radio and printed materials	Schools and hospitals	Free

What	Why	Where	When	Who	How	How much
Disseminate information about vaccine safety and efficacy	Information on safety and efficacy conveys confidence about the vaccine to the public and facilitates decision-making by increasing adherence. This information is the main target of anti-vaccine groups.	Throughout the Brazilian territory	During the campaign in both doses	Federal and state governments	Dissemination on TV, internet, radios, billboards, schools, primary healthcare units, and by physicians and healthcare providers.	NA
Inform the vaccination scheme	This information helps the target audience plan itself regarding deadlines and procedures.	Throughout the Brazilian territory	During the campaign in both doses	Federal and state governments	Dissemination on TV, internet, radios, billboards, schools, primary healthcare units, and by physicians and healthcare providers.	NA
Disseminate expected adverse symptoms and what should be done in such cases	Information about expected symptoms prevents panic and conveys tranquility and information on safety and efficacy, educating the public on the procedure to be followed and avoiding unnecessary searches for physicians and hospitals in case of events.	Throughout the Brazilian territory	During the campaign in both doses	Federal and state governments	Dissemination on TV, internet, radios, billboards, schools, primary healthcare units, and by physicians and healthcare providers.	NA
Inform the gratuity of the vaccine	This information is well known to Brazilians, but it is necessary to consider the immigrants who live in it. Strengthen information on gratuity will remove another possible barrier to adherence.	Throughout the Brazilian territory	During the campaign in both doses	Federal and state governments	Dissemination on TV, internet, radios, billboards, schools, primary healthcare units, and by physicians and healthcare providers.	NA
Inform campaign investments	Information about investment brings a sense of responsibility to some people and reinforces the importance of transparent spending.	Throughout the Brazilian territory	During the campaign in both doses	Federal and state governments	Dissemination on TV, internet, and radios.	NA
Using schools for vaccination	Vaccination in schools facilitates access to children and guardians. It facilitates adherence, information dissemination, and campaign control.	Schools throughout Brazil	During the campaign in both doses	Federal and state governments	Create of a program with shared responsibilities between the federal and state governments.	NA
Using primary healthcare units for repechage	For audiences outside the goal of the campaign, primary healthcare units should remain a primary vaccination site. For children who missed vaccination in schools for some reason, these institutions will serve as a repechage site.	Primary healthcare units	During the campaign in both doses	Federal and state governments	Use the Unified Health System (SUS).	NA
Prepare and distribute information leaflets	Leaflets help to disseminate information about the vaccine and serve as a manual to ask questions and know what to do in case of events, etc.	Schools, primary healthcare units, and with physicians and healthcare providers	During the campaign in both doses	Federal and state governments	Create campaign materials with the help of physicians, healthcare providers, and advertising agencies and distributing it to the target audience and guardians by schools, primary healthcare unit, and physicians.	NA
Giving lectures to guardians and the target audience in schools	As schools facilitate access to guardians, children, and adolescents, it is possible to directly transmit information and solve doubts in a personalized way.	Schools	During the campaign in both doses	Federal and state governments	Send prepared healthcare providers to lecture to guardians, children, and adolescents.	NA
Identify the target audience and educate the age group	It is important that the target audience is clearly identified and informed so that they know they will be approached or should seek help.	Schools	During the campaign in both doses	Federal and state governments	By physicians and healthcare providers using an updated IBGE database.	NA
Tailor the information to different audiences	An important manner of inclusion, in which people are approached with appropriate information, respecting the culture, religion, and nationality of all.	In all campaign materials	During the campaign in both doses	Federal and state governments	Using advertising agencies.	NA
Using mass media	The internet, TV, and radio are the main global communication channels and Brazil is no different. To favor any to disseminate campaign information excludes a large part of the population without access to information.	TV, internet, radios, and billboards	During the campaign in both doses	Federal and state governments	Using pieces, commercials, jingles, and influencers.	NA
Focus on information about the benefits of the vaccine	Information on the lack of vaccination (diseases, risks, and harms) should be avoided. People absorb this information as negative points of the vaccine.	In all campaign materials	During the campaign in both doses	Federal and state governments	Creating campaign materials with the help of physicians, healthcare providers, and advertising agencies.	NA
Include information on pap smears in the campaign	Although the percentage of pap smears is high ¹⁵ , it will be possible to further increase adherence by mass dissemination.	In all campaign materials	During the campaign in both doses	Federal and state governments	Creating campaign materials with the help of physicians, healthcare providers, and advertising agencies.	NA
Encourage medical prescription	Use federal and regional boards to give physicians directives about the vaccine.	Federal and regional councils	All the time (should become a daily routine)	Federal and state governments	Contact the health councils in Brazil and start a program to create guidelines.	NA
Prepare physicians and healthcare providers to answer questions.	Send support materials via federal and regional councils to solve the public’s doubts, including guardians.	Federal and regional councils	All the time (should become a daily routine)	Federal and state governments	Contact the health councils in Brazil and start a program to create guidelines.	NA
Automate notaries for automatic registration on ConectSus	The idea is that at the time of registration of a newborn, the notary can automatically create a registration for the child in ConectSus or generate an access code that enables the system to control their vaccination since birth.	Notaries and application	All the time (should become a daily routine)	Federal and state governments	Create a function to interconnect notary systems with ConectSus.	NA
Fight disinformation (antivaxx)	These radical groups are growing rapidly and the internet has facilitated the spread of false information. They must be fought before the issue becomes even more serious.	Throughout the Brazilian territory	All the time	Federal and state governments	Disinformation is fought with reliable information, which is only possible with investment in research to generate knowledge.	NA
Investment in research	It is impossible to move forward as a society and as a country if investments in research are suppressed. Research generates knowledge and relevant information that determine how the country should react to a given problem. Brazil has an investment rate far below what is necessary to generate relevant knowledge for society.	Throughout the national territory (universities, hospitals, schools, research centers, etc.)	Must be part of the annual budget	Federal and state governments	The state and federal governments should increase their budget for investments in research. Considering the current numbers, it is practically impossible to significantly advance in the following years ¹⁶ .	NA

Faculdade de Saúde Pública da Universidade de São Paulo Avenida Dr. Arnaldo, 715, 01246-904 São Paulo SP Brazil, Tel./Fax: +55 11 3061-7985 - São Paulo - SP - Brazil
E-mail: revsp@usp.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Correspondence: Wagner Mesojedovas Santos Avenida Doutor Assis Ribeiro, 8.02003827-000 – São Paulo, SP, Brasil Email: wagner_mesojedovas@outlook.com.br