Banca de DEFESA: Jadher Pércio

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : Jadher Pércio
DATE: 21/11/2022
TIME: 14:00
LOCAL: Núcleo de Medicina Tropical (Microsoft Teams)
TITLE:

Evaluation of the effect and adherence of vaccination against Covid-19 in Brazil

KEY WORDS:

SARS-CoV-2. Covid-19. Pandemic. Vaccines. Vaccination program. Ecological studies. Time series. Spatial analysis. Brazil.

PAGES: 115
BIG AREA: Ciências da Saúde
AREA: Medicina
SUBÁREA: Clínica Médica
SPECIALTY: Doenças Infecciosas e Parasitárias
SUMMARY:

Introduction: the disease caused by the new coronavirus 2019 (Covid-19) was responsible for the greatest public health emergency in recent centuries. As of 2020, worldwide, more than 607 million people have been confirmed for Covid-19, including more than 6.5 million deaths. Brazil was one of the epicenters of the Covid-19 pandemic, ranking third in number of cases (more than 34.6 million) and second in deaths (more than 685 thousand) from the disease. Quickly, several safe and effective vaccines were developed, approved and distributed to fight Covid-19. Objectives: this thesis was developed with the aim of analyzing the general effect of the vaccination program against Covid-19, after more than a year of its introduction in Brazil, and to investigate the factors associated with the population's adherence to the recommendations of the public health authorities about the use of COVID-19 vaccines. Methods: two ecological studies were carried out. In the first study, the temporal trends of vaccine coverage were analyzed in relation to indicators of morbidity and mortality by Covid-19, in two age groups (18 to 59 years/60 years or older), using the JoinPoint and Poisson regression models. In the second study, the association between the abandonment rate of the multidose vaccine regimens of Covid-19 vaccines with demographic, economic, political and human development indicators, obtained at the municipal level, was investigated. A spatial analysis was then carried out to detect municipal clusters with high dropout rates and two multivariable regression models (Poisson and logistic). Results: the average weekly percentage change (VPSM) of morbidity and mortality indicators reduced after the introduction of vaccination against Covid-19: hospitalization rate (from 15.3% to -6.0%), severity (from 0.4% to -0.2%), lethality (from 0.3% to -0.2%) and mortality (from 20.5% to -4.3%). The following indicators were inversely associated with the increase in vaccine coverage against Covid-19: hospitalization (IRR: 0.974), mortality (IRR: 0.975) and lethality for people aged 60 years and over (IRR: 0.997). The North, Northeast and Central-West regions concentrated the largest “cluster” of municipal areas with high abandonment rates. The risk for high dropout rates increased with the population size of the municipalities. With each increase in the Municipal Human Development Index (IDHM) and in the number of vaccine rooms for every thousand inhabitants, there was a reduction, respectively, of 98% and 20% in vaccine abandonment rates. On the other hand, with each increase in the GINI index, there was a 20% increase in vaccine abandonment rates. Conclusion: the national vaccination program against Covid-19 contributed to the control of morbidity and mortality from the disease in Brazil. Despite the epidemic waves that occurred due to the predominance of new variants and the high rates of abandonment of multidose vaccine regimens, even when the country reached high vaccine coverage, the disease burden was lower after the introduction of COVID-19 vaccines. Adherence to the population was strongly influenced by several municipal issues, making it imperative to adopt public health measures to resolve inequities, including the increase in vaccine rooms to increase the population's access to this important public health technology.

BANKING MEMBERS:
Presidente - 1961891 - WILDO NAVEGANTES DE ARAUJO
Interna - 484663 - ELISABETH CARMEN DUARTE
Interna - 235612 - MARIA REGINA FERNANDES DE OLIVEIRA
Externo à Instituição - EXPEDITO JOSE DE ALBUQUERQUE LUNA - USP
Externa à Instituição - MARCIA DE CANTUARIA TAUIL - UNIEURO