Immunization and Cardiovascular Disease in Latin America. The CorVacc Study: Sub Analysis by Regions

Introduction: In Latin America, the mortality rate from influenza and pneumococcal disease has increased in recent years. Several challenges limit the implementation of vaccination strategies. These factors contribute to lower-than-expected immunization rates in Latin America. Objective: The objective of this sub-analysis of the Inter-American Registry of Influenza and Pneumococcal Vaccination (CorVacc) is to determine vaccination rates and analyze the factors that influence the North – Central America and Carribean Spanish Speaking (NCC); Andean region (AR) and South Cone (SCR). Methods: A cross-sectional survey of the general population was conducted in 19 Latin American countries. Adults aged 18 and older completed a 34-question online survey. Data were grouped into seven categories: demographic, socioeconomic, and non-demographic. Multivariate logistic regression comparisons were performed between regions to assess the association between vaccination rates and their explanatory variables. Results: Influenza, Pneumococcus and ≥3 doses of COVID-19 vaccination was received by 4,126 (45.18%) CAC, 3,576 (50, 13%) AR and 3,024 (62, 99%) SC; 5,904 (65, 09%) CAC, 5,162 (68, 9%) AR and 3,486 (72, 61%) SC; and 6,266 (68, 61%) CAC, 6,001 (80, 09%) AR and 2,892 (79, 99%), respectively. No association was detected between the regions and the likelihood of receiving the influenza vaccine: AR OR 0.94 (95% CI 0.84–1, 06; p = 0.33), CAC OR 0.81 (CI 0.80–1, 00; p = 0.053). On the contrary, a positive association was detected with Streptococcus pneumoniae vaccination: AR OR 1.12 (CI 1, 01–1, 24; p = 0.032), CAC OR 1.33 (CI 1, 20–1, 47; p < 0.001). A negative association was observed in CAC with COVID-19 ≥ 3 doses vaccination: OR 0.56 (CI 0, 65; p = 0.032; p < 0.001). Social, economic and confidence barriers were identified, but cardiovascular risk factors and comorbidities were not significantly associated with lower vaccination rates. Conclusions: Social, economic, and cultural, but not cardiovascular risk factor or disease variables in Latin American region could explain the lower-than-expected rates of vaccination and the differences observed between regions in vaccination frequencies.