RESUMO Objetivo Estimar a cobertura vacinal e analisar fatores sociodemográficos associados à não vacinação em crianças nascidas vivas em 2017 e 2018 nas capitais do Nordeste brasileiro. Métodos Realizou-se inquérito domiciliar com amostragem por conglomerados, entre 2020 e 2022, para estimar cobertura e hesitação vacinal. Fatores associados à não vacinação foram analisados usando-se regressão logística para calcular odds ratio (OR) e seus intervalos de confiança (IC95%). Resultados A capital com menores coberturas vacinais foi Natal, com < 75,0% para a maioria dos imunizantes; Teresina apresentou coberturas ≥ 90,0% em todos os imunizantes. Dos entrevistados, 99,1% (IC95% 98,9;99,3) acreditavam que vacinas são importantes para a saúde; 95,4% (IC95% 95,0;95,8) confiavam nos imunobiológicos distribuídos pelo governo; e 79,6% (IC95% 78,8;80,3) não tinham medo de reações adversas. Residir em estrato socioeconômico mais alto (OR ajustado: 1,34 – IC95% 1,20;1,50) foi fator associado à não vacinação. Conclusão As baixas coberturas destacam a necessidade de entender melhor as especificidades regionais e as desigualdades sociais. 201 brasileiro Realizouse Realizou se conglomerados 202 2022 usandose usando OR IC95%. IC95 IC . (IC95%) Natal 750 75 0 75,0 imunizantes 900 90 90,0 entrevistados 991 99 1 99,1 (IC95 98,999,3 989993 98,9 99,3 98 9 3 98,9;99,3 saúde 954 95 4 95,4 95,095,8 950958 95,0 95,8 8 95,0;95,8 governo 796 79 6 79,6 78,880,3 788803 78,8 80,3 78 80 78,8;80,3 adversas ajustado 134 34 1,3 1,201,50 120150 1,20 1,50 20 50 1,20;1,50 sociais IC9 7 75, 90, 99, (IC9 999 98,999, 98999 989 98, 993 98,9;99, 95, 095 95,095, 95095 950 958 95,0;95, 79, 880 78,880, 78880 788 78, 803 80, 78,8;80, 13 1, 1,201,5 12015 120 1,2 150 1,5 2 5 1,20;1,5 (IC 98,999 9899 98,9;99 09 95,095 9509 95,0;95 88 78,880 7888 78,8;80 1,201, 1201 12 15 1,20;1, 98,99 98,9;9 95,09 95,0;9 78,88 78,8;8 1,201 1,20;1 98,9; 95,0; 78,8; 1,20;

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ABSTRACT Objective To estimate vaccination coverage and analyze sociodemographic factors associated with non-vaccination in children born in 2017 and 2018 in the state capitals of Northeast Brazil. Methods A household survey using cluster sampling was conducted from 2020-2022 to estimate vaccination coverage and hesitancy. Factors associated with non-vaccination were analyzed using logistic regression to calculate Odds Ratios (OR) and their Confidence Intervals (95%CI). Results Natal was the capital with the lowest vaccination coverage, below 75.0% for most immunizers. Teresina had rates equal to or greater than 90.0% for all vaccines. Among those interviewed, 99.1% (95%CI 98.9;99.3) believe that vaccines are important for health; 95.4% (95%CI 95.0;95.8) trust immunobiologicals and 79.6% (95%CI% 78.8;80.3) are not afraid of reactions. Belonging to the highest socioeconomic stratum (adjusted OR: 1.34 – 95%CI 1.20;1.50) was as a factor associated with non-vaccination. Conclusion Low coverage highlights the need for a better understanding of regional specificities and social inequalities. nonvaccination non 201 Brazil 20202022 2020 2022 2020-202 hesitancy OR (OR 95%CI. 95CI CI . 95 (95%CI) 750 75 0 75.0 immunizers 900 90 90.0 interviewed 991 99 1 99.1 98.999.3 989993 98.9 99.3 98 9 3 98.9;99.3 health 954 4 95.4 95.095.8 950958 95.0 95.8 8 95.0;95.8 796 79 6 79.6 95%CI% 78.880.3 788803 78.8 80.3 78 80 78.8;80.3 reactions adjusted 134 34 1.3 1.201.50 120150 1.20 1.50 20 50 1.20;1.50 nonvaccination. vaccination. inequalities 2020202 202 2020-20 7 75. 90. 99. 999 98.999. 98999 989 98. 993 98.9;99. 95. 095 95.095. 95095 950 958 95.0;95. 79. 880 78.880. 78880 788 78. 803 80. 78.8;80. 13 1. 1.201.5 12015 120 1.2 150 1.5 2 5 1.20;1.5 202020 2020-2 98.999 9899 98.9;99 09 95.095 9509 95.0;95 88 78.880 7888 78.8;80 1.201. 1201 12 15 1.20;1. 20202 2020- 98.99 98.9;9 95.09 95.0;9 78.88 78.8;8 1.201 1.20;1 98.9; 95.0; 78.8; 1.20;

RESUMO Objetivo Estimar a cobertura vacinal e analisar fatores sociodemográficos associados à não vacinação em crianças nascidas vivas em 2017 e 2018 nas capitais do Nordeste brasileiro. Métodos Realizou-se inquérito domiciliar com amostragem por conglomerados, entre 2020 e 2022, para estimar cobertura e hesitação vacinal. Fatores associados à não vacinação foram analisados usando-se regressão logística para calcular odds ratio (OR) e seus intervalos de confiança (IC95%). Resultados A capital com menores coberturas vacinais foi Natal, com < 75,0% para a maioria dos imunizantes; Teresina apresentou coberturas ≥ 90,0% em todos os imunizantes. Dos entrevistados, 99,1% (IC95% 98,9;99,3) acreditavam que vacinas são importantes para a saúde; 95,4% (IC95% 95,0;95,8) confiavam nos imunobiológicos distribuídos pelo governo; e 79,6% (IC95% 78,8;80,3) não tinham medo de reações adversas. Residir em estrato socioeconômico mais alto (OR ajustado: 1,34 – IC95% 1,20;1,50) foi fator associado à não vacinação. Conclusão As baixas coberturas destacam a necessidade de entender melhor as especificidades regionais e as desigualdades sociais.

ABSTRACT Objective To estimate vaccination coverage and analyze sociodemographic factors associated with non-vaccination in children born in 2017 and 2018 in the state capitals of Northeast Brazil. Methods A household survey using cluster sampling was conducted from 2020-2022 to estimate vaccination coverage and hesitancy. Factors associated with non-vaccination were analyzed using logistic regression to calculate Odds Ratios (OR) and their Confidence Intervals (95%CI). Results Natal was the capital with the lowest vaccination coverage, below 75.0% for most immunizers. Teresina had rates equal to or greater than 90.0% for all vaccines. Among those interviewed, 99.1% (95%CI 98.9;99.3) believe that vaccines are important for health; 95.4% (95%CI 95.0;95.8) trust immunobiologicals and 79.6% (95%CI% 78.8;80.3) are not afraid of reactions. Belonging to the highest socioeconomic stratum (adjusted OR: 1.34 – 95%CI 1.20;1.50) was as a factor associated with non-vaccination. Conclusion Low coverage highlights the need for a better understanding of regional specificities and social inequalities.

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Resumo A avalição da efetividade de vacinas é feita com dados do mundo real e é essencial para monitorar o desempenho dos programas de vacinação ao longo do tempo bem como frente a novas variantes. Até o momento, a avaliação da efetividade das vacinas para COVID-19 tem sido baseada em métodos clássicos como estudos de coorte e caso controle teste-negativo, que muitas vezes podem não permitir o adequado controle dos vieses intrínsecos da alocação das campanhas de vacinação. O objetivo dessa revisão foi discutir os desenhos de estudo disponíveis para avaliação de efetividade das vacinas, enfatizando os estudos quase-experimentais, que buscam mimetizar os estudos aleatorizados ao introduzir um componente exógeno para atribuição ao tratamento, bem como suas vantagens, limitações e aplicabilidade no contexto dos dados brasileiros. O emprego de métodos quase-experimentais, incluindo as séries temporais interrompidas, o método de diferença em diferenças, escore de propensão, variáveis instrumentais e regressão descontínua, são relevantes pela possibilidade de gerar estimativas mais acuradas da efetividade de vacinas para COVID-19 em cenários como o brasileiro, que se caracteriza pelo uso de várias vacinas, com respectivos número e intervalos entre doses, aplicadas em diferentes faixas etárias e em diferentes momentos da pandemia.

Abstract The evaluation of vaccine effectiveness is conducted with real-world data. They are essential to monitor the performance of vaccination programmes over time, and in the context of the emergence of new variants. Until now, the effectiveness of COVID-19 vaccines has been assessed based on classic methods, such as cohort and test-negative case-control studies, which may often not allow for adequate control of inherent biases in the assignment of vaccination campaigns. The aim of this review was to discuss the study designs available to evaluate vaccine effectiveness, highlighting quasi-experimental studies, which seek to mimic randomized trials, by introducing an exogenous component to allocate to treatment, in addition to the advantages, limitations, and applicability in the context of Brazilian data. The use of quasi-experimental approaches, such as interrupted time series, difference-in-differences, propensity scores, instrumental variables, and regression discontinuity design, are relevant due to the possibility of providing more accurate estimates of COVID-19 vaccine effectiveness. This is especially important in scenarios such as the Brazilian, which characterized by the use of various vaccines, with the respective numbers and intervals between doses, applied to different age groups, and introduced at different times during the pandemic.

Resumo A avalição da efetividade de vacinas é feita com dados do mundo real e é essencial para monitorar o desempenho dos programas de vacinação ao longo do tempo bem como frente a novas variantes. Até o momento, a avaliação da efetividade das vacinas para COVID-19 tem sido baseada em métodos clássicos como estudos de coorte e caso controle teste-negativo, que muitas vezes podem não permitir o adequado controle dos vieses intrínsecos da alocação das campanhas de vacinação. O objetivo dessa revisão foi discutir os desenhos de estudo disponíveis para avaliação de efetividade das vacinas, enfatizando os estudos quase-experimentais, que buscam mimetizar os estudos aleatorizados ao introduzir um componente exógeno para atribuição ao tratamento, bem como suas vantagens, limitações e aplicabilidade no contexto dos dados brasileiros. O emprego de métodos quase-experimentais, incluindo as séries temporais interrompidas, o método de diferença em diferenças, escore de propensão, variáveis instrumentais e regressão descontínua, são relevantes pela possibilidade de gerar estimativas mais acuradas da efetividade de vacinas para COVID-19 em cenários como o brasileiro, que se caracteriza pelo uso de várias vacinas, com respectivos número e intervalos entre doses, aplicadas em diferentes faixas etárias e em diferentes momentos da pandemia.

Abstract The evaluation of vaccine effectiveness is conducted with real-world data. They are essential to monitor the performance of vaccination programmes over time, and in the context of the emergence of new variants. Until now, the effectiveness of COVID-19 vaccines has been assessed based on classic methods, such as cohort and test-negative case-control studies, which may often not allow for adequate control of inherent biases in the assignment of vaccination campaigns. The aim of this review was to discuss the study designs available to evaluate vaccine effectiveness, highlighting quasi-experimental studies, which seek to mimic randomized trials, by introducing an exogenous component to allocate to treatment, in addition to the advantages, limitations, and applicability in the context of Brazilian data. The use of quasi-experimental approaches, such as interrupted time series, difference-in-differences, propensity scores, instrumental variables, and regression discontinuity design, are relevant due to the possibility of providing more accurate estimates of COVID-19 vaccine effectiveness. This is especially important in scenarios such as the Brazilian, which characterized by the use of various vaccines, with the respective numbers and intervals between doses, applied to different age groups, and introduced at different times during the pandemic.

Abstract The main objective of this paper is to calculate and evaluate the behavior of coastal morphodynamics in the northern coast of the state of Veracruz over the past 45 years (1973-2017) from regional and local perspectives. This study included three sites suitable for establishing engineering prototypes for the use of wave power and its conversion into electricity micro-generation in the coastal towns Barra de Cazones, Palma Sola, and Villa Rica. To this end, we used geospatial data of aerial photographs, ortho- photos and satellite images for different years (1973, 1986, 1995, 2000, 2011, and 2017) to identify and demarcate the shoreline based on Boak and Turner (2005). Subsequently, this attribute was classified according to its prevailing process (progradation or regression) in the DSAS module (USGS, 2012) to determine the shoreline change rates. Besides, a baseline was set to determine the potential future impacts of installing the engineering prototypes. According to the availability of inputs, the northern zone was approached regionally for the period 2000-2017, while Barra de Ca- zones and Palma Sola covered the years 1995-2017, and Villa Rica encompassed the years 1973-2017. The results in terms of the net shoreline movement (NSM) show an overall regional trend toward the prevalence of progradation in the northern coast. Progradation values reach up to +27 m near river mouths, dune fields, and anthropized areas, with figures higher than +90 m in some localities. Coastal regression shows values as high as -97 m and -27 m in fluvial- marine and wind-marine environments, as well as in highly anthropized areas. Barra de Cazones shows three distinctive sectors. The first shows a net shoreline regression of -16 m at Playa Chaparrales. The second sector, more widespread, comprises approximately 60% of the local coast, with pro- gradation values of up to +26 m. Finally, the third sector, in its northern part around the fluvial-marine bar near the Cazones river mouth, shows a regressive process reaching values between -16 and -27 m. Palma Sola displays an overall trend towards shoreline progradation, reaching its peak value in Palma Sola beach, with +51.59 m over 22 years. The most significant regression is located in the La Loma cliffs, with -28.29 m. Unlike the figures found for the progradation zones, regressive processes correspond to abrasive coasts (La Loma and Miradores), except for the Barra Palma Sola mouth and, with less intensity, the adjacent Playa Andrea. Finally, in Villa Rica, the entire abrasive mound coastline maintains regressive process rates. The greatest regression was recorded in the front cliff of the Villa Rica mound, with -17.03 m. Maximum progradation values of +90.27 m occur to the south of the mound. The southern sector shows greater dynamism, with values from -12 m to +90 m, corresponding to the characteristics of a cumulative coastline. At a regional scale, the statistical result of the endpoint rate (EPR) shows that most data range from -1 to +2 m/ year, dominated by progradation, in the period 2000-2011 In the period 2011-2017, 50% of the data varied from -3 to +1 m/year. At specific sites, the structural-geological context, whether frontal lavic spills (Miradores-La Loma and the Villa Rica mound) or tectonic ascents of coastal blocks (Barra de Cazones), largely determines the morphogenetic development of the coastal relief and its most recent morphodynamics. Its variations according to the end point rate (EPR) indicate that progradation is the dominant process in Palma Sola and Villa Rica, whereas regression is prevalent in Barra de Cazones. In general, the northern coast of Veracruz shows a predominance of progradation processes. Isolated localities show prevalent regressive processes in response to the local physical-geographic conditions, which are in turn determined by the geological-geomorphological context and the presence of human settlements related to tourist- recreational activities.

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INTRODUÇÃO: A peste, doença infectocontagiosa milenar, continua sendo considerada da maior importância do ponto de vista epidemiológico devido ao alto potencial epidêmico, estando inclusive sujeita ao Regulamento Sanitário Internacional. Apesar da ausência de casos humanos da doença no Brasil, seu agente etiológico, a bactéria Yersinia pestis, permanece firmemente arraigado em seus focos naturais. A ocorrência de sorologia positiva em carnívoros domésticos de regiões pestígenas da Bahia, nos últimos anos, objetivou a realização deste estudo, que se propõe a verificar a existência de circulação do agente no estado, tendo em vista que fatores condicionantes para a doença são mantidos, oferecendo riscos à população. MÉTODOS: Trata-se de um estudo para verificação da presença de infecção por Y. pestis através do inquérito de soroprevalência em humanos, cães e roedores; e pesquisa da bactéria em roedores e pulgas. Utilizou-se de questionário estruturado para avaliação da associação existente entre fatores ambientais, sócioeconômicos e biológicos e a soroprevalência da infecção em humanos. RESULTADOS: Os 630 soros examinados (88 de humanos, 480 de cães, 62 de roedores) apresentaram-se não reagentes para peste e as análises bacteriológicas realizadas em 14 roedores e dois lotes de pulgas não identificaram a bactéria. CONCLUSÕES: Os resultados não configuram erradicação da doença no estado, pois sua natureza cíclica indica que pode passar longos períodos silente e depois ressurgir acometendo um grande número de pessoas. Portanto, a manutenção da vigilância ativa e permanente se faz necessária para a detecção precoce da doença e desenvolvimento oportuno das medidas de controle pertinentes.

INTRODUCTION: From an epidemiological point of view, the plague is still being considered of great importance, because of its high epidemic potential. Despite the absence of cases of human plague in Brazil, its etiologic agent, the bacteria Yersinia pestis, is still deep rooted in its natural environment. The occurrence of positive serology for plague in domestic carnivores in plague areas in Bahia in the past few years implies the need for a more rigorous evaluation in order to verify whether the bacillus of the plague is still active in these areas. METHODS: In this study, the presence of infection caused by Y. pestis was analyzed by seroprevalence tests on humans, dogs and rodents and by the detection of the bacteria in rodents and fleas. A structured questionnaire was used to analyze the association between environmental, socioeconomic and biological factors and seroprevalence in humans. RESULTS: Of the 630 serum samples examined (88 from humans, 480 from dogs and 62 from rodents), all were nonreactive for plague and bacteriological analyses performed on 14 rodents and 2 flea lots showed no signs of the bacteria. CONCLUSIONS: These results cannot confirm the eradication of the disease in the entire State, since the cyclic nature of the plague indicates that it can go silent for long periods and then resurge, affecting large numbers of people. Thus, maintenance of active, permanent surveillance is required for early detection and the development of adequate control measures.