Análise da taxa de abandono das vacinas de multidose do calendário nacional de vacinação infantil nos municípios de uma Região do Estado de São Paulo, Brasil

Abstract

Introduction: the scope of the National Immunization Program and the proper fulfillment of the National Vaccination Calendar as well as the vaccination coverage goals are crucial for the control of vaccine-preventable diseases. A considerable and worrying decrease in vaccination coverage in the country has been observed since 2015. However, the causes are still unknown.The dropout rate is one of the indicators of vaccination coverage and it can be directly related to the quality of vaccination services. Purpose: the aim of this study was to analyze the rates of multidose vaccines dropouts, recommended in children under two years of age, according to the National Vaccination Calendar of the National Immunization Program from Baixada Santista cities. Method: this is an exploratory ecological study with secondary data. We collected doses of multidose vaccines applied in 2017 by the Information System of the National Immunization Program (SI-PNI), from the SUS Computer Department (DATASUS). The dropout rates were calculated and categorized. We also made the descriptive analysis, the georeference map and Dunn´s multiple comparison test (p<0,05). Results: it was verified that in Baixada Santista cities, there were high dropout rates for immunobiologicals against Measles-Mumps-Rubella (57.80 ± 6.60), Hepatitis B (11.35 ± 9.59), Haemophilus influenzae type B (11.15 ± 9.59) and Diphtheria, Tetanus and Whooping Cough (11.06 ± 9.64). According to Dunn´s test, a significant difference of dropout rates was found not only by cities and immunobiologicals (p<0,001), but also by immunobiologicals and cities (p<0,001). The immunobiological against measles, mumps and rubella was considered the highest dropout rate due to being the only multidose vaccine for children under one year of age. Conclusion: Identifying the high rates of abandonment of multidose vaccines in these cities, we realized these dynamics occured in different aspect.Thus, it is important to propose a better strategic planning to reduce the rates of abandonment and improve the effectiveness of immunization in vaccination rooms highlighting the role of Primary Prevention from SUS.