Vacinação contra Covid-19 e fatores relacionados em pessoas em situação de vulnerabilidade em Palmas - Tocantins

Abstract

Introduction: The recent COVID-19 pandemic has had a significant impact on global public health. Although current knowledge about COVID-19 is still limited, it is already known that individuals in vulnerable situations are disproportionately affected compared to those who are not in such circumstances. In this context, vaccination is a crucial protective measure, but it is currently compromised by vaccine hesitancy, which has become a global concern and a barrier to public health initiatives. Objective: To analyze the influence of sociodemographic characteristics, housing and health conditions, and perceptions about vaccines on COVID-19 vaccination completeness among vulnerable individuals in Palmas, Tocantins. Method: A cross-sectional study conducted in Palmas, Tocantins, as part of a multicenter study called 'COVID-19 Social Thermometer.' Participants were individuals in situations of social vulnerability, including residents of settlements, slums/communities, and individuals experiencing homelessness. Data were collected through interviews, using a validated instrument for Brazil, between September 2022 and April 2023, after approval from the Research Ethics Committees (CEP) and with the consent of the Municipal Health Department of Palmas-TO. Descriptive and inferential statistics were used for data analysis, and binary logistic regression was used to identify factors associated with the outcomes of interest. Results: In this study, 154 socially vulnerable individuals in Palmas-TO were interviewed. The mean age of participants was 44.03 years (SD 14.84), and the majority were predominantly female (63.64%; n=98) and self-identified as Black/Mixed race (81.17%; n=125). It was observed that individuals who own their own residence have a higher chance of their children, aged 7 to 18 years, completing the COVID-19 vaccination schedule (OR: 2.02; 95% CI: 1.04 – 8.35). Additionally (in the second regression model), individuals aged 39 to 59 years and those aged 60 years and above have 3.35 (95% CI: 1.23 - 9.81) and 6.41 (95% CI: 1.59 – 29.82) times more chances, respectively, of completing the COVID-19 vaccination schedule. Being female (OR: 3.54; 95% CI: 1.28 - 10.73), living with up to 4 people (OR: 4.49; 95% CI: 1.41 – 15.94), having health insurance (OR: 1.22; 95% CI: 1.10 – 8.83), having a health center in the neighborhood (OR: 8.46; 95% CI: 2.12 - 39.23), not experiencing adverse effects after vaccination (OR: 42.34; 95% CI: 5.74 – 92.58), trusting in vaccine efficacy (OR: 3.90; 95% CI: 1.28 – 12.87), and having a child aged 5 to 11 years (OR: 2.20; 95% CI: 1.06 – 12.54) were associated with a higher chance of completing the COVID-19 vaccination schedule. Individuals who experienced adverse effects after vaccination (OR: 0.83; 95% CI: 0.12 – 0.93) and those who sought information about vaccination in religious institutions or from religious leaders (OR: 0.10; 95% CI: 0.01 – 0.74) were associated with a lower chance of completing the COVID-19 vaccination schedule. Conclusion: This study identifies factors associated with COVID-19 vaccination completeness among socially vulnerable individuals, findings that could contribute to the development of strategies by healthcare professionals to increase vaccination uptake in this population.