Hesitação vacinal e adesão no Programa Nacional de Imunização: fatores que influenciam a decisão dos pais e responsáveis

Abstract

This study examines the factors that influence parental hesitancy regarding childhood vaccination within the framework of the National Immunization Program (PNI) in Brazil. Established in 1973 and officially implemented in 1975, the PNI is a key public health strategy responsible for the free distribution and administration of vaccines. However, in recent years—especially during the COVID-19 pandemic—there has been a notable decline in childhood vaccination coverage. This drop has been attributed to various factors such as misinformation, limited access to health services, changes in the operating hours of health units, social distancing, and sociocultural aspects. The methodology adopted was an integrative literature review, utilizing databases such as PubMed, SciELO, Google Scholar, and official documents from the Ministry of Health and the World Health Organization (WHO). Publications from the past ten years that address vaccine hesitancy, the impacts of the pandemic, and coping strategies were analyzed. The results show that vaccine hesitancy is not limited to outright refusal; it also includes other barriers such as fear of side effects, the influence of fake news, ambiguous political speeches, and religious and cultural factors. During the pandemic, fear of virus exposure, temporary suspension of services, and the spread of false information intensified the problem, leaving many children without proper immunization. Strategies such as outreach vaccination, school-based campaigns, extended hours at vaccination rooms, and the involvement of Community Health Workers (CHWs) proved essential for improving vaccination coverage. The study also highlights the importance of legal regulations—such as Law No. 6.259/1975 and Decree No. 78.231/1976—which mandate free vaccination in Brazil. In conclusion, tackling vaccine hesitancy requires intersectoral and ongoing actions such as continuous education, combating fake news, strengthening primary care, using digital tools, and maintaining open communication with the public. Overcoming this challenge is vital to preserve the achievements of the PNI and protect public health, especially that of children