Use of private vaccination services by infants in Brazilian municipalities: National Vaccine Coverage Survey 2020

Epidemiol Serv Saude. 2024 Nov 1;33(spe2):e20231203. doi: 10.1590/S2237-96222024v33e20231203.especial2.en. eCollection 2024.
[Article in English, Portuguese]

Abstract

Objective: To characterize the use of private services in infant vaccination and assess vaccination coverage according to the service used.

Methods: : This was a national vaccination survey conducted in 2020 that estimated the use of private vaccination services and vaccination coverage among infants residing in state capitals and 12 inland municipalities.

Results: : Of the 37,801 participants, 25.1% (95%CI 23.2;27.2) used private services at least once, with higher proportions in capitals, larger cities and in the South and Southeast regions. Socioeconomic and demographic differences were identified among families, based on the service used. The coverage for the set of vaccines administered up to 24 months was 60.3% (95%CI 58.6;62.0) in the public service and 59.5% (95%CI 55.9;63.0) in private services, and up-to-date vaccines, 10.3% (95%CI 9.1;11.6) and 9.4% (95%CI 7.4;11.8), respectively.

Conclusion: The use of private services was frequent, with low coverage for the set of vaccines, regardless of the type of service used, especially for up-to-date vaccines.

Objetivo: Caracterizar el empleo de servicios privados en la vacunación de lactantes y evaluar la cobertura vacunal según el servicio utilizado.

Método: Encuesta nacional de vacunación realizada en 2020, que estimó la utilización de servicios privados y cuberturas vacunales de lactantes residentes en capitales y 12 ciudades del interior.

Resultados: De los 37.801 participantes, 9.287 (25,1% IC95% 23,2;27,2) utilizaron alguna vez servicios privados, con mayores proporciones en capitales, ciudades más grandes y regiones Sur y Sureste. Se identificaron diferencias socioeconómicas y demográficas en las familias, según servicio utilizado. La cobertura del conjunto de vacunas administradas hasta 24 meses fue 60,3% (IC95% 58,6;62,0) en servicios públicos y 59,5% (IC95% 55,9;63,0) en privados, y de vacunas al día 10,3% (IC95% 9,1;11,6) y 9,4% (IC95% 7,4;11,8) respectivamente.

Conclusión: El uso de servicios privados fue frecuente, con baja cobertura para el conjunto de vacunas, independientemente del tipo de servicio utilizado, específicamente para vacunas al día.

Plain language summary

Main results: The use of private vaccination services was observed in 25% of the municipalities studied, as well as low complete vaccination coverage in children up to 24 months old in both private and public services, especially for up-to-date vaccines.

Implications for services: The increasing role of private vaccination services highlights the importance of coordination between immunization program managers at all levels and private vaccination services.

Perspectives: Monitoring the vaccination status and conducting studies to understand the factors associated with incomplete and delayed vaccination are necessary. Such research can contribute to the adoption of new strategies that also include private vaccination services.

MeSH terms

  • Brazil
  • Child, Preschool
  • Cities
  • Cross-Sectional Studies
  • Female
  • Health Care Surveys*
  • Humans
  • Immunization Programs* / statistics & numerical data
  • Infant
  • Infant, Newborn
  • Male
  • Private Sector* / statistics & numerical data
  • Public Sector / statistics & numerical data
  • Socioeconomic Factors
  • Vaccination Coverage* / statistics & numerical data
  • Vaccination* / statistics & numerical data
  • Vaccines / administration & dosage

Substances

  • Vaccines

Grants and funding

This study received financial support from the Department of Science and Technology of the Ministry of Health, through the National Council for Scientific and Technological Development, process No. 404131/2019-0.