Longitudinal Profiling of the Vaccination Coverage in Brazil Reveals a Recent Change in the Patterns Hallmarked by Differential Reduction Across Regions

Césare, Náthaly; Mota, Tiago F.; Lopes, Fernanda F.L.; Lima, Ana Claudia M.; Luzardo, Ricardo; Quintanilha, Luiz Fernando; Andrade, Bruno B.; Queiroz, Artur T.L.; Fukutani, Kiyoshi F.

Abstract Objective Vaccination coverage is decreasing worldwide, favoring potential reemergence of vaccine-preventable disease. Here, we performed a longitudinal characterization of the vaccination coverage in Brazil and compared the profiles between the distinct regions in the country to test whether there has been a substantial change over the last five years. Methods We retrieved de-identified data publicly available from the repository of the Brazilian Ministry of Health, comprising detailed information on vaccination coverage, in all age groups, between 1994 and 2019. We examined the vaccination coverage from the whole country and each Brazilian region, by year, and performed a time-series pattern analysis. Results A significant decrease in overall vaccination coverage across the country regions was observed between 2017 and 2019, especially in childhood immunization. BCG, Hepatitis B, influenza and rotavirus vaccines displayed a reduction in coverage. Conversely, vaccines against measles, mumps, rubella, varicella, and meningococcus had an increase in coverage. Region-specific changes in vaccination patterns within the study period were observed. Conclusions Substantial reduction in vaccination coverage was detected in Brazil, a country already highly susceptible to emergency of epidemic infectious diseases. Recursively evaluation of the immunization program actions may help to improve vaccination coverage and prevent new epidemics.