Vaccination Barriers in Brazil: Exploring Hesitancy, Access, and Missed Opportunities in a Cohort of Children (2017–2018)—National Vaccination Coverage Survey Results (2020–2021)

Background/Objectives: In recent years, Brazil has experienced declining vaccination coverage, raising concerns about vaccine hesitancy and barriers to access. This research analyzes the reasons for non-vaccination among children born in 2017 and 2018 in a metropolitan area of the state of São Paulo...

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Main Authors: Letícia Bezerra Faria, Ana Paula França, José Cássio de Moraes, Maria Rita Donalisio
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Vaccines
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Online Access:https://www.mdpi.com/2076-393X/13/5/516
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author Letícia Bezerra Faria
Ana Paula França
José Cássio de Moraes
Maria Rita Donalisio
author_facet Letícia Bezerra Faria
Ana Paula França
José Cássio de Moraes
Maria Rita Donalisio
author_sort Letícia Bezerra Faria
collection DOAJ
description Background/Objectives: In recent years, Brazil has experienced declining vaccination coverage, raising concerns about vaccine hesitancy and barriers to access. This research analyzes the reasons for non-vaccination among children born in 2017 and 2018 in a metropolitan area of the state of São Paulo in 2020 and 2021. Methods: Data were obtained from a retrospective cohort of children born in 2017 and 2018, living in Campinas, monitored during the first 24 months by vaccination records. A stratified and clustered sample by census sector was performed according to socioeconomic conditions. The reasons for non-vaccination were obtained from interviews with the children’s guardians. Results: A total of 1775 caregivers were interviewed, and 63.1% of children had complete vaccination coverage, with lower socioeconomic groups presenting the highest rates for non-vaccination. The study identified three main groups for non-vaccination: vaccine hesitancy (e.g., fear of side effects, misinformation) in 1.7% of respondents, access difficulties (e.g., service location, financial constraints) in 7.9%, and missed opportunities (e.g., lack of vaccines, administrative barriers) in 16.4%. Conclusions: The findings indicate that the main reported barriers to childhood vaccination are missed opportunities in healthcare services, often due to vaccine shortages or administrative issues, along with social vulnerabilities. Vaccine hesitancy stems from misinformation and fear of side effects. Despite these challenges, families persist in seeking vaccination. However, coverage remains below the national targets, particularly in the second year of life. Targeted public health interventions are urgently needed to improve vaccine confidence, accessibility, and healthcare system efficiency.
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spelling doaj-art-ed836dc577b54f909a39e5d5c77148a32025-08-20T03:12:05ZengMDPI AGVaccines2076-393X2025-05-0113551610.3390/vaccines13050516Vaccination Barriers in Brazil: Exploring Hesitancy, Access, and Missed Opportunities in a Cohort of Children (2017–2018)—National Vaccination Coverage Survey Results (2020–2021)Letícia Bezerra Faria0Ana Paula França1José Cássio de Moraes2Maria Rita Donalisio3Faculty of Medical Sciences of the University of Campinas, Campinas 13083-887, BrazilFaculty of Medical Sciences of the Santa Casa de São Paulo, São Paulo 01224-001, BrazilFaculty of Medical Sciences of the Santa Casa de São Paulo, São Paulo 01224-001, BrazilFaculty of Medical Sciences of the University of Campinas, Campinas 13083-887, BrazilBackground/Objectives: In recent years, Brazil has experienced declining vaccination coverage, raising concerns about vaccine hesitancy and barriers to access. This research analyzes the reasons for non-vaccination among children born in 2017 and 2018 in a metropolitan area of the state of São Paulo in 2020 and 2021. Methods: Data were obtained from a retrospective cohort of children born in 2017 and 2018, living in Campinas, monitored during the first 24 months by vaccination records. A stratified and clustered sample by census sector was performed according to socioeconomic conditions. The reasons for non-vaccination were obtained from interviews with the children’s guardians. Results: A total of 1775 caregivers were interviewed, and 63.1% of children had complete vaccination coverage, with lower socioeconomic groups presenting the highest rates for non-vaccination. The study identified three main groups for non-vaccination: vaccine hesitancy (e.g., fear of side effects, misinformation) in 1.7% of respondents, access difficulties (e.g., service location, financial constraints) in 7.9%, and missed opportunities (e.g., lack of vaccines, administrative barriers) in 16.4%. Conclusions: The findings indicate that the main reported barriers to childhood vaccination are missed opportunities in healthcare services, often due to vaccine shortages or administrative issues, along with social vulnerabilities. Vaccine hesitancy stems from misinformation and fear of side effects. Despite these challenges, families persist in seeking vaccination. However, coverage remains below the national targets, particularly in the second year of life. Targeted public health interventions are urgently needed to improve vaccine confidence, accessibility, and healthcare system efficiency.https://www.mdpi.com/2076-393X/13/5/516vaccinationvaccination hesitancymiss opportunity of vaccinationcohort studychildren
spellingShingle Letícia Bezerra Faria
Ana Paula França
José Cássio de Moraes
Maria Rita Donalisio
Vaccination Barriers in Brazil: Exploring Hesitancy, Access, and Missed Opportunities in a Cohort of Children (2017–2018)—National Vaccination Coverage Survey Results (2020–2021)
Vaccines
vaccination
vaccination hesitancy
miss opportunity of vaccination
cohort study
children
title Vaccination Barriers in Brazil: Exploring Hesitancy, Access, and Missed Opportunities in a Cohort of Children (2017–2018)—National Vaccination Coverage Survey Results (2020–2021)
title_full Vaccination Barriers in Brazil: Exploring Hesitancy, Access, and Missed Opportunities in a Cohort of Children (2017–2018)—National Vaccination Coverage Survey Results (2020–2021)
title_fullStr Vaccination Barriers in Brazil: Exploring Hesitancy, Access, and Missed Opportunities in a Cohort of Children (2017–2018)—National Vaccination Coverage Survey Results (2020–2021)
title_full_unstemmed Vaccination Barriers in Brazil: Exploring Hesitancy, Access, and Missed Opportunities in a Cohort of Children (2017–2018)—National Vaccination Coverage Survey Results (2020–2021)
title_short Vaccination Barriers in Brazil: Exploring Hesitancy, Access, and Missed Opportunities in a Cohort of Children (2017–2018)—National Vaccination Coverage Survey Results (2020–2021)
title_sort vaccination barriers in brazil exploring hesitancy access and missed opportunities in a cohort of children 2017 2018 national vaccination coverage survey results 2020 2021
topic vaccination
vaccination hesitancy
miss opportunity of vaccination
cohort study
children
url https://www.mdpi.com/2076-393X/13/5/516
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