A importância da qualificação dos registros nas salas de vacina: Ações de vigilância da cobertura vacinal no município de Arraial do Cabo

Abstract

Vaccines represent an important advance in improving people's health. In recent years, the country has observed a drop in vaccine coverage of various immunobiologicals that pose a risk of the reappearance of some immunopreventable diseases and the resurgence of others, which were previously under control. The diversity of information systems and the change in the registration process for the application of vaccines and other immunobiologicals, with changes from the SI-PNI web system to e-SUS AB, may be generating inconsistencies and non-migration of the vaccine data that contribute to low vaccination coverage rates. The study was intended to analyze the components that qualify the records of the information system existing in the vaccination rooms of primary health care in the city of Arraial do Cabo-RJ, for the evaluation and surveillance of the vaccination coverage of children under two years old. This is a case study, with an exploratory and descriptive approach, which involved (i) the survey and comparison of the applied doses of immunobiologicals indicated for children under two years old existing in the SI-PNI and e-SUS in Arraial do Cabo, aiming to identify discrepancies between the two vaccine registration systems; (ii) the identification of some aspects that interfered in the records in the municipal immunization rooms and the data registered in the systems, and (iii) the report on the implementation of a set of actions developed by the Coordination of the Municipal Immunization Program based on this diagnosis, to improve local vaccination coverage. The studyidentified inconsistencies between the data recorded in the e-SUS and SI-PNI systems, and factors preventing data migration and even registration of applied immunizations, such as incorrect registration of dose, batch, expiration date and manufacturer of the vaccine administered, which according to the adequacy of the data registered in the National Immunization System should be registered with the correct identification of the vaccinated child (usage of the child's SUS card) and with appropriate link to the municipal e-SUS database. Difficulties that went beyond the registration itself were also detected, such as weaknesses related to monitoring the use of the systems; inadequate archiving of vaccine records in vaccination units; insufficient infrastructure in the UBS where immunizations are carried out; shortages and deficiencies in the training of professionals; missed opportunities for immunization and low control of unvaccinated subjects. The methodology developed for the diagnosis of the municipal situation and some instruments generated, such as shared forms for controlling demand and vaccine records, a step-by-step guide to help with the migration of vaccination records from the e-SUS system to SI-PNI and a booklet on factors that influence municipal vaccination coverage, can be appropriated and adapted by other locations that experience similar realities and difficulties.