Social Determinants of Health and their Influence on the Homogeneity of Vaccination Coverage in Paraíba

Abstract

The Homogeneity of Vaccination Coverage (HVC) is an important public health indicator for identifying pockets of susceptible individuals. To analyze the spatial distribution of HVC in the municipalities of Paraíba and its relation to social determinants of health. This is a mixed ecological study design, utilizing secondary and publicly available data for the period from 2016 to 2020. Spatial analysis techniques were employed to achieve the study’s objective.  HVC was found to be heterogeneous across the state, with the formation of pockets of susceptible individuals. Adequate prenatal care coverage (OR=0.572; 95% CI: 0.409-0.799; p<0.001) was positively associated with adequate HVC. The proportion of individuals with inadequate water and sewage networks (OR=1.345; 95% CI: 1.007-1.796; p=0.045) and the proportion of women as heads of households (OR=1.512; 95% CI: 1.082-2.113; p=0.015) were inversely associated with adequate HVC. Our study highlights the importance of identifying geographic areas with susceptible individuals and the factors that individually and collectively interfere with HVC. This enables targeted and efficient actions, ensuring resolution.