Contemporary challenges in adherence to childhood immunization in Brazil

Abstract

Childhood immunization is a crucial strategy to prevent diseases and reduce child morbidity and mortality, playing a vital role in public health. However, Brazil faces increasing challenges with low adherence to childhood vaccination, negatively impacting the health of children and the general population. This qualitative and descriptive study conducts an integrative literature review to identify the main factors that influence this low adherence, analyzing publications between 2018 and 2023 in the VHL, Scielo, and PubMed databases. Of the 91 studies initially identified, 10 were selected for in-depth analysis. The discussion covers the history of childhood vaccination, the importance of vaccines, and the factors that contribute to low vaccination coverage, such as misinformation, sociodemographic factors, anti-vaccine movements, cultural and religious influences, as well as deficiencies in the infrastructure and qualification of health professionals. The loss of the measles eradication certificate in 2016 and the worsening of the situation during the Covid-19 pandemic and the return of yellow fever highlighted the urgency of this problem. The media, sociocultural aspects and the ineffectiveness of Basic Health Units are determinant for the current scenario. It is concluded that a holistic approach, which includes the expansion of UBS in vulnerable areas, awareness through educational programs and the adequate preparation of health professionals from academic training, is essential to improve adherence to childhood immunization and reverse this worrying situation.