OBJECTIVES : Dengue fever (DF) and yellow fever (YF) are infectious, mosquito-borne diseases that represent a significant public-health concern in tropical/sub-tropical regions, including Brazil. Vaccinations play a key role in reducing the spread of DF/YF. The objective of this study was to determine sociodemographic characteristics associated with vaccination for DF or YF in Brazil.

METHODS : The 2018 National Health and Wellness Survey (NHWS), a cross-sectional, nationally-representative stratified-sample was used for this study. Participants (age≥18) were classified based on self-reported vaccination for DF/YF as: in the past 12-months, before the past 12-months, and never-vaccinated. Participants vaccinated within the past 12-months were compared to those never-vaccinated across multiple sociodemographics, including sex, age, race, socioeconomic-status, education, income, employment, health-coverage-type, marital status, and region. Significant predictors of DF-vaccination and YF-vaccination were assessed using logistic regression modeling.

RESULTS : Of the 12,000 adult participants in the Brazil 2018 NHWS, 3.8% (n=457) had a DF-vaccination in the past 12-months, 7.3% (n=876) had received earlier DF-vaccination, and 88.9% (n=10,667) reported no DF-vaccination. Higher vaccination rates were seen for YF, with 25.3% (n=3,034) vaccinated in the past 12-months, 25.9% (n=3,108) vaccinated prior, and 48.8% (n=5,858) never vaccinated. Statistically-significant predictors of recent DF/YF vaccination included sex, age, race, socioeconomic-status, region, education, and health-coverage-type. Compared to the Southeast region, the odds of DF-vaccination were lower in the South and Northeast, and the odds of YF-vaccination lower in all regions. Being female was associated with a decreased odds of DF-vaccination (OR=0.76; 95%CI:0.63-0.93) but an increased odds of YF-vaccination (OR=1.21; 95%CI:1.10-1.34). Participants with a health-coverage-type of non-private displayed a lower odds of DF-vaccination (OR=0.80; 95%CI:0.65-0.99) and YF-vaccination (OR=0.81; 95%CI:0.73-0.90) compared to privately-insured.

CONCLUSIONS : Multiple sociodemographic characteristics are significantly associated with dengue fever or yellow fever vaccination. Efforts to improve vaccination rates could potentially include consideration of these significant predictors to better target unvaccinated individuals.