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Avaliação do cumprimento da primovacinação com a VASPR e vacina BCG, após atualização dos respetivos esquemas vacinais, no âmbito do Programa Nacional de Vacinação
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Introdução: Os esquemas vacinais, de acordo com o Programa Nacional de Vacinação (PNV), da Vacina contra o Sarampo, Parotidite Epidémica e Rubéola (VASPR) e da vacina Bacille Calmette-Guérin (BCG), foram atualizados em 2012 e 2016, respetivamente. Os principais objetivos deste estudo foram avaliar: o cumprimento da primovacinação com a VASPR, aos 12 meses de idade; a realização da vacinação com a BCG pelos grupos de risco incluídos na Norma 06/2016 da Direção-Geral de Saúde (DGS); quais os fatores relacionados com a vacinação incorreta com estas vacinas.
Métodos: Estudo observacional, transversal, realizado através da aplicação de um inquérito anónimo, entregue em mão, aos acompanhantes das crianças que se dirigiram ao Serviço de Urgência Pediátrica do Departamento de Pediatria do Hospital de Santa Maria do Centro Hospitalar Universitário Lisboa Norte, EPE (SUPHSM-CHULN), entre janeiro e março de 2023. Analisaram-se os parâmetros sociodemográficos, realização da primeira dose da VASPR e da vacina BCG, razões do possível atraso/não realização e análise da integração em grupos de risco da Norma. Entregou-se um folheto informativo com o esquema vacinal mais recente e contraindicações falsas das vacinas.
Resultados: Entrevistaram-se 203 acompanhantes, sendo 40,4% das crianças imigrantes ou com pais imigrantes; 95,6% residiam no distrito de Lisboa, com idade compreendida entre os 13 meses e os 11 anos. 93,1% fizeram a primeira dose da VASPR, mas 27,1% realizaram com um atraso médio de 2,24 meses. Verificou-se uma relação estatisticamente significativa entre a população imigrante e o atraso na primovacinação com a VASPR (p-value = 0,012). Das 141 crianças que nasceram a partir de 2016, 61,7% pertenciam a grupos de risco incluídos na Norma e destas, 88,5% realizaram a BCG. Das crianças que faziam parte de um grupo de risco, 14,3% das imigrantes não realizaram a BCG, ao contrário de 6,5% das crianças não imigrantes.
Conclusão: A cobertura vacinal com a primeira dose da VASPR aos 12 meses, na população estudada, encontra-se abaixo do limite recomendado e existe uma bolsa populacional de crianças pertencentes a grupos de risco que não foram vacinadas com a BCG. Essas taxas de cobertura vacinal são influenciadas pelos contextos nacionais e internacionais, durante os anos de nascimento das crianças e o ano subsequente, pelo concelho de residência e por constituírem a população imigrante.
Introduction: The vaccination schedule of measles, mumps and rubella vaccine (MMRV) and BCG vaccine, according to the Portuguese National Program of Vaccination, were updated in 2012 and in 2016, respectively. The main objectives of this study were to evaluate the fulfillment of the first dose of MMRV, at 12 months of age, and the execution of the BCG vaccine by risk groups included in the DGS 06/2016 regulation; to verify which factors may lead to a wrongly fulfillment of these two vaccines. Methods: Observational and cross-section study using an anonymous inquiry, handed to the parents of children who went to the Pediatric Emergency Room of Santa Maria Hospital of the North Lisbon University Hospital Centre, EPE, between January and March of 2023. Socio-demographic parameters were analyzed, as well as the fulfillment of the first dose of MMRV and the BCG vaccine, the possible reasons of delay/non-vaccination and the integration in risk groups according to the DGS regulation. It was handed an information leaflet with the most recent vaccination schedule and a list of false vaccine contraindications. Results: 203 parents were interviewed and 40.4% of the children were immigrant and/or had parents who were immigrants. 95.6% lived in Lisbon district and their age ranged between 1 and 11 years old. 93.1% fulfilled the first dose of the MMRV, but 27.1% had an average delay of 2.24 months. It was verified a statistically significant relation between the population of immigrant and/or with immigrant parents and delay in the first dose of MMRV. Of the 141 children born since 2016, 61.7% integrated the risk groups included in the DGS regulation and 88.5% of those children received BCG. Furthermore, 14.3% of the children that were immigrant and were also integrated in a risk group were not vaccinated against tuberculosis, comparatively with 6.5% of the children that were integrated in a risk group but were not immigrant. Conclusion: The vaccination coverage with the first dose of MMRV, at 12 months of age, was below the recommended limit and there are clusters of unvaccinated individuals against tuberculosis, who are integrated in risk groups. National and international contexts, the residency county, birth year and subsequent year, as well integrating the immigrant population have a direct influence on vaccination coverages.
Introduction: The vaccination schedule of measles, mumps and rubella vaccine (MMRV) and BCG vaccine, according to the Portuguese National Program of Vaccination, were updated in 2012 and in 2016, respectively. The main objectives of this study were to evaluate the fulfillment of the first dose of MMRV, at 12 months of age, and the execution of the BCG vaccine by risk groups included in the DGS 06/2016 regulation; to verify which factors may lead to a wrongly fulfillment of these two vaccines. Methods: Observational and cross-section study using an anonymous inquiry, handed to the parents of children who went to the Pediatric Emergency Room of Santa Maria Hospital of the North Lisbon University Hospital Centre, EPE, between January and March of 2023. Socio-demographic parameters were analyzed, as well as the fulfillment of the first dose of MMRV and the BCG vaccine, the possible reasons of delay/non-vaccination and the integration in risk groups according to the DGS regulation. It was handed an information leaflet with the most recent vaccination schedule and a list of false vaccine contraindications. Results: 203 parents were interviewed and 40.4% of the children were immigrant and/or had parents who were immigrants. 95.6% lived in Lisbon district and their age ranged between 1 and 11 years old. 93.1% fulfilled the first dose of the MMRV, but 27.1% had an average delay of 2.24 months. It was verified a statistically significant relation between the population of immigrant and/or with immigrant parents and delay in the first dose of MMRV. Of the 141 children born since 2016, 61.7% integrated the risk groups included in the DGS regulation and 88.5% of those children received BCG. Furthermore, 14.3% of the children that were immigrant and were also integrated in a risk group were not vaccinated against tuberculosis, comparatively with 6.5% of the children that were integrated in a risk group but were not immigrant. Conclusion: The vaccination coverage with the first dose of MMRV, at 12 months of age, was below the recommended limit and there are clusters of unvaccinated individuals against tuberculosis, who are integrated in risk groups. National and international contexts, the residency county, birth year and subsequent year, as well integrating the immigrant population have a direct influence on vaccination coverages.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2023
Palavras-chave
Programa nacional de vacinação Vacina contra o sarampo, parotidite epidémica e rubéola (VASPR) Bacille Calmette-Guérin (BCG) Norma 06/2016 Pediatria