Racial inequalities in child vaccination and barriers to vaccination in Brazil among live births in 2017 and 2018: an analysis of a retrospective cohort of the first two years of life

• Published in: Epidemiologia e serviços de saúde 2024-01, Vol.33 (spe2), p.e20231216
• Main Authors: Boing, Antonio Fernando, Boing, Alexandra Crispim, França, Ana Paula, Moraes, José Cássio de, Silva, Adriana Ilha da, Ramos, Jr, Alberto Novaes, Oliveira, Andrea de Nazaré Marvão, Domingues, Carla Magda Allan Santos, Oliveira, Consuelo Silva de, Maciel, Ethel Leonor Noia, Guibu, Ione Aquemi, Mirabal, Isabelle Ribeiro Barbosa, Barbosa, Jaqueline Caracas, Lima, Jaqueline Costa, Luhm, Karin Regina, Caetano, Karlla Antonieta Amorim, Lima, Luisa Helena de Oliveira, Antunes, Maria Bernadete de Cerqueira, Teixeira, Maria da Gloria, Teixeira, Maria Denise de Castro, Borges, Maria Fernanda de Sousa Oliveira, Queiroz, Rejane Christine de Sousa, Gurgel, Ricardo Queiroz, Barata, Rita Barradas, Azevedo, Roberta Nogueira Calandrini de, Oliveira, Sandra Maria do Valle Leone de, Teles, Sheila Araújo, Gama, Silvana Granado Nogueira da, Mengue, Sotero Serrate, Simões, Taynãna César, Nascimento, Valdir, Araújo, Wildo Navegantes de
• Format: Article
• Language: eng ; por
• Subjects: Adult; Black People - statistics & numerical data; Brazil; Child; Child, Preschool; Cohort Studies; Female; Health Care Sciences & Services; Health Inequities; Health Policy & Services; Health Services Accessibility - statistics & numerical data; Health Surveys; Healthcare Disparities - statistics & numerical data; Humans; Immunization Programs - statistics & numerical data; Infant; Infant, Newborn; Male; Mothers - statistics & numerical data; Original; Retrospective Studies; Socioeconomic Factors; Time Factors; Vaccination - statistics & numerical data; Vaccination Coverage; Vaccination Coverage - statistics & numerical data; White People - statistics & numerical data; Young Adult
• ISSN: 2237-9622; 1679-4974; 2237-9622
• DOI: 10.1590/S2237-96222024v33e20231216.especial2.en

To describe timely vaccination completion and obstacles in the first 24 months of life in Brazil, examining associations with maternal race/skin color. Study participants were 37,801 children born in 2017 and 2018 included in the National Immunization Coverage Survey. We calculated prevalence and 95% confidence intervals for timely vaccine completeness and obstacles at 5, 12 and 24 months of life, according to maternal race/skin color. Associations were analyzed using logistic regression. 7.2% (95%CI 6.3;8.2) of mothers faced difficulties in taking their children to be vaccinated, and 23.4% (95%CI 21.7;25.1) were not vaccinated when taken. These proportions were 75% (95%CI 1.25;2.45) and 97% (95%CI 1.57;2.48) higher, respectively, among Black mothers. At least one vaccination was delayed among 49.9% (95%CI 47.8;51.9) and 61.1% (95%CI 59.2;63.0) of children by 5 and 12 months, respectively. These rates were higher among Black/mixed race mothers. There are racial inequalities in both the obstacles faced and in vaccination rates in Brazil. Marked racial inequalities were found in the obstacles to vaccination of children under 24 months in Brazil and to timely vaccination at 5 months and in the first year of life. Racial inequalities in the occurrence of vaccination shortcomings in health services, in the objective restrictions faced by families in taking their children to vaccination centers and in incomplete vaccination in a timely manner need to be addressed by the Brazilian National Health System. Equal public policies to address barriers to vaccination and qualification of health services need to be implemented. Studies need to deepen understanding of the structural determinants that lead to racial disparities.