Abstract
OBJECTIVE: To analyze vaccine hesitancy associated factors and repercussions on vaccination coverage. METHODS: Cohort of children born in 2017-2018, living in Brazilian state capitals, Federal District (FD), and 12 inner region cities, stratified by socioeconomic level. National Vaccination Coverage Survey (2020) data on hesitancy, access and programmatic difficulties were obtained by interview and coverage was calculated from vaccination card dose and date records. RESULTS: 37801 children were studied, 31001 in the capitals/FD, 6800 in the inner cities. Hesitation between 38.8(95%CI 33.6;44.4) and 57.9(95%CI 54.1;61.6) in high versus low stratum; 64.1(95%CI 58.9;68.9) to 41.7(95%CI 38.4;45.8) among mothers with <8 years of schooling versus 16 years or more; 42.1(95%CI 38.2;46.2) to 55.0(95%CI 52.0;54.7) among private service users versus public service only users. Coverage: full=7.2(95%CI 1.0;38.3); 25.3(95%CI 18.7;33.3) for hesitant people; and 44.7(95%CI 43.0;46.4) for the remainder. CONCLUSION: High vaccine hesitancy in several groups affecting vaccination coverage and hindering vaccination target achievement. Access problems and programmatic difficulties contribute to low coverage.