VACCINE COVERAGE IN BRAZIL: CURRENT CHALLENGES AND STRATEGIES TO RECOVER IMMUNIZATION RATES

Abstract

Vaccination is one of the main strategies for disease prevention and public health promotion, contributing significantly to reducing morbidity and mortality and to controlling or eliminating several vaccine-preventable diseases. In Brazil, the National Immunization Program (Programa Nacional de Imunizações – PNI) has become an important public health policy by expanding free access to vaccines and establishing immunization strategies throughout the country. However, in recent years, declining vaccination coverage and disparities in immunization rates among regions, municipalities, and population groups have raised concerns, particularly due to the risk of reintroduction and spread of previously controlled diseases. In this context, this chapter aims to analyze the main factors associated with declining vaccination coverage in Brazil and to discuss strategies that may contribute to the recovery and maintenance of adequate immunization rates. This is a narrative literature review based on scientific publications and official documents addressing vaccination and immunization policies in Brazil. The main challenges identified include vaccine hesitancy, the spread of misinformation, socioeconomic and territorial inequalities, difficulties in accessing healthcare services, incompatibility between health facility opening hours and people's daily routines, and weaknesses in monitoring vaccination schedules. Recovering vaccination coverage therefore requires coordinated actions involving the strengthening of primary health care, active outreach to individuals with delayed vaccinations, expansion of vaccination opportunities, improvement of health information systems, and development of evidence-based communication strategies. The importance of integrated action among healthcare professionals, schools, families, public administrators, and communities is also emphasized as a means of strengthening public confidence in vaccines. It is concluded that restoring high and homogeneous vaccination coverage depends not only on vaccine availability but also on addressing the social, territorial, informational, and organizational barriers that affect adherence to vaccination, thereby contributing to individual and collective protection and to the sustainability of public immunization policies in Brazil.