University of São Paulo: Doses are missing to complete vaccination of children against covid in Brazil

On July 13, 2022, the National Health Surveillance Agency (Anvisa) approved the emergency use of the CoronaVac vaccine in children aged three to five years, but according to an article published in the “Comment” section of The Lancet Child & Adolescent Health , the Ministry of Health lacks will, plans, in addition to the doses necessary to guarantee protection for the 8.3 million people in this age group in Brazil.

The text, entitled Government Inaction on COVID-19 Vaccines contributions to the Persistence of Childism in Brazil , aimed to draw attention to systematic institutionalized practices of discrimination and disrespect for children’s rights. “The right to health and education are constitutional, and they are not being respected,” says Lorena Barberia, professor at the Department of Political Science at USP’s Faculty of Philosophy, Letters and Human Sciences (FFLCH).

Since the beginning of the pandemic, the Covid-19 BR Observatory , of which some authors are part, has been following the public policies that have been adopted and that specifically affect children. “It is tested much less, there are reports of many aggravations, in addition to the long covid, which brings sequels and enormous costs to society in the long term”, reports Lorena.

Alexandra Boing, an epidemiologist at the Federal University of Santa Catarina (UFSC) and a member of the Covid-19 Br Observatory and the Brazilian Association of Collective Health (Abrasco), told Jornal da USP that children were neglected throughout the pandemic. “The restrictions imposed affected the closure of schools and, as a result, they were exposed to greater risk of violence, food insecurity, mental health problems, with worsening health outcomes,” she says. “Among the poorest, those with disabilities, institutionalized or belonging to minority groups, the situation was even worse.”

From the beginning of the pandemic until the 22nd epidemiological week of 2022 (which corresponds to the period from May 29 to June 4), when the article was written, 41,395 children between three and five years old were hospitalized for Severe Acute Respiratory Syndrome ( SARS) , 4,470 were due to covid-19 and 450 died (114 from covid-19).

In the text, the authors mention that Brazil is in a particularly worrying scenario, as we have a universal public health system, with a history of success in vaccination campaigns. However, we are experiencing an increase in cases due to the spread of the BA.4 and BA.5 omicron.

Delays in vaccination
At least 13 countries already vaccinate children under five against Covid-19. In Latin America, Argentina, Chile, Colombia, Costa Rica, Cuba, Ecuador, Nicaragua and Venezuela already immunize children under five years of age.

Official data show that there is a deficit of approximately 7 million doses of CoronaVac, while other countries that use this vaccine in children belonging to the same age group, such as Chile and Argentina, are already administering the booster dose.

In Brazil, vaccination is moving at a slow pace. São Luís (MA), Manaus (AM), Salvador (BA), Fortaleza (CE), Belém (PA) and Boa Vista (RR) were the first six capitals to start immunization. On July 20, São Paulo began vaccinating children aged 3 and 4 with comorbidities, disabilities or indigenous people. The choice for the priority group is due to the lack of sufficient doses of CoronaVac in stock to apply to all children in the municipality. “One of the facts that concerns us is that campaigns depend on the will of local governments, and each one of them is adopting different communication strategies and orientations. This is the opposite of what should happen in a country with one of the best national immunization programs in the world”, says Lorena.

In the period from June 11, 2021 to January 20, 2022, the Pfizer vaccine was the only one authorized for use in adolescents over 12 years of age in Brazil. When CoronaVac received emergency authorization from Anvisa for use in children from six years of age, Chile had already been immunizing the same age group for 136 days. During this period, there were 194 SARS deaths, 67 of which were confirmed by covid-19 in children aged between six and 11 years.

Reopening of schools and spread of fake news
The article also touches on a very controversial subject: the reopening of schools with limited protocols to ensure a safe return. “We saw a great desire to return to school, but each school did it the way it thought it should”, says Leonardo Bastos, researcher at Fiocruz and member of the Covid-19 BR Observatory . “With that, we saw several outbreaks happen, an increase in hospitalizations and in the number of deaths, which could have been avoided with the vaccine.”

Actions that delay vaccination, in addition to parental concern about the effectiveness of immunizations, tend to have a severe impact on children and families, who are less likely to turn to other options to protect their health and are more at risk of being vaccinated. infected by sars-cov-2, highlights the text. “What is observed is a movement against the vaccination of children, fake news not fought in an organized way by the government, a discourse that minimizes the disease, that does not consider sequelae, disease burden and the long covid itself, which also occurs in children. It is a portrait of the negligence to which this group is subjected in Brazil”, concludes Alexandra.

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