Immunization against COVID-19

impact on incidence, hospitalization, and mortality rates between 2020 and 2022*

Authors

Keywords:

COVID-19, Vaccination, Incidence, Mortality, Hospitalization

Abstract

Objective: To analyze the impact of COVID-19 immunization on incidence, hospitalization, and mortality rates between 2020 and 2022.

Method: Ecological time series study using secondary data from the Notifica COVID-19 and National Immunization Program systems. All confirmed cases, hospitalizations, and deaths were considered, with rates calculated per 100,000 inhabitants. The indicators were compared with the evolution of vaccination coverage over time, measured by the cumulative number of doses administered per epidemiological week.

Results: There were 84,194 cases, 4,425 hospitalizations, and 1,252 deaths. Hospitalization fell from 929.25 in 2021 to 135.77 in 2022, while mortality decreased from 291.28 to 43.99 per 100,000 inhabitants. A temporal association was found between vaccination progress and reductions in indicators.

Conclusion: Immunization was instrumental in reducing hospitalizations and deaths, reinforcing the importance of specific strategies in border regions.

Author Biographies

Carmensita Aparecida Gaievski, State University of Western Paraná, Foz do Iguaçu, PR, Brazil.

Pharmacist. Master's degree in Public Health in Border Regions from the State University of Western Paraná, Foz do Iguaçu, PR, Brazil.

Gustavo Cezar Wagner Leandro, University of Maringá, Maringá, PR, Brazil.

Public health specialist. PhD candidate in Health Sciences at the State University of Maringá, Maringá, PR, Brazil.

Flavia Meneguetti Pieri, State University of Londrina, Londrina, PR, Brazil.

Nurse. PhD in Public Health, Professor at the State University of Londrina, Londrina, PR, Brazil.

Oscar Kenji Nihei Nihei, State University of Western Paraná, Foz do Iguaçu, PR, Brazil.

Biologist. PhD in Sciences, Professor at the State University of Western Paraná, Foz do Iguaçu, PR, Brazil.

Marcos Augusto Moraes Arcoverde, State University of Western Paraná, Foz do Iguaçu, PR, Brazil.

Nurse. PhD in Nursing, Professor at the State University of Western Paraná, Foz do Iguaçu, PR, Brazil.

References

1. Hale T, Angrist N, Hale AJ, Kira B, Majumdar S, Petherick A et al. Government responses and COVID-19 deaths: global evidence across multiple pandemic waves. PLoS One [Internet]. 2021 [cited 2025 Aug 1];16(7):e0253116. Available from: https://doi.org/10.1371/journal.pone.0253116

2. Leandro GCW, Luz LDP, Arenhart CGM, Izuka ADL, Doldan RV, Bom CAG, Britto AS. Intervenções não farmacológicas como medidas de enfrentamento à pandemia de Covid-19 em municípios de fronteira. Rev Saúde Pública Paraná [Internet]. 2020 [cited 2025 Aug 1];3(Suppl 1):266-75. Available from: https://doi.org/10.32811/25954482-2020v3sup1p266

3. Pêgo B, Moura R, Nunes M, Krüger C, Moreira P, Ferreira G et al. Pandemia e fronteiras brasileiras: análise a evolução da COVID-19 e proposições [Internet]. Brasília: Instituto de Pesquisa Econômica Aplicada (Ipea); 2020 [cited 2020 Jun 26]. (Nota Técnica, n.16). Available from: https://www.ipea.gov.br/portal/images/stories/PDFs/nota_tecnica/200521_n_16_dirur.pdf

4. Nagamine LY, Ferreira G, Gruger C, Moura R. Disseminação da Covid-19 nas faixas de fronteira terrestre e litorânea do Brasil. Rev Tempo Mundo [Internet]. 2021 [cited 2025 Aug 1];23:203-33. Available from: https://repositorio.ipea.gov.br/bitstream/11058/10435/1/Tempo_Mundo_n23_Artigo8_disseminacao_covid19_faixas.pdf

5. Secretaria de Estado da Saúde (SESA-PR). Coronavírus (COVID-19) [Internet]. Curitiba (PR): Secretaria de Estado da Saúde; 2024 Mar 25 [cited 2024 Mar 26]. Available from: https://www.saude.pr.gov.br/Pagina/Coronavirus-COVID-19

6. Secretaria Municipal da Saúde (Foz do Iguaçu). Vigilância Epidemiológica - Painel Coronavírus: Foz do Iguaçu [Internet]. Foz do Iguaçu: Secretaria Municipal da Saúde; 2023 [cited 2024 Aug 10]. Available from: https://catve.com/files/169219681464dcdfce3a68d.pdf

7. Alves TAL. Enfrentamento da Covid-19 em região transfronteiriça: a importância da cooperação entre as cidades de Foz do Iguaçu, Ciudad del Este e Puerto Iguazú. Espirales [Internet]. 2021 [cited 2024 Aug 10];5(2 Edição Especial):124-129. Available from: https://revistas.unila.edu.br/espirales/article/view/2793

8. Silva-Sobrinho RA, Zilly A, da Silva RMM, Arcoverde MAM, Deschutter EJ, Palha PF, et al. Coping with COVID-19 in an international border region: health and economy. Rev Latino-Am Enferm [Internet]. 2021 [cited 2025 Aug 1];29:e3398. Available from: https://doi.org/10.1590/1518-8345.4659.3398

9. Luz LDP, Braga JU, Maciel EMGS. Detection of covid-19 epidemic waves and their interrelationships in the tri-border region between Brazil, Paraguay, and Argentina, 2020-2023: Covid-19 epidemic waves in the tri-border region. SciELO Preprints [Internet]. 2024 [cited 2025 Aug 1]. Available from: https://doi.org/10.1590/SciELOPreprints.10963

10. Moura EC, Cortez-Escalante J, Cavalcante FV, Barreto ICHC, Sanchez MN, Santos LMP. Covid-19: temporal evolution and immunization in the three epidemiological waves, Brazil, 2020-2022. Rev Saúde Pública [Internet]. 2022 [cited 2025 Aug 1];56:105. Available from: https://doi.org/10.11606/s1518-8787.2022056004907

11. Kunkel M, Gordillo EAF, Cicchelero LM, Porzsolt F, Meira MCR, Ferreira H, et el. Epidemic curves and the profile of patients hospitalized by COVID-19 in a border region. Rev Latino-Am Enferm [Internet]. 2024 [cited 2025 Aug 1];32:e4296. Available from: https://doi.org/10.1590/1518-8345.6772.4297

12. Instituto Brasileiro de Geografia e Estatística (IBGE). Cidades: Foz do Iguaçu [Internet]. Rio de Janeiro (RJ): IBGE; 2025 [cited 2025 Aug 1]. Available from: https://cidades.ibge.gov.br/brasil/pr/foz-do-iguacu/panorama

13. Meira MCR, Nihei OK, Moschini LE, Arcoverde MAM, Britto AS, Silva-Sobrinho RA, Muñoz SS. Influence of the weather on the occurrence of dengue in a triple-border Brazilian municipality. Cogitare Enferm [Internet]. 2021 Nov 4 [cited 2025 Aug 1];26:e76974. Available from: https://doi.org/10.5380/ce.v26i0.76974

14. Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Guia de vigilância epidemiológica: Emergência de Saúde Pública de Importância Nacional pela Doença pelo Coronavírus 2019 - COVID-19 [Internet]. Brasília (DF): Ministério da Saúde; 2022a [cited 2025 Aug 1]. Available from: https://www.gov.br/saude/pt-br/assuntos/saude-de-a-a-z/c/covid-19/publicacoes-tecnicas/guias-e-planos/guia-de-vigilancia-epidemiologica-covid-19/view

15. Viana K, Zarpelon L, Leandro A, Terencio M, Lopes R, Martins C, et al. Infection in asymptomatic carriers of SARS-CoV-2 can interfere with the achievement of robust immunity on a population scale. J Gen Virol [Internet]. 2021 Nov 17 [cited 2025 Aug 2];102(11):001684. Available from: https://doi.org/10.1099/jgv.0.001684

16. Suprinyak FH, Benito GAV, Nihei OK. Efeitos da reabertura de fronteiras terrestres na evolução espacial e temporal da COVID-19 em Foz do Iguaçu, 2020-2021. Hygeia Rev Bras Geogr Méd Saúde [Internet]. 2025 [cited 2025 Aug 1];21:e2131. Available from: https://doi.org/10.14393/hygeia2174219

17. Oliveira LK. Pandemia na fronteira: Foz do Iguaçu, Puerto Iguazú e Ciudad del Este. La Espada [Internet]. 2020 Jul [cited 2025 Aug 1];24:4-5. Available from: https://portal.unila.edu.br/revistas/la-espada

18. Nascimento LMD, Araújo ACM, Souza PCA, Matozinhos FP, da Silva TPR, Fernandes EG. Estratégia do Ministério da Saúde do Brasil para aumento das coberturas vacinais nas fronteiras. Rev Panam Salud Publica [Internet]. 2024 [cited 2025 Aug 1];48:e31. Available from: https://doi.org/10.26633/RPSP.2024.31

19. Brasil. Ministério da Saúde. Plano de ação: estratégia de vacinação nas fronteiras - Agenda 2022 [Internet]. 2nd ed. Brasília (DF): Ministério da Saúde; 2022b [cited 2025 Aug 1]. Available from: https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/svsa/vacinacao-imunizacao-pni/plano-de-acao-estrategia-de-vacinacao-nas-fronteiras-agenda-2022/view

20. Leandro GCW, Cicchelero LM, Massago M, Oliveira DG, Bortoli DM, Murillo RSG, et al. Evaluation of the acute respiratory infections surveillance system and associated factors: a cross-sectional study, Brazil, 2009-2021. Epidemiol Serv Saúde [Internet]. 2025 [cited 2025 Aug 2];34:e20240555. Available from: https://doi.org/10.1590/S2237-9622025v34e20240555.en

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Published

2026-03-20

How to Cite

Gaievski, C. A., Leandro, G. C. W., Pieri, F. M., Nihei, O. K. N., & Arcoverde, M. A. M. (2026). Immunization against COVID-19: impact on incidence, hospitalization, and mortality rates between 2020 and 2022*. Cogitare Enfermagem, 31. Retrieved from https://revistas.ufpr.br/cogitare/article/view/101048

Issue

Vol. 31 (2026)

Section

ORIGINAL ARTICLE

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Copyright (c) 2026 Carmensita Aparecida Gaievski, Gustavo Cezar Wagner Leandro, Flavia Meneguetti Pieri, Oscar Kenji Nihei, Marcos Augusto Moraes Arcoverde

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