Peer-reviewed article
Risk of reintroduction of vaccine-preventable diseases in the state of São Paulo, Brazil.
José Elisomar Silva de Santana, Maria Lígia Bacciotte Ramos Nerger, Tatiana Lang D' Agostini, Joyce Ribeiro da Conceição Santos, Sheila Aparecida Ferreira Lachtim et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined vaccination coverage and the risk of vaccine-preventable diseases returning in municipalities across São Paulo state, Brazil, in 2022 and 2023. Researchers measured vaccination rates for nine vaccines given to children under two years old and classified municipalities by their transmission risk. After implementing a microplanning program for vaccination activities, high-risk classifications decreased across all municipality sizes, though challenges remained particularly in medium-sized and large cities. The findings suggest that tracking vaccination coverage at the municipal level can help guide health interventions.
Key points
- In 2022, rotavirus vaccine had the highest coverage (46% of municipalities met target), increasing to 68% by 2023
- High-risk transmission classification decreased in large municipalities from 100% to 91.2%, in medium municipalities from 90.8% to 66.7%, and in small municipalities from 68.3% to 56%
- Pneumococcal vaccine coverage improved significantly, reaching 57% of municipalities by 2023
- Challenges with vaccination coverage persisted in medium-sized and large municipalities despite improvements
- Municipal-level vaccination indicators were identified as effective for designing health interventions
Limitations
This study uses secondary data and ecological design, so it cannot establish causal relationships between the microplanning intervention and improved coverage, nor can it determine individual-level factors affecting vaccination uptake. The document does not report on actual reintroduction of diseases or explain which specific aspects of microplanning contributed most to improvements.
Abstract
OBJECTIVE: To analyze the risk classification of transmission of vaccine-preventable diseases in the municipalities of the state of São Paulo (SP) and to assess the influence of population size on the risk of transmission of vaccine-preventable diseases (RTDI) before and after the implementation of Microplanning for High-Quality Vaccination Activities. METHODS: This is an epidemiological study with an ecological design, conducted using secondary data on vaccination coverage for nine immunobiologicals recommended in the immunization schedule for children under two years of age. It also examines dropout rates for multi-dose vaccines within the same age group in the state of São Paulo, covering the years 2022 and 2023. Following the calculation of all indicators, municipalities were classified according to their risk of transmission for vaccine-preventable diseases. RESULTS: Analyses of vaccination coverage indicators, dropout rates, homogeneity of vaccination coverage among vaccines for children under two years of age, and the RTDI indicator for children aged one year or younger revealed that, in 2022, the human rotavirus vaccine had the highest proportion of municipalities reaching the coverage target (46%), followed by the meningococcal vaccine (39%). In 2023, the human rotavirus vaccine maintained the highest proportion of municipalities reaching the target (68%), followed by the pneumococcal vaccine (57%). Regarding the RTDI, in large municipalities, high risk fell from 100% to 91.2%, while in medium-sized municipalities there was a reduction from 90.8% to 66.7%, and in small municipalities, from 68.3% to 56%. CONCLUSION: Challenges remain within the state regarding the RTDI classification for vaccination, particularly in medium-sized and large municipalities. The use of immunization indicators at the municipal level can be highly effective for proposing health interventions aimed at increasing vaccination coverage.