Trends in Hospitalizations for Selected Vaccine-Preventable Diseases in Brazil, 2009–2024: A Joinpoint Regression Analysis
1
Universidade Estadual de Campinas, Campinas, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):A3927
ABSTRACT
BACKGROUND:
Hospitalizations due to vaccine-preventable diseases are key indicators of disease control and immunization program performance. Recent declines in vaccination coverage have raised concerns about disease resurgence, making long-term analyses of hospitalization trends essential for monitoring disease burden and informing public health decision-making [1-2].
METHODS:
An ecological time-series study was conducted using hospitalization data from the Hospital Information System of the Unified Health System in Brazil, covering the period from 2009 to 2024. The analysis included hospitalizations due to diphtheria, pertussis, tetanus, measles, mumps, rubella, and hepatitis B, identified through International Classification of Diseases, 10th Revision (ICD-10) codes. Temporal trends were assessed using Joinpoint regression models, estimating Annual Percent Change (APC) and 95% confidence intervals and identifying statistically significant inflection points.
RESULTS:
Hospitalizations due to diphtheria, tetanus, mumps, and rubella showed consistent declining trends throughout the study period, with no joinpoints indicating trend reversal. Pertussis hospitalizations increased between 2009 and approximately 2012, followed by a significant decline from 2012 to 2024. Measles-related hospitalizations displayed episodic increases, with notable upward trends around 2013–2015 and 2018–2019, followed by subsequent declines. Hepatitis B hospitalizations demonstrated a gradual decrease from 2009 onward, with no significant increases identified. Overall, the Joinpoint analysis revealed disease-specific temporal patterns, with declining trends predominating after the early years of the series.
CONCLUSIONS:
The predominantly declining trends in hospitalizations for vaccine-preventable diseases in Brazil from 2009 to 2024 are consistent with the protective role of sustained immunization strategies. At the same time, the temporal fluctuations observed for measles and pertussis highlight the sensitivity of hospitalization patterns to changes in population immunity. These findings underscore the importance of maintaining high vaccination coverage and systematically monitoring both immunization indicators and hospitalization trends to prevent disease resurgence and reduce avoidable severe outcomes.
Hospitalizations due to vaccine-preventable diseases are key indicators of disease control and immunization program performance. Recent declines in vaccination coverage have raised concerns about disease resurgence, making long-term analyses of hospitalization trends essential for monitoring disease burden and informing public health decision-making [1-2].
METHODS:
An ecological time-series study was conducted using hospitalization data from the Hospital Information System of the Unified Health System in Brazil, covering the period from 2009 to 2024. The analysis included hospitalizations due to diphtheria, pertussis, tetanus, measles, mumps, rubella, and hepatitis B, identified through International Classification of Diseases, 10th Revision (ICD-10) codes. Temporal trends were assessed using Joinpoint regression models, estimating Annual Percent Change (APC) and 95% confidence intervals and identifying statistically significant inflection points.
RESULTS:
Hospitalizations due to diphtheria, tetanus, mumps, and rubella showed consistent declining trends throughout the study period, with no joinpoints indicating trend reversal. Pertussis hospitalizations increased between 2009 and approximately 2012, followed by a significant decline from 2012 to 2024. Measles-related hospitalizations displayed episodic increases, with notable upward trends around 2013–2015 and 2018–2019, followed by subsequent declines. Hepatitis B hospitalizations demonstrated a gradual decrease from 2009 onward, with no significant increases identified. Overall, the Joinpoint analysis revealed disease-specific temporal patterns, with declining trends predominating after the early years of the series.
CONCLUSIONS:
The predominantly declining trends in hospitalizations for vaccine-preventable diseases in Brazil from 2009 to 2024 are consistent with the protective role of sustained immunization strategies. At the same time, the temporal fluctuations observed for measles and pertussis highlight the sensitivity of hospitalization patterns to changes in population immunity. These findings underscore the importance of maintaining high vaccination coverage and systematically monitoring both immunization indicators and hospitalization trends to prevent disease resurgence and reduce avoidable severe outcomes.
| eISSN: | 2654-1459 |
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