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[Assessment of vaccination coverage of the basic schedule for the 1st year of life]
A S de Miranda1, I M Scheibel, M R Tavares
1Grupo Hospitalar Conceição, Serviço de Saúde, Comunitária, Unidade Valão, Porto Alegre, Brasil.
Insights
This study assessed childhood immunization rates, finding significant improvements post-primary care implementation. While individual vaccine coverage is high, achieving the full immunization schedule remains a challenge, prompting program reorganization for 100% coverage.
Area of Science:
- Public Health
- Pediatrics
- Epidemiology
Background:
- Baseline immunization coverage in the study area was below 60% prior to primary care establishment.
- Previous studies indicated low immunization rates for scheduled vaccines.
Purpose of the Study:
- To evaluate immunization coverage in children aged 12-23 months.
- To assess the impact of a Primary Care Practice on immunization rates.
- To identify disparities in coverage and inform program improvements.
Main Methods:
- Home visits and immunization chart reviews were conducted.
- Mothers' information was utilized to verify vaccination status.
- Coverage was assessed for individual vaccines (DTP, Sabin, measles, BCG) and the full first-year schedule.
Main Results:
- Coverage reached 87% for DTP, 89% for Sabin, 88% for measles, and 79% for BCG.
- Only 75% of children completed the full first-year immunization schedule.
- Coverage varied by census tract, with higher rates in poorer, remote areas.
- Routine administrative evaluations underestimated actual immunization coverage.
- Maternal antitetanus vaccine uptake was 49%.
Conclusions:
- The Primary Care Practice significantly improved immunization coverage.
- Gaps exist in completing the full immunization schedule, necessitating program adjustments.
- Targeted interventions in underserved areas proved effective.
- Reorganization of the immunization program aimed for 100% coverage.
Abstract:
Immunization coverage was evaluated in all 12-23 month-old children living in the area were five years before a Primary Care Practice had been set up. All children were investigated through home visits, checking of the immunization chart and relying on mothers' information. In 1986, a baseline study had identified an immunization coverage of under 60% for each of the scheduled vaccines. The current study confirmed that coverage was of 87% for three doses of DTP, 89% for Sabin, 88% for one dose of measles vaccine and 79% for BCG. Despite the high coverage achieved for each specific vaccine, when the basic schedule for the first year was verified, it was observed that only 75% of the children had received the full scheme. Immunization coverage is uneven in different census tracts, being higher in the poorest and more remote areas, where seam the health was given extra attention. A comparison with the routine administrative evaluation of the immunization coverage showed that this underestimated the real coverage. Maternal immunization uptake was also evaluated (antitetanus vaccine during pregnancy) and only 49% of the women were found to be adequately protected. The information collected led to a reorganization of the whole immunization program in a 100% coverage.