Vaccination coverage in children under one year of age and associated socioeconomic factors: maps of spatial heterogeneity

Pereira, Matheus Adriano Divino; Arroyo, Luis Henrique; Gallardo, Maria Del Pilar Serrano; Arcêncio, Ricardo Alexandre; Gusmão, Josianne Dias; Amaral, Gabriela Gonçalves; Oliveira, Valéria Conceição de; Guimarães, Eliete Albano de Azevedo

doi:10.1590/0034-7167-2022-0734

Matheus Adriano Divino Pereira

study/research conception or design

data analysis and/or interpretation and final review with critical and intellectual participation in the manuscript

Universidade Federal de São João del-Rei. Divinópolis, Minas Gerais, Brazil

https://orcid.org/0000-0002-5127-5659

Luis Henrique Arroyo

study/research conception or design

data analysis and/or interpretation and final review with critical and intellectual participation in the manuscript

Universidade de São Paulo. Ribeirão Preto, São Paulo, Brazil

https://orcid.org/0000-0003-3302-0502

Maria Del Pilar Serrano Gallardo

study/research conception or design

data analysis and/or interpretation and final review with critical and intellectual participation in the manuscript

Universidad Autónoma de Madrid. Madrid, Spain

https://orcid.org/0000-0002-5163-6821

Ricardo Alexandre Arcêncio

study/research conception or design

data analysis and/or interpretation and final review with critical and intellectual participation in the manuscript

Universidade de São Paulo. Ribeirão Preto, São Paulo, Brazil

https://orcid.org/0000-0003-4792-8714

Josianne Dias Gusmão

study/research conception or design

data analysis and/or interpretation and final review with critical and intellectual participation in the manuscript

Secretaria de Estado da Saúde de Minas Gerais. Belo Horizonte, Minas Gerais, Brazil

https://orcid.org/0000-0001-5109-2687

Gabriela Gonçalves Amaral

data analysis and/or interpretation and final review with critical and intellectual participation in the manuscript

Universidade do Estado de Minas Gerais. Divinópolis, Minas Gerais, Brazil

https://orcid.org/0000-0002-9629-2815

Valéria Conceição de Oliveira

study/research conception or design

data analysis and/or interpretation and final review with critical and intellectual participation in the manuscript

Universidade Federal de São João del-Rei. Divinópolis, Minas Gerais, Brazil

https://orcid.org/0000-0003-2606-9754

Eliete Albano de Azevedo Guimarães Corresponding author: Eliete Albano de Azevedo Guimarães E-mail: elietealbano@ufsj.edu.br

data analysis and/or interpretation and final review with critical and intellectual participation in the manuscript

Universidade Federal de São João del-Rei. Divinópolis, Minas Gerais, Brazil

https://orcid.org/0000-0001-9236-8643

Corresponding author: Eliete Albano de Azevedo Guimarães E-mail: elietealbano@ufsj.edu.br

EDITOR IN CHIEF: Antonio José de Almeida Filho

ASSOCIATE EDITOR: Ana Fátima Fernandes

Variable	Description	Source (reference year)
Urbanization rate	Ratio between the total number of people living in the urban area of the municipality and its total resident population	IBGE/Fundação João Pinheiro (2018)
Number of families with per capita income up to 1/2 minimum wage	Total families who were registered in the single registry, whose per capita income is equal to or less than ½ the minimum wage	Department for Information Assessment and Management - Ministry of Citizenship/Fundação João Pinheiro (2018)
Percentage of population aged 25 and over with a high school education	Ratio between the population aged 25 and over who completed high school and the total number of people in this age group	Atlas of Human Development in Brazil/Fundação João Pinheiro (2013)
Proportion of population assisted by the Family Health Strategy	Ratio between service capacity and the municipality’s total population	State Department of Health of Minas Gerais/Fundação João Pinheiro (2018)
Total population (adjusted estimates)	Resident population estimate	Fundação João Pinheiro (2018)
Budgetary effort in health activities	Share of budgetary expenditures presented in the annual rendering of accounts carried out in the subfunctions of primary care, hospital and outpatient care, prophylactic and therapeutic support, health surveillance, epidemiological surveillance and food and nutrition in total expenditures	Minas Gerais Court of Auditors/Fundação João Pinheiro (2018)
Index of absorption of digital technologies by municipal management	Indicator provides a summary view of each municipality’s position regarding the use of digital technologies in their management activities	Minas Gerais Court of Auditors/Fundação João Pinheiro (2018)
Budget effort on education activities	Participation of budget expenditures presented in the annual rendering of accounts carried out in the elementary education, high school education, professional education, higher education, child education, youth and adult education and special education subfunctions in total expenses	Minas Gerais Court of Auditors/Fundação João Pinheiro (2018)
Basic social protection index	Indicator composed of the existence of Comprehensive Family Protection services, Coexistence and Bond Strengthening for children aged 0 to 6 years and Coexistence and Bond Strengthening for older adults. Each service is worth 1 point, with a total of 3 points	Census of the Unified Social Assistance System/Fundação João Pinheiro (2018)
Percentage of families living in rural areas	Ratio between people from families living in rural areas registered in the single registry and the total population	Department for Information Assessment and Management - Ministry of Citizenship/Fundação João Pinheiro (2018)
Percentage of people aged 15 or over who cannot read and write and the population in this age group in the single registry	Ratio between people aged 15 or over who cannot read and write and the population in this age group registered in the municipality’s single registry	Department for Information Assessment and Management - Ministry of Citizenship/Fundação João Pinheiro (2018)
Percentage of population in households with a bathroom and piped water	Ratio between the population living in private households with piped water and exclusive bathroom and the total resident population	Atlas of Human Development in Brazil/Fundação João Pinheiro (2013)
Proportion of hospital admissions for conditions sensitive to primary care	Ratio between the number of hospital admissions for conditions sensitive to primary care and the total number of hospital admissions (Ordinance 221 of April 17, 2008)	Unified Health System Hospital Information System/Fundação João Pinheiro (2018)
Proportion of live births whose mothers had seven or more prenatal consultations	Ratio between the number of live births whose mothers had 7 or more prenatal consultations and the total number of live births	State Department of Health of Minas Gerais/Fundação João Pinheiro (2018)
20% richest/40% poorest ratio	Measure of existing degree of inequality in the distribution of individuals according to per capita household income. It compares the average per capita income of individuals belonging to the richest quintile with individuals in the poorest two quintiles	Atlas of Human Development in Brazil/Fundação João Pinheiro (2013)
Per capita income	Ratio between the sum of income of all individuals living in permanent private households and the total number of these individuals	Atlas of Human Development in Brazil/Fundação João Pinheiro (2013)
Minas Gerais Social Responsibility Index	Weighted average of the subindices referring to ten dimensions: education, health, income and employment, public safety, environment, sanitation and housing, culture, sport, tourism and leisure, social assistance and municipal finance	Fundação João Pinheiro (2018)
Percentage of poor or extremely poor population in the single registry in relation to the municipality’s total population	Ratio between poor or extremely poor populations registered in the single registry and the municipality’s total population	Department for Information Assessment and Management - Ministry of Citizenship/Fundação João Pinheiro (2018)

Macro-region	Vaccination coverage (%)
Macro-region	Pentavalent	Poliomyelitis	10VPC^{^* * 10VPC - 10-valent pneumococcal conjugate;}	LORV^† † LORV - rotavirus; ‡MNC - meningococcal conjugate;	MNC^‡	YF^§ § YF - yellow fever.
South	96.9	96.3	99.9	98.5	98.8	94.6
South Center	96.8	96.9	99.4	98.4	99.2	97.6
Center	88.9	88.7	92.0	90.0	90.0	90.3
Jequitinhonha	91.7	90.7	91.2	89.1	88.4	87.8
West	96.1	96.1	98.8	97.9	93.3	94.2
East	96.2	95.8	100.6	97.4	98.5	90.4
Southeast	98.8	98.6	102.6	100.7	99.4	96.1
North	96.0	95.5	100.3	97.3	97.8	89.8
Northwest	98.1	98.5	103.1	100.6	99.3	95.9
East south	98.9	99.5	102.4	100.6	100.5	95.3
Northeast	94.4	92.9	95.8	93.4	93.1	88.8
Triângulo do Sul	89.6	88.5	92.5	89.6	86.6	81.2
Triângulo do Norte	124.4	124.3	127.6	127.4	126.7	114.7
Steel valley	93.8	94.0	98.3	95.8	95.0	90.8

Explanatory variable (by vaccine)	Odds Ratio	(95%) Confidence Interval	p value
Rotavirus
Number of families with per capita income up to 1/2 minimum wage	0.98	0.97 - 0.99	0.002^{^* * Significant values (p<0.05)}
Percentage of poor or extremely poor populations in the single registry in relation to the municipality’s total population	1.02	1.01 - 1.04	0.015^{^* * Significant values (p<0.05)}
Minas Gerais Social Responsibility Index	36.75	1.36 - 45.27	0.032^{^* * Significant values (p<0.05)}
20% richest/40% poorest ratio	0.94	0.88 - 1.01	0.081
Proportion of population assisted by the Family Health Strategy	1.01	0.99 - 1.03	0.090
Budgetary effort in health activities	1.00	0.99 - 1.1	0.141
Index of absorption of digital technologies by municipal management	0.65	0.35 - 1.16	0.154
Meningococcal conjugate
Number of families with per capita income up to 1/2 minimum wage	0.98	0.97 - 0.99	<0.001^{^* * Significant values (p<0.05)}
Budgetary effort in health activities	0.97	0.94 - 1.01	0.080
Proportion of population assisted by the Family Health Strategy	1.01	0.99 - 1.03	0.064
Proportion of live births whose mothers had 7 or more prenatal consultations	0.98	0.96 - 1.01	0.074
Minas Gerais Social Responsibility Index	35.72	10.77 - 43.65	0.001^{^* * Significant values (p<0.05)}
Percentage of poor or extremely poor population in the single registry in relation to the municipality’s total population	1.03	1.01 - 1.05	<0.001^{^* * Significant values (p<0.05)}
20% richest/40% poorest ratio	0.92	0.86 - 0.99	0.033^{^* * Significant values (p<0.05)}
Proportion of hospital admissions for conditions sensitive to primary care	0.99	0.98 - 1.01	0.139
10-valent pneumococcal conjugate
Number of families with per capita income up to 1/2 minimum wage	0.98	0.97 - 0.99	0.001^{^* * Significant values (p<0.05)}
Proportion of population assisted by the Family Health Strategy	1.02	1.01 - 1.04	0.002^{^* * Significant values (p<0.05)}
Proportion of live births whose mothers had 7 or more prenatal consultations	0.98	0.97 - 1.01	0.075
Proportion of hospital admissions for conditions sensitive to primary care	0.98	0.97 - 0.99	0.038^{^* * Significant values (p<0.05)}
Budgetary effort in health activities	1.00	0.99 - 1.01	0.105
Pentavalent
Number of families with per capita income up to 1/2 minimum wage	0.98	0.97 - 0.99	0.001^{^* * Significant values (p<0.05)}
Budgetary effort in health activities	0.97	0.94 - 1.01	0.084
urbanization rate	0.42	0.14 - 1.23	0.115
20% richest/40% poorest ratio	0.94	0.87 - 1.01	0.069
Proportion of population assisted by the Family Health Strategy	1.01	1 - 1.02	0.142
Proportion of hospital admissions for conditions sensitive to primary care	0.99	0.98 - 1	0.148
Proportion of live births whose mothers had 7 or more prenatal consultations	0.99	0.97 - 1	0.087
Minas Gerais Social Responsibility Index	63.02	31.11 - 81.70	0.017^{^* * Significant values (p<0.05)}
Percentage of poor or extremely poor population in the single registry in relation to the municipality’s total population	1.02	1.01 - 1.04	0.049^{^* * Significant values (p<0.05)}
Poliomyelitis
Number of families with per capita income up to 1/2 minimum wage	0.98	0.97 - 0.99	<0.001^{^* * Significant values (p<0.05)}
Budgetary effort in health activities	0.96	0.94 - 1.02	0.087
Proportion of population assisted by the Family Health Strategy	1.02	1.01 - 1.03	0.024^{^* * Significant values (p<0.05)}
Proportion of hospital admissions for conditions sensitive to primary care	0.99	0.97 - 1	0.058
Yellow fever
Number of families with per capita income up to 1/2 minimum wage	0.97	0.96 - 0.98	<0.001^{^* * Significant values (p<0.05)}
Proportion of population assisted by the Family Health Strategy	1.01	0.99 - 1.03	0.102
Minas Gerais Social Responsibility Index	33.66	26.34 - 67.90	0.002^{^* * Significant values (p<0.05)}
Percentage of poor or extremely poor population in the single registry in relation to the municipality’s total population	1.02	1.01 - 1.03	0.048^{^* * Significant values (p<0.05)}
20% richest/40% poorest ratio	0.92	0.86 - 0.98	0.017^{^* * Significant values (p<0.05)}
urbanization rate	0.42	0.15 - 1.15	0.093
Budget effort on education activities	1.00	0.99 - 1.01	0.159
Total population (adjusted estimates)	1.00	0.99 - 1.01	0.270

[1] Corresponding author: Eliete Albano de Azevedo Guimarães E-mail: elietealbano@ufsj.edu.br

Brasil

Brasil

Vaccination coverage in children under one year of age and associated socioeconomic factors: maps of spatial heterogeneity

Coberturas de vacunación en menores de un año y factores socioeconómicos asociados: mapas de heterogeneidad espacial

ABSTRACT

Objective:

Methods:

Results:

Conclusions: