Trends in BCG Vaccination Coverage in Brazil (2016–2025): A Nationwide Analysis Based on Public Health Data

Introduction:
The BCG (Bacillus Calmette-Guérin) vaccine is used in Brazil to prevent severe forms of tuberculosis in children, including tuberculous meningitis and miliary tuberculosis. Under the National Immunization Program (PNI), BCG is administered in a single dose to children under one year of age, with a target coverage of 90%. Vaccination efforts are primarily conducted by the Unified Health System (Sistema Único de Saúde – SUS), Brazil’s public, free, and universal healthcare system. Vaccination coverage (VC) is an indicator that measures the proportion of the vaccinated population relative to the total eligible. It is calculated by dividing the number of doses administered by the number of eligible individuals, multiplied by 100. For BCG, the denominator is based on the number of live births recorded in the Live Birth Information System (SINASC). This study aims to analyze BCG VC in Brazil from 2016 to 2025 using data exclusively from the National Health Data Network (RNDS), an official SUS database.

Methods:
A descriptive study was conducted using secondary data from RNDS on annual BCG coverage from 2016 to 2025. Data for 2025 includes records up to May. Percentages were compared to the national target of 90% and analyzed descriptively.

Results:
From 2016 to 2018, VC remained above 90%, peaking in 2018 (99.72%). Coverage declined starting in 2019 (86.67%), reaching the lowest levels in 2020 (77.14%) and 2021 (74.97%) during the COVID-19 pandemic. Recovery began in 2022 (90.09%), with 87.99% in 2023, 96.61% in 2024, and 87.91% reported through May 2025.

Conclusion:
BCG coverage in Brazil showed significant variation over the last decade. The drop during the pandemic and subsequent recovery highlight the need for sustained immunization strategies and the strength of SUS data as a public health surveillance tool.