OBJECTIVES: Vaccination is a key strategy to avoid preventable diseases, however, adequate vaccination coverage (VC) is needed to achieve a successful policy. Therefore, this real-world study aims to evaluate the VC among infants (0-12 months) in Brazil pre- and post-COVID-19, from 2016 and 2022.

METHODS: This is a descriptive analysis using real-world data from the Expanded Immunization Program System from Brazil (SI-PNI). We calculated from 2016 until 2022 the annual variation of VC for all vaccines available in Brazilian NIP for newborns until 12 months age (BCG, HBV, Rotavirus, Meningococcus C, Pentavalent, Pneumococcal, Polio, HAV and MMR) and described it by region of the country.

RESULTS: The VC among all vaccines included in the analysis dropped from the period pre-COVID-19 until 2022. The overall average VC among the selected vaccines decreased from 89.9% in 2016 to 71.7% in 2021, followed by a recovery to 79.5% in 2022. Regarding the geographic regions, the North region had the lowest VC in the whole period (76.1% VC); the Southeast region demonstrated the most discrete VC recovery in 2022, reaching 76.4%, compared to 92% in 2016. Overall, the most expressive impacts were observed in MMR and Pneumococcal-10 vaccination, which dropped from 95.4% and 95.0%in 2016 to 74.9 and 74.8% in 2021, respectively. In 2022, MMR and Pneumococcal-10 VC reached 80.7% and 81.5%, respectively.

CONCLUSIONS: The decreases of VC on infants in Brazil can lead into outbreaks of vaccine-preventable diseases, leading to clinical and economic burden to healthcare system already pressured by other demands. Also, increasing in anti-vaccines and fake news movements are observed worldwide, therefore, educational, and geographic access strategies are essential tools to avoid the decrease of VC in the country, especially in regions hard to reach, such as North region.