SEARCHCOHORTpediatrics, epidemiology

cohort·pediatrics, epidemiology, public health, immunology, nutrition·PMC10013469

Factors associated with incomplete vaccination and negative antibody test results for measles, mumps, and hepatitis A among children followed in the MINA-BRAZIL cohort

Revista do Instituto de Medicina Tropical de São Paulo · 5 authors, 3 centres

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TL;DR

This population-based cohort study of 825 Brazilian children found that vaccination coverage for MMR and hepatitis A was below national targets and was associated with specific maternal sociodemographic factors. Among vaccinated children, negative antibody tests for measles and mumps were linked to receiving Bolsa Familia allowance, and negative mumps tests were also associated with vitamin A deficiency.

Full summary

827 CHARS

The study analyzed a population-based cohort of 825 children in Cruzeiro do Sul, Brazil, to assess vaccination adherence and seropositivity for measles, mumps, and hepatitis A at age 2. Modified Poisson regression identified factors associated with incomplete vaccination: white-skinned mother, paid maternity leave, multiparity, fewer antenatal consultations, and attending childcare for MMR; white-skinned mother and no cohabiting partner for hepatitis A. Among vaccinated children, negative antibody tests for measles and mumps were significantly associated with receiving Bolsa Familia allowance, and negative mumps tests were also associated with vitamin A deficiency. Implications suggest targeted strategies are needed to improve vaccine adherence and address social and nutritional factors influencing immune responses.

STUDY TYPE

cohort

SPECIALTY

pediatrics

SUMMARISED BY

AI pipeline

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100% · A

ORIGINAL PAPER

PMC10013469

Factors associated with incomplete vaccination and negative antibody test results for measles, mumps, and hepatitis A among children followed in the MINA-BRAZIL cohort

Revista do Instituto de Medicina Tropical de São Paulo

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ABSTRACT

ABSTRACT Vaccination coverage has been dropping in Brazil and other countries. In addition, immune responses after vaccination may not be homogeneous, varying according to sociodemographic and clinical factors. Understanding the determinants of incomplete vaccination and negative antibody test results may contribute to the development of strategies to improve vaccination effectiveness. In this study, we aimed to investigate the frequency of vaccine adherence, factors associated with incomplete vaccination for measles, mumps, rubella (MMR) and hepatitis A, and factors associated with the seronegative test results for measles, mumps and hepatitis A at 2 years of age. This was a population-based cohort that addressed health conditions and mother/infant nutrition in Cruzeiro do Sul city, Brazil. Vaccination data were obtained from official certificates of immunization. The children underwent blood collection at the two-year-old follow-up visit; the samples were analyzed using commercially available kits to measure seropositivity for measles, mumps, and hepatitis A. We used modified Poisson regression models adjusted for covariates to identify factors associated with incomplete vaccination and negative serology after vaccination. Out of the 825 children included in the study, adherence to the vaccine was 90.6% for MMR, 76.7% for the MMRV (MMR + varicella), and 74.9% for the hepatitis A vaccine. For MMR, after the adjustment for covariates, factors associated with incomplete vaccination included: white-skinned mother; paid maternity leave; raising more than one child; lower number of antenatal consultations; and attending childcare. For hepatitis A, the factors included: white-skinned mother and not having a cohabiting partner. The factors with statistically significant association with a negative antibody test result included: receiving Bolsa Familia allowance for measles and mumps; incomplete vaccination for measles; and vitamin A deficiency for mumps. Strategies to improve the efficiency of vaccine programs are urgently needed. These include improvements in communication about vaccine safety and efficacy, and amplification of access to primary care facilities, prioritizing children exposed to the sociodemographic factors identified in this study. Additionally, sociodemographic factors and vitamin A deficiency may impact the immune responses to vaccines, leading to an increased risk of potentially severe and preventable diseases.

CITATION EXPORT

Midiã Silva Ferreira, Marly Augusto Cardoso, Lalucha Mazzucchetti et al.. Factors associated with incomplete vaccination and negative antibody test results for measles, mumps, and hepatitis A among children followed in the MINA-BRAZIL cohort. Revista do Instituto de Medicina Tropical de São Paulo. (2023). https://doi.org/10.1590/S1678-9946202365016

AUTHORS

5 · 3 CENTRES

Midiã Silva Ferreira, Marly Augusto Cardoso, Lalucha Mazzucchetti, Ester Cerdeira Sabino, Vivian Iida Avelino-Silva

1Universidade de São Paulo, Faculdade de Medicina, Departamento de Doenças Infecciosas e Parasitárias, São Paulo, São Paulo, Brazil
2Universidade de São Paulo, Faculdade de Saúde Pública, Departamento de Nutrição, São Paulo, São Paulo, Brazil
3Universidade de São Paulo, Faculdade de Medicina, Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil