Since the beginning of the National Immunization Program (PNI), vaccination coverage for children has never been so low in Brazil. The reduction has been gradual and continuous since 2015 and, as expected, worsened in the pandemic.
A survey commissioned by GLOBO revealed that last year, the average number of people fully immunized within the target audience of each vaccine from the National Immunization Program (PNI) was 60.8%. In 2015, the index was 95.1%.
“Unfortunately, from 2015 onwards we saw a drop in vaccine coverage in all age groups. But of course our focus is always on children, who are the most vulnerable group. In 2019, we reached the point where none of the vaccines used in childhood reached the goal. And this had never happened before”, says pediatrician Juarez Cunha, president of the Brazilian Society of Immunizations (SBIm).
The three immunizers that had the lowest coverage in 2021 were polio vaccines (52.1% coverage), the second dose of MMR, which protects against measles, mumps and rubella, (50.1%) and tetra viral, which adds the prevention of chickenpox (5.7%).
The coverage target to keep these diseases under control is above 95%. The 2021 numbers are not yet closed, but Cunha does not believe that the final indices will be very different from these.
It is also important to mention these numbers refer to the country as a whole. But this coverage is very heterogeneous. In the Northeast and North, for example, the percentage for complete immunization against polio is 42% and 44%, respectively. Specialists warn that the homogeneity of coverage is an important aspect to provide individual and, mainly, collective protection.
“Vaccination is very important as an individual protection, but it is much more important as a collective protection. If we vaccinate a large number of the population, even those people who cannot be vaccinated because they do not have the age limit, because they are immunosuppressed or for any other reason. reason, they are indirectly protected because the virus or bacteria stops circulating and does not reach this population”, emphasizes pediatric infectious disease specialist Cristiana Meirelles, medical coordinator at Beep Saúde, the largest home health company in Brazil.
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The problem is that experts expected that the start of the vaccination campaign against Covid-19 would be an opportunity to recover the vaccination rate of children. But that’s not what happened.
“We had hoped that the start of the Covid-19 vaccination campaign would boost the other vaccines. But unfortunately, coverage in 2021 was worse than in 2020. This means that children are vulnerable to all diseases, both eliminated and when controlled”, warns Cunha.
Strictly speaking, no one should be talking about the risk of recurrence or outbreaks of these diseases in the 21st century, for the simple fact that there are safe and highly effective vaccines against them. However, low vaccination rates in a globalized world pose a very real threat.
Just remember the return of measles in 2018. The disease was considered officially eliminated from the country in 2016, but returned two years later, after major outbreaks in countries such as the United States, Europe and Venezuela. Israel has already reported seven cases of polio this year in unvaccinated people. It had been almost 30 years since the country had registered the disease.
Although the problem is not unique to Brazil, the low rates in the country draw attention because the National Immunization Program (PNI), created in the early 1970s, is the most complete in the world and has always been considered an example.
The reasons for the drop in vaccination coverage are many. Including a sort of side effect of the successful vaccination itself. The campaigns controlled these diseases in such a way that they were no longer considered a threat to parents, who, over time, lost sight of the need for the vaccine.
There are also anti-vaccination movements; the lack of trust motivated by fake news; problems in accessing vaccination services; failures in the capitation of health professionals and, mainly, communication problems.
Reversing the frame is perfectly possible. Conducting effective mass and continuous communication campaigns to emphasize the importance of immunization was cited by all experts consulted by GLOBO as one of the main actions to increase vaccination rates.
For infectious disease specialist and pediatrician Renato Kfouri, it is necessary to talk to parents on digital networks, which is where they are. Doctor Juarez Cunha, president of SBIm, reinforces the need for partnerships with schools to encourage vaccination.
While this is not effective for young children, it helps with school-age vaccines and helps to catch up on the late calendar by making access easier. Expanding the number of places that apply vaccines and making opening hours of health units more flexible are also fundamental factors, especially for the vaccination of young children.
To parents who have their children’s vaccination cards overdue, all experts are unanimous in saying that the opportunity to immunize children should not be missed. Giving the antigen out of time is still better than not giving it at all. Cunha explains that “applied vaccine does not lose”. Even if the application is delayed, it is not necessary to restart the schema. It will just resume.
For those who have not taken any dose, the application will take place on the schedule recommended for the child’s current age group. If there is more than one vaccine overdue, they can be applied on the same day to speed up the process. The best schedule will be defined by the health professional at the time of vaccination. Precisely for this reason, he needs to be very well trained.
Kfouri recalls that vaccines are one of the greatest health interventions to reduce mortality, sequelae and increase life expectancy.
“It was because of the existence of vaccination programs around the world that we achieved many advances”, says the doctor.
Therefore, we cannot go back.
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