Regional inequalities in vaccination coverage and COVID-19 risk among children and adolescents: spatial analysis, Brazil, 2020-2024.
- 1Universidade de São Paulo Escola de Enfermagem de Ribeirão Preto Ribeirão PretoSP Brazil Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Ribeirão Preto, SP, Brazil.
Abstract
Objective
To identify space-time risk clusters for cases and deaths from severe acute respiratory syndrome (SARS) caused by COVID-19 and to characterize the spatial distribution of vaccination coverage among children and adolescents aged 0-19 years in Brazil.Methods
Spatial analysis study using secondary data from the 5,570 municipalities in Brazil. Cases and deaths from SARS caused by COVID-19 among children and adolescents aged 0-19 years reported between March 2020 and December 2024 in the Influenza Epidemiological Surveillance Information System (Sistema de Informação da Vigilância Epidemiológica da Gripe, SIVEP-Gripe) were included. Vaccination records from January 2021 to December 2024 were analyzed. Vaccination coverage rates were calculated by age group and vaccination schedule. Space-time clusters were identified using the spatial scan technique.Results
A total of 74,470 cases and 3,749 deaths were recorded in the population aged 0-19 years. Significant clusters of high and low risk were identified, including one protective cluster for cases among individuals aged 0-19 years (relative risk [RR] 0.28; 95% confidence interval [95%CI] 0.27; 0.29) and another high-risk cluster for deaths in the North, Northeast, and Central-West regions (RR 3.28; 95%CI 3.00; 3.59). Primary vaccination reached high coverage (85.2%), especially among adolescents aged 15-19 years (96.8%), whereas booster dose coverage remained insufficient (23.1%). The spatial distribution showed heterogeneity, with lower vaccination coverage in the North and Central-West regions.Conclusion
Space-time inequalities were observed in cases and deaths from severe acute respiratory syndrome (SARS) caused by COVID-19 among children and adolescents, with risk clusters and heterogeneity in vaccination coverage, characterized by high primary coverage and low booster coverage, especially in the North and Central-West regions..
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BibTeX
@article{tavares2026regional,
title = {{Regional inequalities in vaccination coverage and COVID-19 risk among children and adolescents: spatial analysis, Brazil, 2020-2024.}},
author = {Reginaldo Bazon Vaz Tavares and Yan Mathias Alves and Nathalia Zini and Ariela Fehr Tártaro and Maria Eduarda Pagano Pelodan and Luanne Karolyne Leal Dos Santos and Daniele de Moraes Pinheiro and Tatiana Ferraz de Araújo Alecrim and Ricardo Alexandre Arcêncio},
journal = {Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil},
year = {2026},
month = jul,
doi = {10.1590/s2237-962220v35e20251042.en},
url = {https://europepmc.org/article/MED/42922896},
note = {CC BY},
}
RIS
TY - JOUR
TI - Regional inequalities in vaccination coverage and COVID-19 risk among children and adolescents: spatial analysis, Brazil, 2020-2024.
AU - Reginaldo Bazon Vaz Tavares
AU - Yan Mathias Alves
AU - Nathalia Zini
AU - Ariela Fehr Tártaro
AU - Maria Eduarda Pagano Pelodan
AU - Luanne Karolyne Leal Dos Santos
AU - Daniele de Moraes Pinheiro
AU - Tatiana Ferraz de Araújo Alecrim
AU - Ricardo Alexandre Arcêncio
PY - 2026
DA - 2026/07/24
JO - Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil
DO - 10.1590/s2237-962220v35e20251042.en
UR - https://europepmc.org/article/MED/42922896
AB - Objective To identify space-time risk clusters for cases and deaths from severe acute respiratory syndrome (SARS) caused by COVID-19 and to characterize the spatial distribution of vaccination coverage among children and adolescents aged 0-19 years in Brazil.Methods Spatial analysis study using secondary data from the 5,570 municipalities in Brazil. Cases and deaths from SARS caused by COVID-19 among children and adolescents aged 0-19 years reported between March 2020 and December 2024 in the Influenza Epidemiological Surveillance Information System (Sistema de Informação da Vigilância Epidemiológica da Gripe, SIVEP-Gripe) were included. Vaccination records from January 2021 to December 2024 were analyzed. Vaccination coverage rates were calculated by age group and vaccination schedule. Space-time clusters were identified using the spatial scan technique.Results A total of 74,470 cases and 3,749 deaths were recorded in the population aged 0-19 years. Significant clusters of high and low risk were identified, including one protective cluster for cases among individuals aged 0-19 years (relative risk [RR] 0.28; 95% confidence interval [95%CI] 0.27; 0.29) and another high-risk cluster for deaths in the North, Northeast, and Central-West regions (RR 3.28; 95%CI 3.00; 3.59). Primary vaccination reached high coverage (85.2%), especially among adolescents aged 15-19 years (96.8%), whereas booster dose coverage remained insufficient (23.1%). The spatial distribution showed heterogeneity, with lower vaccination coverage in the North and Central-West regions.Conclusion Space-time inequalities were observed in cases and deaths from severe acute respiratory syndrome (SARS) caused by COVID-19 among children and adolescents, with risk clusters and heterogeneity in vaccination coverage, characterized by high primary coverage and low booster coverage, especially in the North and Central-West regions..
SN - 1679-4974
SN - 2237-9622
ER -