Searching for non-vaccinated people through the WhatsApp application, distributing circus tickets and even bicycle raffles are among the strategies of city halls in several Brazilian states to expand vaccination coverage against polio. Until this Tuesday, the 25th, the rate was 70%, when the ideal is to vaccinate 95% of children under 5 years old. 3.4 million in this age group need to be immunized across the country, according to the Ministry of Health.
The effort in the search for the unvaccinated is justified. In 2020, the Pan American Health Organization (PAHO) classified Brazil as a place at risk of reintroduction of the disease – also called infantile paralysis -, which had been eradicated since the early 1990s. classification rose to “high risk”, putting the country on high alert.
According to the Ministry of Health, 8.1 million children were vaccinated until yesterday, out of a total of 11.5 million that make up the target audience – under 5 years old. The immunizer, informed the folder, remains available at health posts across the country, even with the end of the national campaign in September. Some cities maintain the mobilization.
The states that most vaccinated so far were Amapá (95.88% of the target audience), Pernambuco (86.15%) and Alagoas (83.53%). Those with less coverage are Acre (38.65%), Roraima (41.15%) and Rio de Janeiro (45.24%).
In the capital of Rio de Janeiro, the application of doses more than doubled after the city hall began an active search for unvaccinated children, even using the WhatsApp groups of health professionals. According to the Secretary of Health, Daniel Soranz, the daily average rose from 750 to 1,600 doses applied. “We still have 130,000 unprotected children. In addition to the doses provided for in the regular schedule, we are applying another booster dose to children aged 1 to 4 years. We ask parents to take these children to the post,” he said.
While the state of Rio had less than half of the target public vaccinated until Tuesday, the capital had 55.20% of children vaccinated, according to the city hall. 174 thousand doses were applied, but the goal is to reach 300 thousand children (95% of the target audience). In addition to using social media, teams from family clinics and municipal health centers are going to the resident’s homes. Primary care units are also open on Saturdays, from 8 am to 12 noon.
In the capital of São Paulo, the campaign was extended for an indefinite period, informed this Tuesday, 25, the Municipal Health Department. In addition to the polio vaccine, for children aged 1 to 4 years and 11 months, doses will be applied against other diseases that are part of the multi-vaccination campaign for children and adolescents aged 0 to 15 years. Since the beginning of the campaign, on August 8, 1.4 million doses have been applied, 352,000 against poliomyelitis and 1.1 million of another 15 immunizing agents.
In the case of polio, coverage is at 79.2%, below the target of 95%. “The extension is another opportunity for those who have not yet received the booster dose against polio. We will also continue with efforts to update the cards with the other immunizing agents in the national calendar”, said the coordinator of Health Surveillance in the capital, Luiz Artur Caldeira.
In the State of São Paulo, with coverage of 64.70%, city halls have been intensifying actions to attract the unvaccinated. The State Department of Health reported that, regardless of campaigns, the polio vaccine is permanently available at the posts, according to the national vaccination schedule defined by the ministry.
sweepstakes
In Araçatuba, in the interior of São Paulo, a wheeled car was used to actively search for unvaccinated people in the most distant neighborhoods. In addition, the city hall partnered with a circus to distribute tickets to children under five who have been vaccinated. In the city, 7,752 children were immunized, a rate of 88%.
In Presidente Prudente (SP), children taken for the vaccine won coupons to compete in bicycle raffles. “We are all concerned, as we have more than 10,000 children in the target audience and there are still many left to be vaccinated”, said the supervisor of Epidemiological Surveillance, Elaine Bertacco.
The bicycle raffle was also used in Paranavaí, in the interior of Paraná, in Aparecida do Taboado (MS) and in Diamantino (MT). “The Rewarded Dose campaign is a way to encourage parents to seek the health unit, where they are warned about the risks of polio and other diseases that can be avoided with vaccination”, said the secretary of Health of the city of Mato Grosso. , Marineze Meira.
In Goiânia, Hellena Rebeka Santos Barbosa, 5 years old, won a “reward” after taking the drops on October 8th. The city hall of the capital of Goiás, in partnership with the Social Service of Industry, distributed tickets to the park maintained by Sesi on Children’s Day. “She enjoyed the sunny day at the pool and was able to participate in games and games, in addition to receiving food. It was the first time she went to a club and she loved it”, says Hellena’s mother, Kenya Rodrigues Barbosa.
To try to attract families, some cities have adopted alternative schedules. In Chapecó, in Corujão da Vaccination, doses are applied between 6:00 pm and 9:30 pm. According to the Secretary of Health, Jader Danielli, the objective is to assist parents who work and are unable to take their children to vaccinate during the day. In Santa Catarina, which has 82.26% vaccination coverage, a state law requires the presentation of a complete vaccination certificate for the enrollment of children in public and private schools.
“We offer (vaccine) on weekends and at night and the action was well publicized, so there is no justification for the lack of demand”, said the coordinator of the Acre immunization program, Renata Quiles.
Task force monitors sewage
In Campinas (SP), where just over half of the target audience received the doses, community health agents from the city hall are going to the homes to find out why the children did not go to be vaccinated, in the action called Adopt a Card. Homeless families are also being approached. In the city, the coverage considered ideal, 95%, was last achieved in 2018.
According to the director of the Department of Health Surveillance (Devisa), Andrea von Zuben, there is concern about the reintroduction of the polio virus because Campinas has a flow of people from different regions of the world, through Viracopos International Airport. In addition, the metropolitan region of Campinas is considered a commercial, industrial, university and research hub.
These factors, combined with the drop in coverage in recent years, increase the risk of reintroduction of infantile paralysis, she said. In 2015, the rate was 101.7%, falling to 82.8% in 2021. “Each year, the number of children without the vaccine increases. Our numbers, which were no longer going well, have gotten a lot worse in the pandemic,” she said. The municipality intensified surveillance at the airport, including the search for unvaccinated refugees, strengthening the suspicious notification scheme and even environmental monitoring of sewage to identify possible presence of the virus.
Infantile paralysis is a contagious disease caused by a virus that lives in the intestine, the poliovirus, which can infect children and adults through direct contact with feces or the mouth secretions of infected people. In severe cases, muscle paralysis occurs in which the lower limbs are the most affected. The last case in Brazil was registered in 1989. In 1994, the eradication of the disease in the Americas was certified.
According to researcher Akira Homma, from the Oswaldo Cruz Foundation (Fiocruz), the drastic drop in immunization, especially in the last two years, leaves the country with low protection against an eventual return of the disease. “For almost 30 years, Brazil has not had a single case of polio. In the 1980s, with the participation of the whole society, we achieved high vaccination coverage. In two national vaccination days, in which we vaccinated 18 million children in a single day, we eliminated this terrible virus from the country. This drop in coverage has left huge numbers of children unprotected,” he said.
What does the Ministry of Health say?
The Ministry of Health reported that Brazil is one of the world references in immunization and has one of the largest vaccination programs in the world, which applies an average of 100 million doses per year. “Updating the vaccine situation increases protection against vaccine-preventable diseases, preventing outbreaks and hospitalizations, sequelae, rehabilitation treatments and deaths,” he said in a note.
According to the folder, Brazil has already eliminated five diseases with immunization – infantile paralysis, congenital rubella syndrome, rubella, maternal and neonatal tetanus and smallpox -, but the occurrence of low coverage can cause the reintroduction of these diseases in the country, returning to a public health problem. (Collaborated with Andréia Bahia, special for Estadão)
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