Parents of children under 11 years old who have not taken their children to be vaccinated against meningococcal disease at the recommended age, they have another chance to update their immunizations until December 2021. The Ministry of Health distributed 900,000 doses of meningococcal C vaccine (conjugate) in August and increased the age of the target audience to reach those who stopped going to the clinics in the last years.
The vaccine protects against meningococcus C bacteria, which causes serious conditions such as meningitis (inflammation of the membranes that line the central nervous system) and meningococemia (generalized infection by meningococcus). The PNI (National Immunization Program) makes this immunizer available in the vaccination routine, in a schedule of two doses, at 3 and 5 months of age, with a booster dose at 12 months of age.
For guardians who, for some reason, lost the opportunity to take their children to health centers at the indicated age, the PNI provided for the administration of a dose up to 4 years, 11 months and 29 days. To expand coverage, since July, the vaccination posts are also authorized to vaccinate children under 11 who are late with this vaccine. According to the Ministry of Health, the number of unvaccinated children under the age of 10 could reach 1.8 million.
In the statement to the state immunization coordinators, the PNI General Coordination states that the measure was taken “in view of the low vaccine coverage, observed from 2016 onwards, a situation that worsened from 2020 onwards with the covid-19 pandemic , possibly due to the population’s fear of seeking health services to update the Vaccination Calendar”.
According to the text, the aim of the expansion is to increase protection against meningococcal disease, preventing the occurrence of outbreaks by serogroup C, hospitalizations, sequelae, rehabilitation treatments and deaths, especially when returning from in-person classes. In addition, the measure seeks to optimize the use of vaccine doses, adds the statement, “due to the low consumption of this vaccine in recent years, and the existence of quantitative doses.”
The president of SBIm (Brazilian Society of Immunizations), Juarez Cunha, points out that Brazil has had a significant drop in the number of cases of the disease since adopting the vaccine in the SUS (Unified Health System) in 2010. The drop in coverage in recent years, however, brings a warning, because the disease has not stopped circulating.
“This means that we have a contingent of many children who have not been vaccinated and are susceptible to a disease that is endemic in the country. This bacterium, for many years, has been present in our environment, has already caused epidemic outbreaks at other times, and the risk if we do not have adequate coverage, we have new cases of these diseases, which are serious,” he said.
As the transmission of this bacterium is respiratory, Cunha assesses that prevention measures against the SARS-CoV-2 virus have also contained the number of cases of meningococcal disease. “The scenario worries us a lot, because, with the return to schools and the greater flexibility of all non-pharmacological measures, this can lead to an increase in the number of cases, for a disease that is preventable and for which we have a vaccine available in the public network.”
The president of SBIm also draws attention to the vaccination of the next age group, children and adolescents aged 11 and 12, who must take the meningococcal ACWY vaccine, against four meningococcal serotypes.
Infectologist and medical manager of vaccines at the pharmaceutical company GSK, which supplies the vaccine to SUS, Lessandra Michelin warns that meningococcus C is an aggressive bacterium that can cause serious neurological sequelae, amputations and lead to death in less than 24 hours, even when diagnosed and treated.
“The meningococcus not only causes meningitis. This bacteria can enter the bloodstream and cause a systemic infection, affecting many organs, and can also manifest itself in the form of pneumonia. But the most frequent form is meningitis.”
In addition to the parents, the infectologist asks health professionals to also pay attention to the vaccination schedule and recommend immunization against meningococcus C. “Health professionals have a fundamental role in the indication. Often, in the rush of daily life, in a doctor’s appointment, we forget to ask how the vaccination card is. This is our role as health professionals. And it’s not just the doctor. The nurse, the nursing assistant at the unit and even the pharmacy professional.”
A survey conducted by GSK and released in March this year showed that covid-19 pandemic caused parents to postpone meningitis vaccination in several countries. In the case of Brazil, 72% of respondents who did not take their children to be vaccinated mentioned restrictions on preventing covid-19 as one of the causes; 45% said they were afraid of being infected by the new coronavirus and 19% said they did not take their children to be immunized against meningitis because they contracted covid-19 or had to take care of someone with the disease.
Lessandra Michelin emphasizes that, following the preventive measures, going to the vaccination posts is safe and should no longer be postponed. “We are in another moment of the pandemic, and it is part of us having to update the calendars now, because children are also having greater mobility, are returning to school and extracurricular activities and they need to be protected.”