Human papillomavirus vaccination in Brazil: Universal health coverage or discriminatory practice? Público

Volpini Gattegno, Mariana (2016)

Permanent URL: https://etd.library.emory.edu/concern/etds/6m311p847?locale=es
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Abstract

In 1988, Brazil's Unified Health System (SUS) established a right to health in the constitution granting all Brazilians universal access to health care. Brazil introduced human papillomavirus (HPV) vaccination into its vaccination program in 2014. Despite the universal nature of SUS, HPV vaccination was limited to females aged 9-13. The goal of this study was to evaluate parental knowledge and attitudes regarding HPV vaccination exclusion criteria. Data were collected from parents with children aged 9-17 in the municipality of Mauá (São Paulo, Brazil) through questionnaires. We documented high knowledge and positive parental attitudes regarding HPV vaccination safety and efficacy among the low-income population. Additionally, the majority of parents supported the inclusion of males and females over 13 into the vaccination program, and the demand for non-discriminatory HPV vaccination is high among parents. Exclusion of these populations violates the basic principle of non-discrimination as a part of universal health coverage (UHC), as well as Brazil's constitution. Worldwide, approximately 100 million individuals fall into poverty each year due to health care costs. Excluding these individuals from HPV vaccination perpetuates inequality in a health system that was created to provide UHC, as the majority of individuals cannot afford the cost of HPV vaccination.

Table of Contents

TABLE OF CONTENTS

Chapter 1: Background ............................................................................................... 1

Chapter 2: Manuscript ............................................................................................... 13

Chapter 3: Public Health Implications...................................................................... 32

Chapter 4: References ................................................................................................ 34

Appendix A: Tables .................................................................................................... 43

Appendix B: Study Instrument.................................................................................. 48

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