[Preventable diseases by vaccination. Coverage and impact].
OBJECTIVE
to evaluate the coverage and impacts of the vaccination component in Integrated Health Programs.


METHODS
a descriptive study of secondary data analysis was carried out. We analyzed data generated by the Universal Vaccination Program (PROVAC) since 1991, the data compiled in the 2000 National Health Survey (ENSA) and the 2005 National Survey of Coverage of Integrated Health Programs (ENCOPREVENIMSS), as well as the IMSS Annual Epidemiological Gazettes since 1973.


RESULTS
the coverage of the basic schemes of the Extended Immunization Program (PAI) in children from one to four years old increased from 46.0% in 1990 to 92.5% in 1992 and 98.2% in 2005. The coverage with booster doses was substantially lower, ranging between 57.0% and 97.3% depending on the type of vaccine and the number of doses. The coverage also varied, although to a lesser extent, among public healthcare institutions. In relation to the impact of the Universal Vaccination Program and the PREVENIMSS strategy among IMSS affiliates, we distinguished at least three situations: (1) illnesses in which a drop in incidence predates the Universal Vaccination Program: tuberculous meningitis, diphtheria, whooping cough, and tetanus; (2) illnesses in which the drop in incidence is clearly related to the program: measles, rubella, mumps, and meningitis due to H. influenzae b. (3) illnesses for which the impact has not yet been assessed: hepatitis B. In addition to a drop in the incidence of immunopreventable diseases, we observed changes in the age distribution of cases.


CONCLUSIONS
the PREVENIMSS strategy has not interfered with, and in some case has helped to consolidate the achievements of the Universal Vaccination Program. The results of this investigation point to the need to modernize the current system of evaluating coverage and expanding vaccination schemes with booster doses.
Gutiérrez-Trujillo
Gonzalo
G
Instituto Mexicano del Seguro Social. gonzalo.gutierrez@imss.gob.mx
Pérez-Enríquez
Luis R
LR
González-García
Armando
A
Coreño-Juárez
Maria Ofelia
MO
Ramírez-Rosales
Gustavo
G
Grajales-Muñiz
Concepción
C
D002648:Child; D002675:Child, Preschool; D019033:Delivery of Health Care, Integrated; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008800:Mexico; D009313:National Health Programs; D011314:Preventive Health Services; D014611:Vaccination / Q000706:statistics & numerical data*