{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T23:54:25Z","timestamp":1771458865974,"version":"3.50.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2024,7,13]],"date-time":"2024-07-13T00:00:00Z","timestamp":1720828800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Bacillus Calmette-Guerin (BCG) vaccination and tuberculosis (TB) incidence in children under 1 year of age are critical public health indicators in Brazil. The coronavirus disease 2019 pandemic disrupted vaccination coverage (VC), potentially impacting TB incidence. Understanding regional disparities in VC and TB incidence can inform targeted interventions. We conducted an observational and ecological study using BCG vaccination data (2019\u201321) and TB incidence (2020\u201322) for all births in Brazil. Data were collected from public health databases, stratified by state, and analyzed using descriptive and analytical statistics to explore VC and TB incidence. Between 2019 and 2021, average BCG VC was 79.59%, with significant variation among states (P\u2009&amp;lt;\u2009.001). Only four states achieved minimum recommended coverage (&amp;gt;90%). TB incidence varied significantly among states (P\u2009=\u2009.003). There was a notable decline in VC from 2019 (90.72%) to 2021 (78.67%) (P\u2009&amp;lt;\u2009.001). This study highlights regional disparities in BCG VC and TB incidence among Brazilian states. Lower VC post-pandemic may increase TB incidence, requiring targeted interventions in states with inadequate coverage. The findings underscore the importance of sustaining vaccination programs amidst public health crises and implementing strategies to enhance access and uptake.<\/jats:p>","DOI":"10.1093\/tropej\/fmae023","type":"journal-article","created":{"date-parts":[[2024,8,10]],"date-time":"2024-08-10T01:20:58Z","timestamp":1723252858000},"source":"Crossref","is-referenced-by-count":1,"title":["Regional disparities in BCG vaccination coverage and tuberculosis incidence in infants among Brazilian states"],"prefix":"10.1093","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9903-0861","authenticated-orcid":false,"given":"Guilherme S","family":"Procianoy","sequence":"first","affiliation":[{"name":"School of Medicine, Universidade Federal de Ci\u00eancias da Sa\u00fade de Porto Alegre (UFCSPA) , Porto Alegre, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renato S","family":"Procianoy","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rita C","family":"Silveira","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,8,9]]},"reference":[{"key":"2024081001205015200_fmae023-B1","first-page":"392","article-title":"The natural history of childhood intra-thoracic tuberculosis: a critical review of literature from the pre-chemotherapy era","volume":"8","author":"Marais","year":"2004","journal-title":"Int J Tuberc Lung Dis"},{"key":"2024081001205015200_fmae023-B2","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/S1473-3099(16)30474-1","article-title":"Mortality in children diagnosed with tuberculosis: a systematic review and meta-analysis","volume":"17","author":"Jenkins","year":"2017","journal-title":"Lancet Infect Dis"},{"key":"2024081001205015200_fmae023-B3","author":"World Health Organization","year":"2023"},{"key":"2024081001205015200_fmae023-B4","doi-asserted-by":"crossref","first-page":"e1307\u201316","DOI":"10.1016\/S2214-109X(22)00283-2","article-title":"Infant BCG vaccination and risk of pulmonary and extrapulmonary tuberculosis throughout the life course: a systematic review and individual participant data meta-analysis","volume":"10","author":"Martinez","year":"2022","journal-title":"Lancet Glob Health"},{"key":"2024081001205015200_fmae023-B5","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1542\/peds.28.4.622","article-title":"BCG vaccination against tuberculosis in Chicago. A twenty-year study statistically analyzed","volume":"28","author":"Rosenthal","year":"1961","journal-title":"Pediatrics"},{"key":"2024081001205015200_fmae023-B6","doi-asserted-by":"crossref","first-page":"1590","DOI":"10.1016\/S1473-3099(20)30994-4","article-title":"The effect of BCG revaccination on all-cause mortality beyond infancy: 30-year follow-up of a population-based, double-blind, randomised placebo-controlled trial in Malawi","volume":"21","author":"Glynn","year":"2021","journal-title":"Lancet Infect Dis"},{"key":"2024081001205015200_fmae023-B7","doi-asserted-by":"crossref","first-page":"5509","DOI":"10.1590\/1413-812320212611.13932021","article-title":"Vacinas no Brasil: an\u00e1lise hist\u00f3rica do registro sanit\u00e1rio e a disponibiliza\u00e7\u00e3o no Sistema de Sa\u00fade","volume":"26","author":"Peres","year":"2021","journal-title":"Ci\u00eanc sa\u00fade coletiva"},{"key":"2024081001205015200_fmae023-B8","doi-asserted-by":"crossref","first-page":"e00222919","DOI":"10.1590\/0102-311x00222919","article-title":"46 anos do Programa Nacional de Imuniza\u00e7\u00f5es: uma hist\u00f3ria repleta de conquistas e desafios a serem superados","volume":"36","author":"Domingues","year":"2020","journal-title":"Cad Saude Publica"},{"key":"2024081001205015200_fmae023-B9","doi-asserted-by":"crossref","first-page":"2292","DOI":"10.1016\/j.vaccine.2022.02.076","article-title":"The impact of COVID-19 on routine pediatric vaccination delivery in Brazil","volume":"40","author":"Moura","year":"2022","journal-title":"Vaccine"},{"key":"2024081001205015200_fmae023-B10","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1590\/1413-81232022273.20082021","article-title":"Impact of the COVID-19 pandemic on the vaccination of children 12 months of age and under: an ecological study","volume":"27","author":"Procianoy","year":"2022","journal-title":"Cien Saude Colet"},{"key":"2024081001205015200_fmae023-B11","doi-asserted-by":"crossref","first-page":"3404","DOI":"10.1016\/j.vaccine.2021.04.046","article-title":"Missed childhood immunizations during the COVID-19 pandemic in Brazil: analyses of routine statistics and of a national household survey","volume":"39","author":"Silveira","year":"2021","journal-title":"Vaccine"},{"key":"2024081001205015200_fmae023-B12","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1093\/jpids\/piae013","article-title":"Impact of BCG vaccination disruptions during the COVID-19 pandemic on tuberculosis incidence in infants: a nationwide study in Brazil","volume":"13","author":"Procianoy","year":"2024","journal-title":"J Pediatric Infect Dis Soc"},{"key":"2024081001205015200_fmae023-B13","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1590\/S1415-790X2008000500011","article-title":"Desigualdades sociais e cobertura vacinal: uso de inqu\u00e9ritos domiciliares","volume":"11","author":"Moraes","year":"2008","journal-title":"Rev Bras Epidemiol"},{"key":"2024081001205015200_fmae023-B14","first-page":"321","article-title":"Tuberculosis in Amazonian municipalities of the Brazil-Colombia-Peru-Venezuela border: epidemiological situation and risk factors associated with treatment default","volume":"34","author":"Belo","year":"2013","journal-title":"Rev Panam Salud Publica"},{"key":"2024081001205015200_fmae023-B15","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.tube.2009.11.002","article-title":"Cytokine genes are associated with tuberculin skin test response in a native Brazilian population","volume":"90","author":"Zembrzuski","year":"2010","journal-title":"Tuberculosis (Edinb)"},{"key":"2024081001205015200_fmae023-B16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.26633\/RPSP.2023.152","article-title":"Trends in tuberculosis incidence and mortality coefficients in Brazil, 2011\u20132019: analysis by inflection points","volume":"47","author":"Silva J\u00fanior","year":"2023","journal-title":"Revista Panamericana de Salud P\u00fablica"},{"key":"2024081001205015200_fmae023-B17","doi-asserted-by":"crossref","first-page":"eAO6467","DOI":"10.31744\/einstein_journal\/2021AO6467","article-title":"Impact of the COVID-19 pandemic on emergency department visits: reference center","volume":"19","author":"Souza","year":"2021","journal-title":"Einstein (Sao Paulo)"},{"key":"2024081001205015200_fmae023-B18","doi-asserted-by":"crossref","first-page":"4161","DOI":"10.1016\/j.vaccine.2015.04.036","article-title":"Vaccine hesitancy: definition, scope and determinants","volume":"33","author":"MacDonald","year":"2015","journal-title":"Vaccine"},{"key":"2024081001205015200_fmae023-B19","doi-asserted-by":"crossref","first-page":"96","DOI":"10.11606\/S1518-8787.2018052001199","article-title":"What is the importance of vaccine hesitancy in the drop of vaccination coverage in Brazil?","volume":"52","author":"Sato","year":"2018","journal-title":"Rev Saude Publica"},{"key":"2024081001205015200_fmae023-B20","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1016\/j.jped.2018.01.008","article-title":"Vaccine refusal\u2014what we need to know","volume":"94","author":"Succi","year":"2018","journal-title":"J Pediatr (Rio J)"},{"key":"2024081001205015200_fmae023-B21","doi-asserted-by":"crossref","first-page":"e00011618","DOI":"10.1590\/0102-311x00011618","article-title":"Vaccine confidence and hesitancy in Brazil","volume":"34","author":"Brown","year":"2018","journal-title":"Cad Saude Publica"},{"key":"2024081001205015200_fmae023-B22","doi-asserted-by":"crossref","first-page":"e004206","DOI":"10.1136\/bmjgh-2020-004206","article-title":"Social media and vaccine hesitancy","volume":"5","author":"Wilson","year":"2020","journal-title":"BMJ Glob Health"},{"key":"2024081001205015200_fmae023-B23","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1016\/j.micinf.2020.09.005","article-title":"Anti-science extremism in America: escalating and globalizing","volume":"22","author":"Hotez","year":"2020","journal-title":"Microbes Infect"},{"key":"2024081001205015200_fmae023-B24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/21645515.2021.1893062","article-title":"Vaccine hesitancy in the era of COVID-19: could lessons from the past help in divining the future?","volume":"18","author":"Wiysonge","year":"2022","journal-title":"Hum Vaccin Immunother"},{"key":"2024081001205015200_fmae023-B25","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1001\/jama.2016.1353","article-title":"Association between vaccine refusal and Vaccine-Preventable diseases in the United States","volume":"315","author":"Phadke","year":"2016","journal-title":"JAMA"},{"key":"2024081001205015200_fmae023-B26","author":"Brazil","year":"2016"},{"key":"2024081001205015200_fmae023-B27","first-page":"50","article-title":"BCG vaccination strategy: health unit versus maternity","volume":"24","author":"Mai","year":"2021","journal-title":"Revista de APS"},{"key":"2024081001205015200_fmae023-B28","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1001\/archpediatrics.2011.73","article-title":"Effectiveness of a citywide patient immunization navigator program on improving adolescent immunizations and preventive care visit rates","volume":"165","author":"Szilagyi","year":"2011","journal-title":"Arch Pediatr Adolesc Med"},{"key":"2024081001205015200_fmae023-B29","first-page":"CD003941","article-title":"Patient reminder and recall interventions to improve immunization rates","volume":"1","author":"Vann","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"2024081001205015200_fmae023-B30","doi-asserted-by":"crossref","first-page":"e1446\u201352","DOI":"10.1542\/peds.2011-2921","article-title":"Effectiveness and cost of immunization recall at School-Based health centers","volume":"129","author":"Kempe","year":"2012","journal-title":"Pediatrics"}],"container-title":["Journal of Tropical Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/tropej\/article-pdf\/70\/4\/fmae023\/58790308\/fmae023.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/tropej\/article-pdf\/70\/4\/fmae023\/58790308\/fmae023.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,10]],"date-time":"2024-08-10T01:21:06Z","timestamp":1723252866000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/tropej\/article\/doi\/10.1093\/tropej\/fmae023\/7731119"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,13]]},"references-count":30,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,7,13]]}},"URL":"https:\/\/doi.org\/10.1093\/tropej\/fmae023","relation":{},"ISSN":["1465-3664"],"issn-type":[{"value":"1465-3664","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,8]]},"published":{"date-parts":[[2024,7,13]]},"article-number":"fmae023"}}