Análise espacial e fatores de risco da cobertura vacinal de crianças de 0 até 2 anos moradoras na Região Metropolitana da Baixada Santista

Abstract

Introduction: The National Immunization Program is a global reference in preventing diseases and combating child mortality, being an essential strategy to guarantee a healthy population. Objectives: To spatially analyze the vaccination coverage of children aged 0 to 2 years and identify the risk factors for non-vaccination in the Met-ropolitan Region of Baixada Santista (RMBS). Method: These are two epidemiologi-cal studies. The first is an ecological study with a mixed approach, which used public domain secondary data. The second consists of a cross-sectional study, based on primary data obtained through a population survey carried out at RMBS. Results: The analysis, which used maps as an essential tool for dynamic understanding and decision-making in health, revealed a significant drop in vaccination rates in RMBS municipalities in 2020, especially due to the COVID-19 pandemic. In some regions, rates were below 50%. Factors such as the lack of clear information about vaccines, distrust in the health system and logistical barriers, including inadequate opening hours of health units and lack of vaccines, contributed to this reduction. The research showed that, when health professionals do not inform about the vaccine adminis-tered, the probability of the child not being up to date with vaccinations is 2.55 times greater. Furthermore, the pandemic increased the chance of vaccines being delayed by 3.42 times. Conclusion: The spatial analysis of vaccination coverage in munici-palities is essential to identify geographic inequalities and guide strategic interven-tions. Mapping regions with low vaccine adherence allows us to correlate social, eco-nomic, environmental and health factors, such as access to services, educational levels and local infrastructure. This facilitates the creation of more effective public policies, in addition to enabling continuous monitoring of vaccination rates, evaluating the effectiveness of campaigns and adjusting strategies according to the needs of the most vulnerable areas. The analysis of difficulties in accessing health services, based on self-reported information, highlights barriers perceived by the population, such as lack of information, distance to health posts and lack of trust in the health system. This data is essential to understand the reasons that lead to non-compliance with the vaccination schedule, identifying specific groups that face greater challenges, such as residents of rural areas or outskirts. This understanding allows for the adaptation of vaccination and health education strategies, promoting greater inclusion and en-suring equitable access to vaccines for all.