ANALYSIS OF HEALTH DETERMINANTS AND HUMAN PAPILLOMAVIRUS VACCINATION COVERAGE IN THE STATE OF PARÁ

Abstract

Human Papillomavirus (HPV) is one of the most prevalent sexually transmitted infections worldwide and is associated with the development of neoplasms, especially cervical cancer. Despite the inclusion of the HPV vaccine in the Brazilian National Immunization Program (PNI) in 2014, vaccination coverage in Brazil remains below recommended targets, with significant regional inequalities. This study aimed to analyze HPV vaccination coverage in the state of Pará, considering its temporal and spatial distribution and its relationship with health determinants. This is an ecological, observational, and quantitative study conducted using secondary data obtained from DATASUS/TABNET between 2014 and 2022. The applied doses of the quadrivalent HPV vaccine were analyzed according to sex and health regions of the state. The results showed high vaccination coverage in 2014, followed by a reduction in subsequent years, with partial recovery from 2017 onwards after the inclusion of males in the vaccination schedule. A predominance of doses administered to females was observed throughout the analyzed period. Regional inequalities were also identified, with higher coverage rates in urbanized areas and lower rates in remote regions. Socioeconomic factors, geographic barriers, limitations in primary health care, and vaccine hesitancy were associated with the observed differences. It is concluded that HPV vaccination coverage in Pará is influenced by social and structural determinants, reinforcing the need to expand access to health services and strengthen educational and vaccination actions to reduce inequalities and prevent HPV-related diseases.