Brazil improves childhood vaccination, but coverage against Covid-19 is worrying: Andréia Peres

For the original article in Portugese language, click here

Andréia Peres * has been working as a consultant in UNICEF Brazil since 2002. Here she also talks about Jim Grant, Agop Kayayan and other colleagues

Between 1980 and 1990, Jim Grant (1922-1995), the legendary executive director of the United Nations Children's Fund (UNICEF), is estimated to have saved the lives of 25 million children. Thanks to his mobilization, there was a large investment of resources for immunization and, in 10 years, global vaccination rates for the six main diseases that killed the most children at that time went from 20% to 80%. The commitment was so great that for the first time in the history of humanity, a war stopped so that children could be vaccinated.

“Twice a year, for two consecutive days, armed conflicts in El Salvador would completely cease so that children could be immunized,” recalls Agop Kayayan, Unicef representative in Central America at that time, in an interview with this column. According to him, the truce in the civil war was repeated for six years. More than 400,000 children were vaccinated in the so-called “days of tranquility”.

This story with a happy ending is in the book “Jim Grant: the visionary of Unicef” (free translation) and in documentaries, such as “The day love stopped a war” or “The untold story of Unicef” (free translation) , all not yet available in Portuguese. It's proof that vaccines and leadership like Jim Grant's can make a difference.

Today, unfortunately, we are witnessing countless setbacks around the world in this area. According to data from the World Health Organization and Unicef, in 2022, 20.5 million children around the world failed to receive one or more vaccines through routine immunization services. The numbers improved compared to 2021, but are still worse than those in 2019, before the Covid-19 pandemic.

In Brazil, until 2015, coverage of vaccines such as MMR (measles, mumps and rubella) and polio was above 90%. Since then, a downward trend has been recorded in most of the country, which began to be reversed from 2023 onwards.

“The numbers at the end of the year show a small recovery in vaccination rates”, says pediatrician José Luiz Egydio Setúbal, president of the foundation that bears his name, member of the Agenda 227 Coordination and Articulation Group, a non-partisan movement in society civil society in favor of guaranteeing absolute priority for children and adolescents.

Eight vaccines recommended in the children's calendar showed an increase in vaccination coverage, according to preliminary data from the Ministry of Health for January to October 2023, when compared with the entire year 2022. For children aged 1 year old, immunizations against hepatitis A, polio, pneumococcal, meningococcal, DTP (diphtheria, tetanus and pertussis) and triple viral 1st dose and 2nd dose (measles, mumps and rubella) recorded growth. There was also an increase in coverage of the yellow fever vaccine, recommended at 9 months of age. The increase was recorded across the country.

“There was a general improvement and a more significant improvement in the one-year-old population”, assesses Eder Gatti, director of the Department of the National Immunization Program (PNI), in an interview with the column.

According to the Ministry of Health, the scenario is even more encouraging when compared to the number of municipalities that reached the recommended vaccination coverage targets. In general, there was an increase of 1/3 in the number of municipalities that reached the target of 95% in essential vaccines for the childhood calendar, which represents more than 2,100 cities with this coverage rate.

“MOVEMENT NEEDS TO BE MADE IN VACCINATION AGAINST COVID-19 IN CHILDREN”

Despite the good news, Setúbal assesses that the results “were not as good as expected” and says that progress is still needed in vaccination against Covid-19 in children. “The fake news regarding Covid vaccines for children worked. Today, the biggest challenge is convincing people that Covid is not over. There continue to be many cases of children with Covid, especially young children. These are people who have not been immunized,” he says.

According to the Ministry of Health's Covid-19 vaccination coverage panel (with data updated until 01/22/24), the vaccination rate (three doses) in the age group from 6 months to 2 years is just 5 .8%; and in the age group of 3 to 4 years, 6.1%.

“We need to increase this coverage”, recognizes Gatti. According to him, the inclusion of the Covid-19 vaccine in the National Childhood Vaccination Calendar, on January 1, 2024, should contribute to improving this index.

In 2023, Covid-19 was responsible for 5,310 cases of severe acute respiratory syndrome and 135 deaths among children under 5 years of age in Brazil. The incidence and mortality from the disease in this age group have been increasing since 2022. Since the beginning of the pandemic until November 2023, 2,103 cases of Pediatric Multisystem Inflammatory Syndrome (SIM-P) were reported in the country, a manifestation.

Given the initiative of the Federal Council of Medicine (CFM) to open a consultation to assess the opinion of the medical profession regarding the mandatory vaccination against Covid-19 in children between 6 months and 5 years of age, the Brazilian Society of Immunizations (SBIm ) publicly spoke out against the measure. According to the entity's statement, “by equating personal beliefs with science, research can generate insecurity in the medical community and keep the population away from vaccination rooms.”

“Immunization is the best way to prevent diseases and is certainly the cheapest health promotion strategy in economic terms”, assesses Setúbal. The José Luiz Egydio Setúbal Foundation also issued a statement supporting the mandatory vaccination of children aged 6 months to 5 years.

These are strange times of fake news, when it is necessary to defend the obvious.

* Journalist and director of Cross Content Comunicação. For more than three decades she has written on topics such as education, children's and adolescent rights, women's rights and the third sector. With more than a dozen national and international awards, she has published several books on education, child labor, violence against women and human rights.