Incompletude do calendário vacinal infantil e fatores associado: análise hierarquizada em uma coorte de nascimento - BRISA, no Nordeste do Brasil

Abstract

The actions of child immunization are important to reducing child mortality, one of the Millennium development goals. For this, it is necessary that the vaccine coverage comply with the Ministry of Health recommendations. The data produced in the vaccination services are less reliable and still occur differences related to socio-economic factors associated to child vaccination. The study aimed to evaluate the factors associated to the incompleteness of basic vaccination schedule (BVS) and vaccination schedule for new vaccines (VSNV) (meningococcal C and pneumococcal 10) in children from 13 to 35 months old, from a birth cohort, in São Luis, Maranhão, Brasil. The sampling was probabilistic at birth, compound 3.076 children born in the year of 2010. The information regarding to vaccination was obtained from the vaccine card. The vaccines considered to BS were BCG, hepatitis B, polio, tetravalent, rotavirus, yellow fever and MMR, and for VSNV, were meningococcal and pneumococcal. An hierarchical analysis was held using Poisson regression with robust variance adjustment. Prevalence ratios (PR) were estimated and respective confidence intervals 95% (CI95%). The BS was incomplete in 33.2 % of children and VSNV at 51.1%. Largest incompleteness ratios of BS as VSNV were found in children whose mothers were teens (BS: PR=1.26 and CI 95% 1.10-1.45; NV: PR=1.15 and CI 95% 1.05-1.27), resided with other children (BS: PR=1,32 and CI95% 1,17-1,49; NV: PR=1,29 and CI95% 1,19-1,40 with one: BS: RP=1,55 and CI95% 1,34-1,80; NV: PR=1,3 and CI95%1,24-1,52 with two or three; BS: PR=1.81 and CI95% 1.41-2.33; NV: PR=1.36 and CI95% 1.11-1.67 with more than three), had smoking habit (BS: PR=1.52 and CI95% 1.28-1.82: NV: PR=1.22 and CI95% 1.07-1.40), don’t planned pregnancy (BS: PR=1.18 and CI95% 1.05-1.31; NV: PR=1.09 and CI95% 1.00-1.10), got pregnant just after the birth of the child under study (BS: PR=1.22 and CI95% 1.04-1.43; NV: PR=1.16 and CI95% 1.03-1.29), made a few prenatal appointment (BS: PR=1.25 and CI95% 1.11-1.40; NV: PR=1.15 and CI95% 1.06-1.25) and started it late (BS: PR=1.40 and CI95% 1.06-1.86; NV: PR=1.27 and CI95% 1.07-1.52). Sociodemographic and behavioral vulnerability indicators and low prenatal service using, were associated to incompleteness of childhood vaccination. It is suggested to consider these vulnerabilities at vaccination strategies, in order to contribute to the achievement of high vaccine coverage both from basic schedule as new vaccines introduced in childhood vaccination, and with that, to enable the child population greater protection against imunopreventable diseases. In addition to provide that pregnant women perform more prenatal appointment and do it so early.