During the 1st Municipal Vaccination Forum, organized by the Municipality of Manaus, on Wednesday 03/16, at the Novotel Manaus, in the Industrial District, South Zone, the head of the Municipal Health Department (Semsa), Shádia Fraxe, drew attention to the gradual reduction in vaccination coverage in the capital and warned of the high risk of the return of vaccine-preventable diseases, already controlled or eradicated in the country, such as measles and poliomyelitis.
Under the theme “Immunoprevention, everyone’s responsibility”, the forum brought together managers and experts with the aim of discussing the subject and mobilizing professionals and institutions in the public and private spheres to promote strategies for recovering adequate vaccination percentages for available vaccines, especially those intended for children aged 0 to 14 years.
Representatives from the field of health, public and private universities, health foundations, cooperatives, medical councils and associations, control bodies, in addition to the Pan American Health Organization (PAHO), Fiocruz and the Ministry of Health participated in the event.
Responsible for the opening theme, “Context of vaccination in Manaus”, Shádia Fraxe presented the vaccination coverage rates for the main diseases of the national surveillance and underlined the need for joint strategies to increase the adherence of the population to the available vaccines and guarantee the increase of the vaccination coverage rates to a minimum level of 95%, as recommended by the Ministry of Health.
“The level of vaccination coverage in Brazil has been declining since 2015, approaching what we had in the 1980s, which is sad and unacceptable”said the secretary.
The historical series from 2014 to 2021 shows that in Manaus the nine main vaccines applied in the first year of life have experienced a drop in coverage in this period and that only BCG, which protects against severe forms of tuberculosis and is applied in maternities shortly after birth, remains above the target, even if it has increased from 134% in 2014 to 98.6% in 2021.
Vaccines against human rotavirus, hepatitis A, poliomyelitis and pentavalent vaccine (against diphtheria, tetanus, pertussis, hepatitis B and infections caused by Haemophilus influenzae type B) have coverage of less than 70 %, based on 2021 data All had reduced coverage over the past seven years.
The meningococcal C vaccine and the pneumococcal and D1 MMR (measles, rubella and mumps) vaccines recorded, in 2021, a vaccination coverage of less than 80% among children under 1 year of age in Manaus.
The lowest rate verified is that of yellow fever (55.3%), considered critical and unacceptable, particularly because the North region is an endemic area for the disease.
“In the national comparison, Manaus still has higher coverage averages than Brazil, but that does not reassure us because, in fact, we have a serious problem to solve and it is the determination of Mayor David Almeida that the current administration do everything possible to reverse this historical loss situation” assured the secretary.
Shadia pointed out that interrupting vaccination, even for short periods, increases the likelihood of disease outbreaks and exposure to disease, sequelae and death. She cited the example of the reintroduction of measles in Brazil in 2018 and the recent emergence of a type I wild polio case in Malawi, Africa, putting the global community on alert.
The Secretary also pointed out that with the gradual reduction in vaccination coverage seen in the rest of the country and around the world, bodies such as the World Health Organization (WHO) and the Ministry of Health itself have drew attention to the problem. According to her, the Covid-19 pandemic has worsened the low coverage, but that is not its main cause.
According to Shadia Fraxe, fake news is among the factors that impact vaccine adherence. Unsubstantiated information and also the lack of priority of vaccination among families, whether due to busy lives or even the idea that, with diseases under control, vaccines are no longer so important, keep the community away from vaccine rooms.
“Vaccination coverage below that recommended by international organizations poses a real risk and everyone must realize the seriousness of this problem and feel responsible for changing the scenario”warned.
To the secretary,It is essential that different health workers, governments and civil society in general act together to deconstruct myths and false news about vaccination”.
As a practical measure, Semsa proposed, during the event, the elaboration of the “Letter of Manaus”, as a demonstration of the commitment of the town hall and representatives of organized civil society with the expansion of vaccination in the capital. A draft of the document is already formatted and will be sent to the authorities present at the forum for signature of the final text, after contributions and approval.
Still as a strategy to reverse the low vaccination coverage, the City Hall of Manaus prepared an advertising campaign, presented by the secretary Shadia Fraxe during the forum. The campaign is now online and is aimed at parents and guardians of children aged 0-14. Under the theme “Every Vaccine Matters,” the coins draw attention to the need to keep children’s immunization records up-to-date, as outlined in the Immunization Schedule.
“We don’t want to simply expose a problem and issue warnings without having our own initiatives that reaffirm our commitment to improving the quality of life of our population”, Shadia said.
The forum included three other presentations: “Vaccination: Evolution and Prospects”, made by the representative of the Brazilian Vaccination Society, Amanda Alecrim; “Safety and efficacy of vaccines”, presented by pediatric immunologist Solange Dourado, from the Brazilian Society of Pediatrics and coordinator of the Immunobiological Reference Center (Crie/AM); and “Promotion of vaccination in Manaus and the structure available in the municipal health network”, addressed by the municipal undersecretary for health management, Djalma Coelho.
The 1st Municipal Immunization Forum brought together approximately 300 people, including municipal, state, and federal health officials and technicians, and interested agencies to discuss the topic and provide solutions.
The President of the Municipal Health Council (CMS), Jorge Carneiro, said that vaccination coverage is the great challenge of the moment and that there is an urgent need to restore the national tradition in vaccination.
“The vaccine is the best strategy to prevent diseases and it is necessary to have a training center and preparation of correct information, capable of generating positive responses”, commented.
The president of the Amazonian Society of Pediatrics (Saped), Elena Marta, also stressed the need to constantly convince the population of the importance of vaccination, with the dissemination of reliable information.
“Vaccination is one of the most important public health actions and it is necessary to combat the myths and false news that circulate freely”. According to her, now is the time for governments and the scientific community to create strong actions to reinforce the importance of the vaccine.
Working with preventable and non-preventable diseases for 48 years, the Director-President of the Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), Marcus Guerra, emphasized that vaccination is one of the most important activities to reduce the social impact of diseases.
The union of the municipal, state and federal spheres was highlighted by the representative of the Ministry of Health, Paulo Ricardo Lima Loureiro. For him, it is not possible to lose the “trophy” that Brazil has won with the National Immunization Program (PNI) over the years and “With actions like these, we will reach“, he stated.
The forum also featured the testimony of Councilor of the City Board of Health, Elson Melo, who was affected by poliomyelitis due to lack of vaccination. Elson made a statement highlighting the role of the vaccine in preventing the disease.