Analysis of the Temporal Trend in Vaccination Coverage for Hepatitis A, Mmr, Mmrv, and Yellow Fever in the State of Pará From 2014 to 2022

Vaccination is one of the most effective strategies for preventing infectious diseases and promoting public health. However, vaccination coverage in Brazil has declined in recent years, especially in the North region. Available data show low vaccination coverage, attributed to various factors such as difficulties accessing health services, lack of knowledge about the importance of vaccination, and fear of post-vaccination adverse events. This study aimed to analyze the temporal trend of vaccination coverage for hepatitis A, MMR (tríplice viral), MMRV (tetra viral), and yellow fever in the state of Pará from 2014 to 2022. This is an ecological study with a quantitative approach, involving retrospective analysis of secondary data obtained from DATASUS and IBGE information systems. Temporal trend analyses were performed using linear regression and Pearson correlation, with BioEstat 5.3 and Stata 17. Thematic maps were constructed using MapChart to assess the spatial distribution of vaccination coverage in the 144 municipalities of Pará, compared with national patterns. A statistically significant downward trend was observed for yellow fever (p=0.0131) and MMRV (p=0.0432) vaccination coverage. MMR coverage showed variation, with a more pronounced decline from 2020 onward (p=0.0829), while hepatitis A coverage stabilized at low levels (p=0.4746). The state average coverage was lower than the national average for all vaccines analyzed. After the COVID-19 pandemic, most municipalities showed further reductions in vaccination coverage, particularly for MMRV. Only a limited number of municipalities maintained or increased coverage in the post-pandemic period. The data reveal a concerning decline in vaccination coverage in the state of Pará between 2014 and 2022, intensified after the pandemic. The findings reinforce the need for specific interventions, such as strengthening primary care, improving access in remote areas, and educational campaigns to address vaccine hesitancy. Continuous monitoring is essential to ensure the effectiveness of immunization programs and prevent the resurgence of vaccine-preventable diseases.