Vaccination coverage plummets in the last ten years, and polio threatens Brazil again

Vaccination coverage plummets in the last ten years, and polio threatens Brazil again

In the last ten years, polio vaccine coverage has dropped from 96.5% (2012) to 61.3% (2021), a figure that raises the alarm, especially at a time when the disease is detected in some countries. Data from DataSUS (Department of Informatics of the Unified Health System) show that, until Friday (12), the level of children vaccinated against polio – a serious and incurable disease – did not even reach 50%.

“It is important to put in context that, in the past, polio was an extremely serious disease, it killed people, left children with paralysis and sequelae for the rest of their lives”, recalls the pediatrician, director of the SBIm (Brazilian Society of Immunizations) and the SBP (Brazilian Society of Pediatrics), Renato Kfouri.

The last case of the disease here was in 1989. In 1994, the WHO (World Health Organization) declared the eradication of the disease in Brazil. But it remained endemic – with frequent outbreaks – in Pakistan and Afghanistan, in Asia.

This year, samples of the virus have already been found in the sewers of New York, in the United States, and London, in the United Kingdom. In addition, Israel and Malawi, in Africa, have confirmed cases of the disease.

The infectious disease specialist and vaccine consultant at Delboni Medicina Diagnóstica, from the Dasa group, draws attention to the circulation of the virus. “We live in the world in a globalized way and, when we least expect it, we can have the reintroduction of a virus that did not circulate here in Brazil”, she emphasizes.

Little epidemiological and environmental surveillance

In 2021, the WHO placed Brazil alongside Haiti and Venezuela as a country at high risk of reintroduction of the disease. In addition to the low vaccination coverage, the explanation for our being in the same condition as less developed neighbors is the lack of environmental and epidemiological surveillance.

“Brazil has low environmental surveillance, low surveillance of flaccid paralysis and low vaccination coverage. It is an invitation for us to have polio here, it takes time to recognize it, and it is already widespread”, says Kfouri.

Environmental surveillance, to which the doctor refers, is precisely done from the collection and analysis of sewage samples, in which it is possible to detect the virus and attest to its circulation in a community.

The infectious disease specialist agrees and completes: “The big problem with poliomyelitis, as it circulates in a way that people cannot easily recognize, it can affect someone who has not received the vaccine, and they can have the disease in the paralytic form and be sequelae for the rest of your life”, points out Maria Isabel.

What is polio?

Poliomyelitis is a disease caused by enteroviruses, it initially infects the nasopharynx, leads to an intestinal infection and, in most cases, recovery is rapid.

Less than 1% of those infected will have the most serious forms, called paralysis. In it, the virus affects the muscles, in general of the lower limbs on one side only, and the person is left with a sequel for the rest of their lives.

“It is worrying the possibility of having people who have not taken the vaccine, in a regimen that is quiet, safe and they may have a disease that will leave them with a serious problem for the rest of their lives”, says the infectologist.

Why did people stop vaccinating children?

There are many reasons for the drop in adherence to vaccines, especially in a country the size of Brazil, and it is possible to see the difference in behavior with data from DataSUS.

For example, in 2021, the North region had the lowest coverage: 53%. Then come the Northeast (54.5%), Southeast (63.8%), Midwest (65.8%) and South (72.2%).

“There are several causes in several different locations, but against the background of all this, as a common cause for all places, there is a low perception of risk. Vaccines are successful because they eliminate diseases, and people no longer feel threatened It is the perception of risk that moves us towards prevention”, explains Kfouri.

Infectologist Maria Isabel adds: “We don’t have many cases of disease, people are not afraid of what they don’t see.”

Communication about the disease and the availability of vaccines in the SUS are essential to make Brazil reach again ideal levels of immunization against polio – above 90% of adherence.

“We need to continue motivating and explaining vaccination even without people living with the disease. This also applies to health professionals. Young professionals who also do not treat, do not care, do not emphatically recommend, as we recommended decades ago, that we charged the calendar on time”, points out Kfouri.

National vaccination campaign

The country is in the midst of a vaccination campaign against the disease that runs until September 9. To be considered immunized, a child needs to receive five doses of the vaccine, three in the first year, one at 1 year and three months and a booster at four years.


In addition to polio, all immunizations that are part of the national calendar of the PNI (National Immunization Plan) are being offered to children and adolescents from zero to 15 years old.

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