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

Trends and spatial distribution of MMR vaccine coverage in Brazil during 2007–2017

We analyzed the time trends and spatial distribution of MMR vaccine coverage in Brazil during 2007–2017. In early 2018, a measles outbreak started in the North region of Brazil, reaching 11 of the 27 federal units by January 24, 2019. In this period, 10,302 cases were confirmed. Although the reintroduction of measles in Brazil is likely due to migration from Venezuela, the spread of the virus was made possible by the low levels of MMR coverage, as a result of significant decreases during the study period. Areas with high concentration of municipalities with low coverage are more susceptible to the spread of the virus, especially in the North and Northeast regions. Increasing vaccination coverage is essential to block the ongoing outbreak in Brazil. Vaccination strategies might target priority areas, especially those with a marked decrease in coverage. Moreover, it is essential to extend actions to travelers, migrants and refugees

Os rituais de passagem segundo adolescentes Los rituales de pasaje según adolescentes Passage rituals according to adolescents

OBJETIVO: Identificar as impressões de adolescentes acerca do que poderia representar um ritual de passagem. MÉTODOS: Estudo descritivo realizado junto a 751 adolescentes de ambos os sexos, entre 12 e 20 anos, que freqüentavam três escolas públicas do ensino fundamental e médio da região de Santo Eduardo do município de Embu, São Paulo. RESULTADOS: Após análise de conteúdo desvelamos as categorias: mudanças físicas; mudanças psicológicas (subcategorias: responsabilidade, experiências, conflitos); mudanças sociais (subcategorias: identidade social, corpo social, inter-relacionamentos); comportamento sexual (subcategorias: interesse sexual, intercurso sexual); fatos traumáticos (subcategorias: sentimento de perda, luto pela infância perdida); independência. CONCLUSÃO: Os rituais de passagem relacionam-se diretamente com a mudança corporal, produto do adolescer, sendo ocorrências marcantes e significativas na vida do individuo.<br>OBJETIVO: Identificar las impresiones de adolescentes respecto a lo que podría representar un ritual de pasaje. MÉTODOS: Estudio descriptivo realizado con 751 adolescentes de ambos sexos, entre 12 y 20 años, que frecuentaban tres escuelas públicas de enseñanza primaria y secundaria de la región de San Eduardo del municipio de Embu, Sao Paulo. RESULTADOS: Después del análisis de contenido develamos las categorías: cambios físicos; cambios psicológicos (subcategorías: responsabilidad, experiencias, conflictos); cambios sociales (subcategorías: identidad social, cuerpo social, interrelaciones); comportamiento sexual (subcategorías: interés sexual, intercurso sexual); hechos traumáticos (subcategorías: sentimiento de pérdida, duelo por la infancia perdida); independencia. CONCLUSIÓN: Los rituales de pasaje se relacionan directamente con el cambio corporal, producto del adolecer, siendo ocurrencias que dejan huellas y que son significativas en la vida del individuo.<br>OBJECTIVE: To identify adolescents' impressions about what could represent a passage ritual. METHODS: This descriptive study was performed with 751 adolescents, of both genders, with ages between 12 and 20 years, who attended three public primary and secondary level schools in the Santo Eduardo region in the municipality of Embu, Sao Paulo state. RESULTS: After the content analysis, the following categories were revealed: physical changes; psychological changes (subcategories: responsibility, experiences, conflicts); social changes (subcategories: social identity, social body, interrelationships); sexual behavior (subcategories: sexual interest; sexual intercourse); traumatic factors (subcategories: feeling of lost, mourning for the lost childhood); independence. CONCLUSION: The passage rituals are directly related to the body changes, a product of adolescence, which are marking and significant occurrences in one's life

Intenções reprodutivas e práticas de regulação da fecundidade entre universitários Reproductive intentions and fertility regulation practices among university students

OBJETIVO: Identificar as intenções reprodutivas e caracterizar as práticas de regulação da fecundidade, abarcando a contracepção e o aborto, entre um grupo de adolescentes e jovens de alta escolaridade. MÉTODOS: Os dados foram levantados a partir de um estudo amplo quali-quantitativo com estudantes de graduação com idade de até 24 anos, de uma universidade pública estadual localizada na cidade de São Paulo. A população estudada foi constituída de 952 estudantes que freqüentavam disciplinas sorteadas pelo método de sorteio aleatório; e numa segunda etapa foram realizadas 33 entrevistas em profundidade com alunos voluntários. Na primeira etapa, os alunos foram entrevistados em sala de aula, através de um questionário auto-aplicável e, na segunda etapa, foram gravadas entrevistas em profundidade, realizadas em um local previamente combinado. RESULTADOS: O padrão de família idealizado pelo grupo era pequeno, com até dois filhos. A idade considerada ideal no nascimento do primeiro filho seria próxima aos 30 anos. Os estudantes referiram uma alta proporção de uso de contraceptivos - sobretudo do condom e da pílula. Ao lado disso, observa-se uma alta proporção de gestações finalizadas pelo aborto. Como resultante desse quadro, a fecundidade é bastante baixa no grupo, ou seja, 27 estudantes referiram uma ou mais gestações. Os dados qualitativos não foram objeto de análise. CONCLUSÕES: Embora o tamanho idealizado para a família reflita uma tendência geral presente na sociedade brasileira, constata-se que o grupo adia a maternidade/paternidade em função de um projeto de vida orientado para a conclusão de um curso superior e a inserção no mercado de trabalho. Ainda assim, a contracepção e a prevenção das doenças sexualmente transmissíveis são vivenciadas precariamente.<br>OBJECTIVE: To identify reproductive intentions and fertility regulation practices, including contraception and abortion, in a group of high schooling adolescents and young adults. METHODS: The data were gathered from a large quali-quantitative study carried out among University of São Paulo undergraduate students aged up to 24 years. The study sample consisted of 952 students who attended the university courses and were randomly drawn. In this first step, a self-administered questionnaire was applied to the students in the classroom. On the next step, in-depth interviews were applied to 33 volunteer students in a preset place. RESULTS: It was observed that the students' idealized family model is to have up to two children. The optimal age for having a first child is close to 30. The students referred high contraceptive use, especially condoms and the pill. High proportion of abortion was also observed. Consequently, fertility is considerably low in the study group, i.e., 27 students reported having one or more pregnancies. Qualitative data were not analyzed. CONCLUSIONS: Although the idealized family size reflects a general trend in the Brazilian society, it can be noted that the group delays maternity/paternity for the sake of a life project of getting a university degree and having autonomy. Despite that, contraception and prevention of sexually transmitted diseases are poor