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The Ministry of Health admits that there is a high risk of polio return in at least 312 Brazilian cities – 44 in the state of São Paulo. The alert was made Thursday (28) at a meeting with state secretaries and municipal health officials. "It's a very serious situation," said Carla Domingues, immunization program coordinator
. Municipalities that have not reached 50% of immunization coverage are most at risk of polio. "A city with these indicators has all the conditions to retransmit the disease in our country, it will be a disaster for the health as a whole." The last case recorded in Brazil dates from 1990. Four years later, the WHO of Health declared the disease eradicated from the Americas
The recommendation is that polio immunization coverage be greater than 95%. The worst situation is in Bahia, where 15% of municipalities vaccinated less than 50% of children, followed by Maranhão with 14.29%. Across the country, only Rondônia, Espírito Santo and the Federal District do not have high risk cities.
The general picture is very worrying. According to data from the Ministry of Health, last year 22 units of the federation did not reach the coverage considered ideal. Also in 2017, at least 800,000 children have not benefited from the comprehensive vaccination program – which includes three doses of vaccines.
"We turn on the red light," says Carla. The concern arises mainly at a time when the entry of the derived poliovirus was again discussed. In Venezuela, health authorities have considered the possibility that a girl has been infected by this mutation of the virus.
When the gout vaccine is administered to the child, the attenuated virus contained in the vaccine may be present in the environment for four to six months. weeks, creating what is called the herd effect. The problem is that during this period, on very rare occasions, the poliovirus may have contact with other viruses, such as rotavirus, mutate and become infected with the virus.
thus creating a new wave of infections. This hypothesis was rejected in the case of the Venezuelan child, but the concern persists
. The president of the Brazilian Vaccination Society, Isabella Ballalai, notes that the risk increases in cases where immunization coverage is lower. "Where the need to maintain vaccination at 95%."
Isabella called the Brazilian indicator "unbelievable and inadmissible". Carla notes that the most significant decline has occurred over the past two years. To try to reduce the risk, the Ministry of Health should be running a national polio immunization campaign between August 6 and 31
Other Diseases
Carla also reinforces that coverage in the country fell significantly. For example, it mentions vaccines such as measles, rubella and mumps, pentavalent (diphtheria, tetanus, pertussis, haemophilus influenzae type b and polio meningitis) and pneumococcus. . "In none of these cases was there a shortage," she said
. For her, the indicators show the need to think about what is done at the end of the care. She notes that the vaccination program offers 14 vaccines. "It takes simultaneity to set up a schedule to offer, during a visit to the post, more than one vaccine." In the ideal scheme, he says, parents take the child nine times in the year to the vaccination post. "If that's not done correctly, that number goes up to 10, 11, 12," he notes
. The resistance to give more than one vaccine to health professionals the same day could be strengthened by capacity building. The same thing applies to completing the vaccination forms. Few municipalities follow the recommendation of registering the nominal vaccination. "Notes are made by dose only.This makes it difficult to search for late children," says Carla
For her, there is also a need for more rationality in the form of a flexible vaccine supply, which corresponds to the work routine of the parents. "The stations work from 8h to 11h and from 14h to 17h. Not all parents can take their children at these times several times a year.
The opening of many vaccination rooms would, in turn, be counter-productive. "You need scale, doses should be opened and used quickly, otherwise there is waste."
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