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Introduction <p>Hepatitis B accounted for more than half of the deaths from viral hepatitis in Brazil.</p> Objective <p>To analyze the trend and spatial distribution of Hepatitis B vaccine coverage in Brazilian children under one year of age and the repercussions of the COVID-19 pandemic.</p> Methods <p>This ecological time-series study used hepatitis B vaccination coverage data from the Brazilian National Immunization Program. Median coverage and period comparisons were calculated for January 2017–April 2025. Temporal trends were analyzed using Prais-Winsten regression through November 2024 to ensure stable estimates, and differences between periods were assessed using the Mann-Whitney U test. Spatial analysis used Global and Local Moran’s indices, extending the pre-pandemic baseline to 2014–2020 to improve spatial autocorrelation estimates.</p> Results <p>The 95% vaccination target was not achieved nationally or regionally; Rondônia was the only Federative Unit to meet the target in the pre-pandemic period. Coverage declined in most regions during the intra-pandemic period, with a post-pandemic increase observed only in the North (8.4%; <i>p</i> = 0.02). Trend analyses indicated an overall decline during the intra-pandemic study period, stability in the Northeast (β = −0.31; <i>p</i> = 0.064; adj. R² = 52.84%), and an increase during the post-pandemic study period, except in the Midwest, where the trend remained stable (β = 0.56; <i>p</i> = 0.081; adj. R² = 10.79%). Spatial analysis highlighted the North Region, which concentrated municipalities below the target and low-low clusters.</p> Conclusion <p>The COVID-19 pandemic reduced hepatitis B vaccination coverage in Brazil.</p>

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Trend and spatial distribution of hepatitis B vaccine coverage in Brazilian children under one year of age and the repercussions of the COVID-19 pandemic

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月9日

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  • Bárbara Aguiar Carrato,
  • Leonardo Lemos Pena,
  • Ana Carolina Micheletti Gomide Nogueira de Sá,
  • Rafaela Siqueira Costa Schreck,
  • Allana dos Reis Corrêa,
  • Deborah Carvalho Malta,
  • Tércia Moreira Ribeiro da Silva

摘要

Introduction

Hepatitis B accounted for more than half of the deaths from viral hepatitis in Brazil.

Objective

To analyze the trend and spatial distribution of Hepatitis B vaccine coverage in Brazilian children under one year of age and the repercussions of the COVID-19 pandemic.

Methods

This ecological time-series study used hepatitis B vaccination coverage data from the Brazilian National Immunization Program. Median coverage and period comparisons were calculated for January 2017–April 2025. Temporal trends were analyzed using Prais-Winsten regression through November 2024 to ensure stable estimates, and differences between periods were assessed using the Mann-Whitney U test. Spatial analysis used Global and Local Moran’s indices, extending the pre-pandemic baseline to 2014–2020 to improve spatial autocorrelation estimates.

Results

The 95% vaccination target was not achieved nationally or regionally; Rondônia was the only Federative Unit to meet the target in the pre-pandemic period. Coverage declined in most regions during the intra-pandemic period, with a post-pandemic increase observed only in the North (8.4%; p = 0.02). Trend analyses indicated an overall decline during the intra-pandemic study period, stability in the Northeast (β = −0.31; p = 0.064; adj. R² = 52.84%), and an increase during the post-pandemic study period, except in the Midwest, where the trend remained stable (β = 0.56; p = 0.081; adj. R² = 10.79%). Spatial analysis highlighted the North Region, which concentrated municipalities below the target and low-low clusters.

Conclusion

The COVID-19 pandemic reduced hepatitis B vaccination coverage in Brazil.