Processo de tomada de decisão na vacinação sazonal

: promoção da literacia

Abstract

Introduction: Vaccine hesitancy is considered by the World Health Organization (WHO) as one of the ten greatest threats to global public health, representing an obstacle to immunization and the control of preventable diseases. In the context of Residential Structures for the Elderly (ERPI), adherence to seasonal vaccination among healthcare professionals has been declining, compromising the protection of institutionalized elderly people, a highly vulnerable group. Within the scope of the Final Internship carried out in a Public Health Unit (USP) in the metropolitan area of Porto, a significant reduction in vaccine coverage among these professionals was identified in the 2023 Local Health Plan (PLS). In response to this scenario, the Community Intervention Project "Vaccination – For You, For Us" was developed, with the aim of increasing adherence to seasonal vaccination against the Flu and COVID-19. Methodology: To support the intervention, a Health Situation Diagnosis (DSS) was carried out, based on epidemiological data from the 2023 PLS and reports from the Directorate General of Health (DGS). Additionally, a literature review was conducted to identify factors influencing vaccine hesitancy, including perceptions of low risk of infection, lack of trust in vaccine efficacy, fear of side effects, and the fear of the vaccination procedure. Based on these data, intervention strategies were outlined, focusing on raising awareness and promoting health literacy, using both in-person and digital approaches to disseminate qualified information. The project was implemented with 592 healthcare professionals from ERPI partners of the USP, encompassing actions aimed both at maintaining the adherence of those already vaccinated and at changing the decision of hesitant professionals. Results: The final evaluation of the intervention showed a 5% increase in adherence to the Flu vaccination and a 4% increase for Covid-19 among the professionals in the ERPI, compared to the data obtained at the end of October 2024. Although modest, this progress demonstrated the positive impact of the actions implemented, with changes in vaccination behaviors. Additionally, a comparative analysis of DGS data for the 2022/2023 and 2023/2024 vaccination campaigns highlighted a national trend of reduced vaccine adherence, which reinforces the relevance of targeted local interventions. Despite the observed progress, vaccine coverage among ERPI professionals remains below the established goals, indicating that vaccine hesitancy continues to be a significant challenge to address. Discussion: The results show that awareness-raising and health literacy promotion strategies can contribute to increased vaccine adherence, although the impact remains limited given the multifactorial nature of the phenomenon. The national trend of reduced vaccine adherence points to the need for broader and continuous actions that combine effective public policies, institutional incentives, and greater involvement of ERPI in promoting vaccination. Furthermore, intensifying in-person and interactive strategies, alongside the use of digital technologies, can increase the reach of actions and facilitate professional engagement. Conclusion: The "Vaccination – For You, For Us" Project demonstrated a positive impact on vaccine adherence among healthcare professionals in the ERPI, highlighting the importance of interventions focused on health literacy. However, the ongoing decline in vaccine coverage at the national and local levels reinforces the need for sustained interventions over time, combining continuous educational campaigns, facilitating access, and innovative awareness strategies, aiming to ensure collective protection and the safety of the most vulnerable groups.

Date of Award	20 May 2025
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Paulo Alves (Supervisor)