ABSTRACT
Access to vaccination has emerged as a growing global public health concern; however, there has been limited research on characteristics of local governments that are associated with vaccination coverage. The objective of this study was to evaluate predictors of vaccination coverage in Brazil for the first year of life between 2013 and 2022. We focused on variables pertaining to the available resources of local governments and their investments in infrastructure and human resources in the health sector. We used binomial generalized linear mixed models to estimate the association of these variables with vaccination coverage in Brazilian municipalities. Our results show that municipalities with better fiscal capacity were more effective in delivering vaccines. Municipalities that rely more on federal and state resources had lower vaccination coverage. Additionally, investment in health professionals was often negatively correlated with vaccination coverage. The study underscores the importance of better understanding the relationship between local government characteristics and vaccination coverage, particularly in regions where local governments are responsible for vaccine delivery.