Posted on 12/25/2022 4:00 AM
(Credit: Estado de Minas)
One of Nicia Trindade Lima’s first challenges when she takes over as Minister of Health in the Luiz Inacio Lula da Silva (PT) authorities will probably be to reform the Unified Health System (SUS) by strengthening the National Immunization Program (PNI). During the administration of Jair Bolsonaro (PL), the program, created 50 years in the past and regarded a historic milestone in Brazilian public well being – to hold out systematic vaccination actions all through the nationwide territory – confronted setbacks, particularly with the power gained by the speech anti-vaccine. needed to do. One of the minister’s missions, in early January, will probably be to announce the targets for the program – which right this moment all indicators are beneath 70% – to regain momentum.
According to Francieli Fontana, General Coordinator of the Ministry of Health’s National Immunization Program (PNI), since 2018, none of the 15 vaccines which can be half of the PNI children’s booklet have reached the immunization target. This yr, a couple of days earlier than the finish of the marketing campaign in opposition to poliomyelitis and multi-vaccination, the ministry determined to increase the deadline till the finish of September to replace the vaccination handbook for children and adolescents beneath 15 years of age. This resolution was taken as a result of there was an extended solution to go to succeed in the 95% immunized inhabitants established by the folder.
On 2nd September, vaccination coverage for poliomyelitis reached 32.5%. After discontinuation, the price of enter rejecting childish paralysis was 57.05% for vaccines administered in the first month of life; 52.19% for doses that ought to be taken inside 15 months; and 53.27% for doses given at age 4 years.
Five years in the past, PNI achieved 99.72% coverage for the BCG vaccine, which fights tuberculosis, and 91.33% for the vaccine in opposition to human rotavirus, which prevents the an infection accountable for extreme diarrhea in children. In 2020, the curve dropped alarmingly. The price of BCG immunization, which was taken early in life, reached 63.88%. On the different hand, the rotavirus vaccine declined to 68.46%. Today the percentages are 67% and 57.23% respectively.
“There is a phrase that’s worldwide and folks say right here in Brazil: vaccines trigger adults. This is the important issue that has made it potential to extend our life expectancy by 30 years. We have managed to extend it from 40 to 70, with vaccination. 80 years. By vaccinating children we give them an opportunity to dwell, to turn out to be adults”, mentioned Isabela Ballalai, Vice President of the Brazilian Society of Immunization (SBIM).
One of the disadvantages of low vaccination coverage is the danger of the return of ailments that have already been eradicated in the nation. Rates are additionally decrease amongst pregnant girls who should obtain DTP and pregnant DTP, which should be given 4 weeks aside to battle the viruses that trigger diphtheria, tetanus and whooping cough. This yr, the sum of the two reached solely 52% (DTP for pregnant girls was 36.03% and grownup sort Acellular DTP for pregnant girls was 15.36%).
“Obviously, we run the danger of reintroducing ailments that have already been eradicated, growing instances of ailments similar to measles, polio, whooping cough and diphtheria”, warned Renato Kafouri, pediatrician and director of the Brazilian Society of Immunization (SBIM). was ).
On Wednesday (21), Health Minister Marcelo Quiroga mentioned “we’re near getting a measles-free certificates once more”. However, infectologists level out that adherence to measles vaccine stays low. In 2019, the nation misplaced that certification, after a yr of the virus of the similar genotype circulating and a brand new outbreak.
In the similar yr, there have been 20,901 confirmed instances of the illness, 8,448 in 2020 and one other 676 instances of measles in 2021. The first dose of the triple viral vaccine, which ought to be utilized to children beneath one yr of age, has an index of 62.26%. When the second dose is noticed, which ought to be taken after 15 months of life, the proportion is 42.21%.
“Brazil is in its fifth yr of measles resurgence. It is not thought-about a measles outbreak nation and is now thought-about measles endemic”, emphasizes Ballalai.
Low vaccination charges weren’t the solely downside confronted by the PNI in current years. The Covid-19 pandemic left public well being technicians racing in opposition to time to develop a fight vaccine. The National Health Surveillance Agency (Anvisa) was a key accomplice in expediting the course of.
“Vaccines, all of them, have at all times been the finest public well being technique, by which therapy prices are low. Therefore, in our work, we attempt to broaden vaccination in all points. We face this debate with nice qualification expertise. Focusing got here in. Saving lives, as a result of it was an unknown illness”, defined Meeruz Freitas.
However, there was a loss of management in the vaccination of Kovid-19, primarily in relation to the youngster age group. One of the most critical issues highlighted in a current report by the Federal Court of Auditors (TCU) was the “blackout” of PNI knowledge.
The inhabitants of six-month-olds and two-year-olds is six million, however there isn’t a data on vaccination for this age group. According to the Health Technical Group (GT), at three to 4 years of age, the proportion between the first and second doses is beneath 20%. The highest price is between 5 and 11 years, with the first dose reported by 70.7% and the second by 50.1%. The reverse state of affairs accounts for greater charges in adults.
GT coordinators identified that the ministry can’t say what number of vaccines have been distributed or the expiration date of the doses, which might finish in January. Contrary to the knowledge, Quiroga mentioned Brazil did very nicely in coping with the Covid-19 pandemic.
The War Against Fake News Campaigns
In parallel with the dissolution of the PNI, organizations specializing in public well being and technicians in this space have, in current years, waged a battle in opposition to faux information. Anti-vaccination speeches, particularly geared toward vaccinating children, gained power with the encouragement of authorities officers. They elevate doubts about the authenticity of the new Covid-19 vaccine, but in addition about immune programs that battle ailments that have already been eradicated.
“The degradation of the nationwide well being authority and the coordination and articulation position of the Ministry of Health (MS) have been main components in the disruption of hitherto profitable insurance policies and packages, similar to the National Immunization Program (PNI),” the closing report suggests. Transition to space.
A qualitative research by the United Nations Children’s Fund (UNICEF) on the components resulting in a lower in vaccination coverage amongst children beneath 5 years of age in 5 Brazilian capitals reveals that ailments, faux information and low notion of the danger of bother. Access to vaccination companies is a crucial component in driving individuals away from vaccination. Isabella Ballalai factors out that that is made worse when individuals don’t see the danger, particularly in ailments that have already been eradicated.
“People don’t have a notion of the danger, they don’t consider and are usually not knowledgeable by public authorities. I have heard from many individuals: why has the ministry by no means carried out a vaccination marketing campaign? And I reply: it’s not true, it does it yearly. Yes, they’re simply covert campaigns. People have to worry the illness to discover a vaccine”, he clarified.
For Meeruz Freitas, director of Envisa, the first step to bringing the inhabitants nearer ought to be reintroducing transparency. With this, technicians consider that PNI ought to reinvent itself. Nísia Trindade mentioned the PNI will have its personal part in the portfolio and will probably be “a nationwide effort, going by means of the well being, faculties, social improvement sectors”.
“The new minister says that he has to hold out an intensive marketing campaign to boost consciousness in faculties, in kindergartens, with dad and mom. We have gone years and years and not using a vaccination marketing campaign. I believe combating faux information and launching a extremely sturdy authorities marketing campaign, well being Ministry, the well-known Zé Gotinha and reveals that the vaccine protects, that children can have critical instances of Covid. Fiocruz).
Another containment mechanism studied by members of the Transition Health WG is to start mapping faux information content material and framing influencers into crimes in opposition to public well being.
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