Vacinação infantil e tomada de decisão por pais de alta escolaridade

OBJECTIVE To analyze the sociocultural aspects involved in the decision-making process of vaccination in upper-class and highly educated families. METHODS A qualitative approach based on in-depth interviews with 15 couples from the city of Sao Paulo, Southeastern Brazil, falling into three categories: vaccinators, late or selective vaccinators, and nonvaccinators. The interpretation of produced empirical material was performed through content analysis. RESULTS The study showed diverse and particular aspects surrounding the three groups’ decisions whether to vaccinate their children. The vaccinators’ decision to vaccinate their children was spontaneous and raised no questions. Most late or selective vaccinators experienced a wide range of situations that were instrumental in the decision to delay or not apply certain vaccines. The nonvaccinator’s decision-making process expressed a broader context of both criticism of hegemonic obstetric practices in Brazil and access to information transmitted via social networks and the internet. The data showed that the problematization of vaccines (culminating in the decision to not vaccinate their children) occurred in the context of humanized birth, was protagonized by women and was greatly influenced by health information from the internet. CONCLUSIONS Sociocultural aspects of the singular Brazilian context and the contemporary society were involved in the decision-making on children’s vaccination. Understanding this process can provide a real basis for a deeper reflection on health and immunization practices in Brazil in light of the new contexts and challenges of the world today.OBJETIVO Analisar os aspectos socioculturais envolvidos no processo de tomada de decisão da vacinação em famílias de alta renda e escolaridade. MÉTODOS Abordagem qualitativa, com uso de técnica de entrevista em profundidade, realizada com 15 casais residentes na cidade de São Paulo, SP, alocados em três grupos: vacinadores, vacinadores tardios ou seletivos e não vacinadores. O percurso analítico-interpretativo do material empírico foi realizado por meio da análise de conteúdo. RESULTADOS O estudo encontrou diversidades e particularidades frente à decisão de (não) vacinação infantil nos três grupos. Nos casais vacinadores, a decisão em vacinar os filhos apresentou-se sem questionamentos. A maioria dos vacinadores tardios ou seletivos vivenciaram diferentes situações que foram determinantes para a decisão de postergar ou excluir algumas vacinas. O processo de decisão nos casais não-vacinadores foi expresso num contexto mais amplo envolvendo a crítica às práticas obstétricas hegemônicas no país e o acesso às informações veiculadas pelas redes sociais e internet. Os dados evidenciaram que a problematização das vacinas (que culminou na tomada de decisão de não vacinar os filhos) ocorreu no contexto do parto humanizado, foi protagonizada pelas mulheres e teve importante influência das informações em saúde veiculadas na internet. CONCLUSÕES Aspectos socioculturais singulares do contexto brasileiro e da sociedade contemporânea mais ampla estão envolvidos na tomada de decisão em vacinar ou não os filhos. A compreensão desse processo é importante para fornecer subsídios a uma reflexão mais profunda sobre as práticas de saúde e imunização no Brasil, nos novos contextos e desafios do mundo contemporâneo

Covid-19 and its impact on immunization programs: reflections from Brazil

Due to social distancing guidelines and the displacement of both human and material resources to fight the covid-19 pandemic, individuals seeking healthcare services face certain challenges. Immunization programs have already been a worrisome topic for health authorities due to declines in vaccine uptake rates and are now especially affected by the covid-19 pandemic. Disbelief in science, dissemination of fake news about vaccines, socioeconomic vulnerability and social inequality are some of the challenges faced. This commentary article discusses the impacts of the covid-19 pandemic on immunization programs in Brazil. In light of advances (and notability) of Brazil’s national immunization program, established in the 1970s, the programs face challenges, such as the recent drop in vaccine uptake rates. In addition to this health crisis, there is also Brazil’s current political crisis, which will undoubtedly require assistance from researchers, policymakers and society to be fixed

Effective recommendations towards healthy routines to preserve mental health during the COVID-19 pandemic

Objective: To assess the adherence to a set of evidence-based recommendations to support mental health during the coronavirus disease 2019 (COVID-19) pandemic and its association with depressive and anxiety symptoms. Methods: A team of health workers and researchers prepared the recommendations, formatted into three volumes (1: COVID-19 prevention; 2: Healthy habits; 3: Biological clock and sleep). Participants were randomized to receive only Volume 1 (control), Volumes 1 and 2, Volumes 1 and 3, or all volumes. We used a convenience sample of Portuguese-speaking participants over age 18 years. An online survey consisting of sociodemographic and behavioral questionnaires and mental health instruments (Patient Health Questionnaire-9 [PHQ-9] and Generalized Anxiety Disorder-7 [GAD-7]) was administered. At 14 and 28 days later, participants were invited to complete follow-up surveys, which also included questions regarding adherence to the recommendations. A total of 409 participants completed the study – mostly young adult women holding university degrees. Results: The set of recommendations contained in Volumes 2 and 3 was effective in protecting mental health, as suggested by significant associations of adherence with PHQ-9 and GAD-7 scores (reflecting anxiety and depression symptoms, respectively). Conclusion: The recommendations developed in this study could be useful to prevent negative mental health effects in the context of the pandemic and beyond

Decision-making on childhood vaccination by highly educated parents

OBJECTIVE To analyze the sociocultural aspects involved in the decision-making process of vaccination in upper-class and highly educated families.METHODS A qualitative approach based on in-depth interviews with 15 couples from the city of Sao Paulo, Southeastern Brazil, falling into three categories: vaccinators, late or selective vaccinators, and nonvaccinators. The interpretation of produced empirical material was performed through content analysis.RESULTS The study showed diverse and particular aspects surrounding the three groups’ decisions whether to vaccinate their children. The vaccinators’ decision to vaccinate their children was spontaneous and raised no questions. Most late or selective vaccinators experienced a wide range of situations that were instrumental in the decision to delay or not apply certain vaccines. The nonvaccinator’s decision-making process expressed a broader context of both criticism of hegemonic obstetric practices in Brazil and access to information transmitted via social networks and the internet. The data showed that the problematization of vaccines (culminating in the decision to not vaccinate their children) occurred in the context of humanized birth, was protagonized by women and was greatly influenced by health information from the internet.CONCLUSIONS Sociocultural aspects of the singular Brazilian context and the contemporary society were involved in the decision-making on children’s vaccination. Understanding this process can provide a real basis for a deeper reflection on health and immunization practices in Brazil in light of the new contexts and challenges of the world today