In 2021, Ceará had a percentage of 53% of application of MMR vaccine– which prevents measles, rubella and mumps – the worst percentage of vaccine coverage of the diseases in eight years. Since 2013, the State has also not reached the goal of vaccinating children with the second dose against measles. The data are from the National Immunization Program Information System (SI-PNI), sent to THE PEOPLE by Ceará State Health Department (Sesa).
The first dose of the MMR vaccine is given to children just 1 year of age and three months later the second dose or booster dose should be given.
The decline in the number worries health professionals as measles was considered eradicated from Brazil in 2016. Since then, outbreaks of the disease have occasionally occurred due to low vaccination coverage. According to epidemiologist Marcelo Gurgel, a professor of public health at the State University of Ceará (Uece), measles is a cyclic disease with susceptible accumulation, and when the coverage is irregular, it tends to reappear every two or three years.
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“Ceará has a history of coverage rates above 100%, but this may reflect a miscalculation of the vaccinated population: either it was less than what is there, or they had more children than I had estimated. The other thing, what can happen is the number of children accumulates from one year to the next, that is, children who should have been vaccinated the previous year are vaccinated the following year, ”explains Gurgel.
From 2019 to 2020, the amount of D2 used decreased by about 16%; and from 2020 to 2021, they were 18% fewer. With the onset of the pandemic in 2019, it was expected that the following year would have the lowest percentage of vaccinated, but it did not happen.
“What happened in 2021 was the increase in cases of Covid-19 in children, which led people to follow the natural tendency to worry. The adult population was given some degree of immunity after the vaccine, and it is time for children to get in touch with the virus. “, he theorizes.
Low measles D2 coverage
While the data for 2020 and 2021 may change, Gurgel does not believe there will be any major changes. “These 53% coverage of D2 may increase, yet it will be far from the historical coverage that it had,” he says.
According to the specialist, “people think that if they take the first dose, they have already received the vaccine”. It is a behavioral problem in the population that already feels safe with just one dose. The structure of the national immunization program is a nationally and internationally recognized model, and this favored preconceptions and studies.
“It’s worrying because measles is a serious disease and has a catastrophic effect on both deaths causing pneumonia leading to death and prolonged blindness,” says Gurgel.
“Brazil had the luxury of being proud to say that Brazilians who went to Japan had to be vaccinated against measles there. We vaccinated our football players so they would travel to Japan because they were going to a country where I still had measles. “The measles coverage was actually a really good coverage more than ten years ago. Today, there are already cases proving that the disease is unfortunately returning,” he adds.
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