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Income transfers and vaccination: impact on COVID-19 mortality and hospitalizations in Brazil. A longitudinal
Mônica Silva Monteiro de Castro1, Anelise Andrade de Souza2, Guilherme Lopes de Oliveira3
1René Rachou Institute, Oswaldo Cruz Foundation (IRR - Fiocruz Minas), Belo Horizonte, Minas Gerais, Brazil.
Objective:
To analyze whether Emergency Aid Program (EAP) availability and COVID-19 vaccination were associated to changes in hospitalizations and mortality due to COVID-19 in Brazil.
Method:
This was a longitudinal ecological study with 5570 Brazilian municipalities as analysis units. Data from March 2020 to December 2021 were analysed. As control covariates, we considered socioeconomic, sociodemographic and morbidity characteristics and health services access, including COVID-19 testing availability and vaccination. Bayesian hierarchical models were adjusted with spatial and temporal effects.
Results:
EAP coverage (RR: 0.986; 95%CI: 0.984-0.988) and COVID-19 vaccine first dose coverage (RR: 0.982; 95%CI: 0.979-0.985) exhibited a negative association with the relative risk of COVID-19 hospitalization in Brazil. EAP coverage (RR: 0.975; 95%CI: 0.973-0.977), first-dose COVID-19 vaccine coverage (RR: 0.983; 95%CI: 0.981-0.985), and coverage of regular vaccination in children under 5 years old (RR: 0.996; 95%CI: 0.994-0.996) exhibited a negative association with COVID-19 mortality.
Conclusions:
The results highlight the important role of income transfer in COVID-19 morbidity and mortality, as well as the complementary effects and relevance of strengthening social protection policies and vaccination efforts in reducing severe cases in a pandemic scenario.
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