The resurgence of controlled diseases so far due to vaccination is a ghost that haunts countries that have seen a steady decline in vaccine coverage, such as Brazil. 1. Following an outbreak of the disease in the country in 2018, the country lost the measles-free country certification provided by the Pan American Health Organization (PAHO) the following year. Since then, cases of measles have been reported annually in Brazil, even during the coronavirus epidemic. 1.
With the first case of wild polio in three decades in Malawi and the recent record of an outbreak of poliomyelitis linked to the vaccine virus in Israel Two The red light has been lit in many countries, including Brazil, as vaccine coverage against the disease has been declining for at least seven years. In 2013, 100% of children who needed to be vaccinated against polio went to a health post. But in 2020, only 75.86% were vaccinated, and last year, that number was even lower: only 63.75% of eligible children were vaccinated against polio. 3. “In a simple calculation, we can say that, out of every 100 children, 30 are not vaccinated properly and are at risk,” said Juarez Cunha, a pediatrician and president of the Brazilian Society of Immunization (SBIm). “And, we’ve got less vaccine coverage since 2015. Can you imagine the number of children susceptible to this disease?”, He asks.
Before the polio vaccination campaign began in the 1980’s 4, The disease was a constant concern in the lives of mother and father. Most of the symptoms are usually mild, such as fever, malaise, headache, sore throat and body aches, but the most severe forms of the disease have consequences such as muscle weakness, problems and pain in the joints, various types of growths. Leg, paralysis. Muscle problems, including speech and swallowing problems, other motor problems that have no cure. 5. In some cases, polio can be fatal. 6. “Polio was a disease that brought drama, because many children went to bed with fever and woke up paralyzed. They started with paralysis, ‘small legs’, usually in the lower limbs and sometimes it goes up, it was climbing, it reached the thighs, arms. When the boys were healed, and most were healed, they were left with a sequel. We all know people who have had polio in the past and have been held accountable, sometimes permanently. He needs equipment to be able to walk and move around. So polio is a serious disease, yes, “said Renato Cafori, infectious disease specialist and head of the vaccination department at the Brazilian Society of Pediatrics (SBP).
“The last case of polio in Brazil was in 1989, and Brazil was awarded the Certificate of Disease-Free Nation in 1994. 7. For many mothers and fathers who have had sick children for many years or have had a polio sequel, this may have led to a misconception of safety, one of the reasons for the hesitation to vaccinate is that caregivers may stop vaccinating their children. The polio vaccine is available free of charge through SUS, ”says Kunha. “In 2019, the World Health Organization identified vaccination hesitation (for world health) as a threat. 8. And one of the reasons for not getting vaccinated may be this false sense of security, because there are diseases that a large part of the population does not know, have never seen, so they think they do not need to vaccinate their children. He doesn’t see the risk, but the risk is there, it’s real, “he added.
“And nowadays, because of these low vaccine coverage, the risk of recurrence of poliomyelitis in Brazil is real,” says Renato Cafouri, a pediatrician and infectious disease specialist. “Brazil is at risk of re-emergence of infantile paralysis after many years without registering the disease. For example, other countries, such as Israel, are already facing polio cases: there were seven cases, because (the country) is not vaccinated. (Right) No, “he added.
There is only one way to get this danger out of the rearview mirror: to lead parents and mothers to understand that they need to be vaccinated against all diseases that can be prevented by polio and vaccines, says Luiza Helena Faleros Arlant, a pediatrician and infectious disease specialist. , President of the Technical Chamber of Poliomyelitis Eradication Certification in Brazil by the Pan American Health Organization (PAHO). “If you maintain 95% vaccine coverage for children, no virus entering the country will do anything. With a sufficiently vaccinated population, the virus can spread to the community and it will be immune, people will be safe,” he guaranteed.
References
1 Bulletin-epidemiologico-vol-53-no03.pdf (www.gov.br)
2 Global Polio Eradication Initiatives Call for Renewal Commitments to Fulfill the Promise of a Polio-Free World (unicef.org)
3 Bio-Manguinhos and SBIm Partners in Vaccine Coverage Resume Project – SBIm
4 Poliomyelitis (fiocruz.br)
5 Poliomyelitis (infantile paralysis) | Virtual Health Library MS (saude.gov.br)
6 Poliomyelitis – PAHO / WHO | Pan American Health Organization (paho.org)
ियो Poliomyelitis – PAHO / WHO | Pan American Health Organization (paho.org)
8 Ten Health Threats to Fight in WHO 2019 – PAHO / WHO | Pan American Health Organization (paho.org)
The importance of vaccinating children
For premature babies, focusing on the calendar is even more important
Pediatricians and infectious disease specialists always emphasize the importance of adhering to our children’s immunization schedule, to protect them from vaccine-preventable diseases. But since 2015, Brazil has been experiencing a decline in child immunization rates for most diseases. 1 Including polio, and the recurrence of diseases such as measles that have already been eradicated, for example Two. If practically all eligible children were vaccinated against infantile paralysis in 2013, last year the number dropped to 67.58%. 3. This deficiency requires most vaccines needed in the first years of a child’s life, such as BCG, which protects against tuberculosis; MMR against measles, rubella and mumps; And meningitis C, just to name a few. 4
And when it comes to premature babies, those babies born before 37 weeks of gestation need to be vaccinated at the right time, because they are part of a group of newborns that are at higher risk for infection. 5 “These babies have immature, developing immune systems. And, because they spent less time in the mother’s womb, they received fewer antibodies than babies born to mothers, “says Lillian Sadek, director of neonatal care at the Brazilian Society of Pediatrics.” There are many reasons for this delay, one of which is sadness for a child who is still underweight and has to go to a health center to get several injections. But we have managed to improve this vaccination schedule. He adds.
Combined vaccines included by the Ministry of Health’s National Immunization Program (PNI), which provides protection against multiple diseases from the use of a single injection, may help parents of premature infants in this task of protecting their children, he assessed. Referral Centers for Special Immunobiological (Crie) make these vaccines available to very premature babies who weigh less than 1 kg or are born up to 31 weeks of gestation. 6. The goal was to make the vaccine for the child less painful and less reactive. 7 In this way, premature infants can be protected from six diseases, including polio and whooping cough, by a single needle.
“These special vaccines are also acellular, that is, they are made up of proteins only responsible for triggering the immune response, not the whole cell, and they have fewer side effects,” says Anna Paula Burian, pediatrician and infectious disease regional president. Espirito Santo of the Brazilian Society of Immunization (SBIM) is a mother of twins who was born prematurely at 36 weeks. Doctors emphasize that all immunizations used by the Ministry of Health are “immunogenic, reliable and safe” and that it is important for the families of premature babies to know that SUS provides this immunosuppressive agent to this particular group of children. “We can find mothers in rural areas far from the capital who do not know that they are entitled to joint vaccination. If the vaccinator does not have this information, the mother can contact the health department, which orders this vaccine for the entire city, “he says.
Vaccine against polio
The immunization schedule against poliomyelitis includes five doses of vaccine for premature babies and infants born during pregnancy. Preterm infants always receive the first three doses of inactivated virus injectable immunizer, the inactivated polio vaccine (VIP) at the ages of 2, 4, and 6 months. 8. Since 2016, full-time children also receive the first three doses of VIP. Two booster doses, given between 15 and 18 months and 4 to 5 years, can be either oral vaccine – ‘drop’ (sabin) – or injectable. 9. SBIm recommends that all dosages offered be of inactivated vaccines as far as possible, as recommended by the World Health Organization. 10.
References
1 Decline in childhood vaccination: Revista Pesquisa FAPESP
2 Measles – SBIm family
3 Decline in childhood vaccination: Revista Pesquisa FAPESP
4 Decline in childhood vaccination: Revista Pesquisa FAPESP
5 Low demand for vaccine anxiety, especially in premature infants – NGO Prematuridade.com
6 inform-incorporacao-penta-hexa-acellulares-210104.pdf (sbim.org.br)
7 Brazil. Ministry of Health Department of Health Monitoring. Department of Vaccines and Communicable Diseases. Available at https://sbim.org.br/images/files/notas-tecnicas/informe-incorporacao-penta-hexa-acellulares-210104.pdf. Consultation in May 2022
8 Premature – SBIm family
9 Brazilian Vaccine Society – calend-sbim-crianca.pdf