ArticlePublic health2023
Spatial clustering of low rates of COVID-19 vaccination among children and adolescents and their relationship with social determinants of health in Brazil: a nationwide population-based ecological study.
Article in Public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.
- Uptake of COVID-19 vaccinations amongst 3,433,483 children and young people: meta-analysis of UK prospective cohorts.Nature communications · 2024Pooled it
- COVID-19 burden in the paediatric population in Latin America during vaccine rollout: a real-world study using national surveillance data.BMC infectious diseases · 2026Observational
- Global Trends in Adolescent Health Inequalities and Their Social Determinants: A Bibliometric and Scoping Review.Healthcare (Basel, Switzerland) · 2026Review
- Potential Epidemic Vulnerability and Socioepidemiological Profile of SARS-CoV2 in the Brazilian Northeast Region.Tropical medicine and infectious disease · 2023Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis study aimed to investigate the spatial clusters of high and low COVID-19 vaccination rates among children and adolescents across Brazilian municipalities and their relationship to social determinants of health. STUDY
designThis is a nationwide population-based ecological study.
methodsWe have obtained for each of the 5570 Brazilian municipalities data on the COVID-19 vaccination rate of children and adolescents by August 16, 2022, the Gini index, the social vulnerability index and the municipal human development index. A Bayesian empirical local model was used to identify fluctuations in the COVID-19 vaccination rates. Spatial clusters were identified using scan spatial statistic tests. The relationship among COVID-19 vaccination rates and social determinants of health was explored by using multiple linear regression models.
resultsOverall, 52.1% of children aged 5-11 years and 72.8% of adolescents aged 12-17 years have been fully vaccinated against COVID-19 in Brazil by mid-August 2022. There was spatial dependence on the smoothed rates for both children (I Moran 0.66; P < 0.001) and adolescent (I Moran 0.65; P < 0.001) groups. The lowest rates occurred in municipalities in the North and Northeast regions. Municipalities with a higher Gini Index, higher social vulnerability index and lower municipal human development index were more likely to have a lower COVID-19 vaccination rate for both children and adolescent groups.
conclusionCOVID-19 vaccination of children and adolescents was heterogeneously distributed, with spatial clusters of the lowest vaccination rates occurring mainly in municipalities with marked socio-economic disparities and social vulnerability, especially in the North and Northeast regions.
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Registered trials
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