Decreased childhood immunization coverage may lead to the return of diseases that have already been eradicated

Summary:

• A review by the Federal Court of Reviewers found a decline in vaccination coverage in Brazil.

• Many possible causes have been identified, but without knowing the contribution of each of them to the decrease in coverage. There is also an undersupply of the immunization unit through vaccination rooms, a situation that highlights the unreliability of available data on vaccine movement.

• The Technical Cooperation Coordination Unit highlighted the need to improve coordination and integration of information systems and made recommendations.

Implemented by the Federal Court of Accounts (TCU) An audit to examine the role of the public sector in ensuring vaccination coverage (CV) Recommendation from the population and support for the activities of the National Immunization Program (PNI).

The main finding is that PNI has not reached the recommended vaccination coverage according to the national immunization calendar. On the contrary, the audit verified, from 2015 to 2021, and in all regions of Brazil, Approximately 30% reduction in investment capital for each of the five priority vaccines in the works.

The aim of the vaccines was those intended for children up to 1 year of age or 1 year of age, such as the pentavalent, trivalent, pneumococcal, meningococcal C and polio vaccines.

One of the results of the audit was that Monitoring of the vaccination status of families and an active search for missing persons could not identify those who had not been vaccinated and people with an incomplete schedule and referred to be vaccinated sufficiently to ensure targets are met. It is necessary to improve the information flow between the identification of late and unvaccinated persons and the vaccination service to enhance follow-up.

There are many reasons for the low coverage of applicable vaccines, but there is no knowledge of the contribution of each of them, such as: Lack of monitoring of vaccination statusDifficulty accessing immunization services The need for greater coordination of communication procedures to clarify beliefs and misconceptions about vaccines Quality limitations of PNI systems and data and the need for joint action between key public interventions and levels of government.

The work concluded that the Ministry of Health and its technical areas need to be evaluated Changes to be implemented in information systems🇧🇷 These need to provide reliable data allowing management analytics to plan the acquisition and distribution of immunomodulatory drugs, to track and monitor PNI results, and to control stocks and potential shortages.

For the rapporteur of the process, Minister Vital do Rigo, “it will be necessary to carry out an inspection coordinated with the state and municipal audit courts to assess, in PNI, the compliance of the states and municipalities with information systems, as well as to check the stocks and losses of vaccines locally.” He even commented that the decrease in the biography subjectivity”Increases the risk of recurrence of eliminated diseases and increasing the number of cases of vaccine-preventable diseases in the population.”

TCU has submitted recommendations and decisions to the Unified Health System (SUS) and the Ministry of Health to contribute to increasing the vaccination coverage rate.

The technical unit of the Technical Cooperation Unit responsible for the inspection was the External Health Oversight Secretariat.