This week, the Ministry of Health announced that it will extend the polio vaccination campaign until September 30. The measure, according to the folder, aims to increase vaccination coverage and population adherence to vaccination. Until last Tuesday (6), the ministry computed that, during the campaign, only 35% of children aged between 1 and 5 years old had been immunized against poliomyelitis. The campaign’s goal is to achieve coverage equal to or greater than 95% in this audience.
The low vaccination coverage observed in Brazil against the disease in recent years has worried specialists, who warn that this scenario can lead to the reintroduction of the virus in the country. “Here in the country, we have a risk of reintroduction [do vírus] with this scenario of low vaccination coverage”, said Caroline Gava, technical advisor of the Department of Immunization and Communicable Diseases of the National Immunization Program.
“The latest exclusive campaigns [para a pólio] were in 2018 and 2020, where we no longer achieved good vaccination coverage goals. And today it is far short of what we would like,” she added. Caroline spoke today (8) at a table that discussed the situation of poliomyelitis in Brazil during the XXIV National Immunization Journey (SBIm 2022), an event that takes place until Saturday (10) at the Frei Caneca Convention Center, in São Paulo.
Polio, which causes infantile paralysis and can be fatal, has become one of the most feared diseases in the world. But, with the vaccination, Brazil stopped presenting cases of the disease since 1989, having received, in 1994, a certificate of elimination of the disease. However, with the low vaccination coverage and problems related to epidemiological surveillance and social conditions, Brazil has returned to appear as a country with great potential for the return of the disease.
“In a risk assessment carried out in the Americas and the Caribbean by PAHO [Organização Pan-Americana de Saúde], considering variables such as vaccination coverage, epidemiological surveillance and other health determinants, Brazil appears in second place, as having a very high risk for the reintroduction of polio, only preceded by Haiti”, said infectious disease specialist Luiza Helena Falleiros Arlant, who also participated in the table, but at a distance. Luiza Helena is part of the Permanent Advisory Group of the Latin American Society of Pediatric Infectious Diseases (Slipe).
During her talk, Caroline presented a map of Brazil almost entirely painted red. The red color indicates the high risk of the country’s municipalities for the reintroduction of the virus, taking into account not only vaccination coverage, but also epidemiological surveillance and sociodemographic indicators. In this situation, 58.9% of Brazilian municipalities were found. The map, with data for 2021, has three color variations in addition to red: orange represents high risk (situation of 25.6% of the municipalities); yellow, medium risk (13.5%); and green, low risk (1.8%).
“This is a scary map. It is a map of our reality in relation to the risk for polio in the country. We have 84% of the counties in the country that register high risk or very high risk for the reintroduction of polio. Only 100 municipalities, at the end of 2021, were at low risk”, explained Caroline.
Infectologist Luiza Helena also highlighted the color of the map. “Our country is practically all in red, a very intense red, with very few places with medium risk. It is no wonder that we see vaccination coverage that, in 2021, did not reach 70% in Brazil as a whole. The state that did best was Santa Catarina, with 83%, but far from reaching the proposed 95% vaccination coverage. And there are figures of great concern, such as only 44% in Amapá. This is all very worrying,” she added.
Since 2015, when it managed to obtain a vaccination coverage of 98.3%, Brazil has not reached the vaccination target for the disease. [estabelecida em 95%]. In 2020, it amounted to only 76.2%. And last year, 69.9%.
Remembering that, with measles, the story was no different. Brazil even received the measles elimination certificate in 2016. But in 2019, also with a drop in vaccines for the disease, the country lost this recognition after failing to control an outbreak, which spread to several states.
Poliomyelitis or polio is an acute contagious disease caused by a virus that lives in the intestines, called poliovirus, which can infect children and adults through direct contact with feces or secretions passed through the mouth of infected people, causing or not paralysis. In severe cases, in which muscle paralysis occurs, the lower limbs are the most affected. The lack of sanitation, poor housing conditions and poor personal hygiene are factors that favor the transmission of the poliovirus.
The disease has no cure. “Poliomyelitis causes irreversible paralysis in the lower limbs. And when severe, it can also cause paralysis of the respiratory muscles. We have a very high lethality rate, which is death from the disease,” said Caroline, in an interview with Agência Brasil.
The only possible form of prevention for the disease is vaccination. “Parents should always be looking at the vaccination booklet [dos filhos], which is marked, indicating when he should return to the health unit”, said Caroline. “Remembering that the vaccine can be given in any room [do país], it does not have to be in your reference unit. So, if I’m traveling, but it’s time or day for the vaccination, with the child’s documentation I’ll be able to vaccinate him at any health unit. And if I was late or if I missed the date, I can come back at any time to the health unit to perform this vaccination and keep my child’s vaccination schedule up to date,” she said.
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