Proposal of a vaccination needs index to prioritize municipal interventions in Brazil

Abstract

AbstractIntroductionTo address the health needs of a population, it is essential to integrate several indicators that are expressed on non-comparable scales. Vaccination is a crucial aspect of public health, and prioritizing vaccination needs through immunization registries can help allocate resources and funding to integral approaches.ObjectiveTo propose and implement an index of vaccination needs (VNI) based on national administrative data on tracer vaccines for children, born between 2019 and 2022, to help prioritize Brazilian municipalities.MethodologyWe analyzed data from 5,570 municipalities in Brazil. The VNI integrated indicators of vaccination coverage and the number of susceptible children regarding tracer vaccines for children including DTP – Diphtheria-Tetanus-Pertussis (third dose), polio (third dose), and MMR – Measles-Mumps and Rubella (second dose). We assessed how the VNI could identify a group of municipalities in challenging situations to improve vaccination.ResultsCompared with criteria based only on the absolute number of unvaccinated children (susceptible children) or the vaccination coverage, the group prioritized for having high VNI exhibited more similar proportions of large, medium, and small municipalities. Additionally, this group included more municipalities located in the Legal Amazon region and Special Sanitary Indigenous Districts than groups prioritized with the other criteria. The VNI also outperformed the other criteria to prioritize municipalities that differed from the rest regarding the Gini coefficient.ConclusionThe proposed VNI can facilitate the identification of populations that need differentiated interventions to prevent the resurgence of eliminated or controlled vaccine-preventable diseases.