With 17 confirmed cases in three states, the Ministry of Health held this Saturday the D-day of measles vaccination. Vaccines against influenza and other diseases will also be applied to expand vaccination coverage, which has fallen in recent years. Measles is a concern because it was a disease that was practically eradicated in the country and, since 2018, it has returned and spread across several states. This year, there are already confirmed cases in São Paulo, Amapá and Roraima. In three other states – Bahia, Piauí and Ceará – suspected cases are being investigated.
The national campaign was divided into two phases: in the first, which ends this Saturday, the 30th, the focus was on people over 60 and health workers. The second, which starts on Tuesday, 3, and runs until June 3, covers children aged 6 months to 5 years old and other priority groups, such as pregnant women, postpartum women, indigenous peoples, teachers and people with comorbidities. Among children, the goal is to vaccinate 95% of the target audience, 12.6 million.
According to the Ministry of Health, the objective is to prevent complications from diseases, avoid deaths and possible pressure on the health system. The goal is to vaccinate 12.2 million children, 95% of the target audience of 12.9 million. In Brazil, between 2018 and 2021, 39,342 cases of measles were confirmed, with 40 deaths caused by the disease. The plan is to reinforce vaccination in order to restore the status of a measles-free country to zero cases.
In the state of São Paulo, two cases of measles were confirmed this year, one in the capital and another in São Vicente, in Baixada Santista. There are still 45 cases under investigation, 31 of which in the capital of São Paulo alone, according to the city hall. Last year, the state recorded 9 cases, without deaths, but in 2020, there were 853 cases and one person died. The disease reemerged in the state in 2018, with 5 cases, and peaked the following year, with 17,976 cases and 18 deaths.
According to the State Department of Health, in recent years, vaccination coverage in children up to 12 months, the recommended period for closing the cycle, was below the target of 95%. In 2019 it was 91.5%, in 2020 it dropped to 85%, and last year it was 67% – the drop is attributed to the covid-19 pandemic. In addition to being highly transmissible, measles can progress to severe cases and cause serious complications, such as pneumonia, encephalitis and death.
In the capital of São Paulo, this Saturday will be the day of multivaccination, focusing on children and adolescents under 15 years old, according to the City Hall. 16 types of vaccine will be offered that protect against about 20 diseases, including the MMR, measles, mumps and rubella. “Whoever has outdated vaccines puts their own health and that of other people at risk. Keeping their vaccination records up to date is important not only for children and adolescents, but also for society as a whole, as it prevents the spread of diseases and hospitalizations “, said the municipal secretary of Health, Luiz Carlos Zamarco.
São Paulo opens all Basic Health Units (UBSs) from 8 am to 5 pm, and Outpatient Medical Assistance (AMAs)/Integrated UBS from 7 am to 7 pm. The vaccine against covid-19 will also be available in the units, although the simultaneous application of this vaccine and the measles vaccine is not recommended for children between 5 and 11 years old. Since April 4, the municipality has administered 59,442 doses of measles vaccines.
The State of Amapá leads the measles ranking in the country this year. There are already 14 positive cases and 33 suspects, according to the Health Department. In Macapá, ten people caught the disease. The other cases are from the municipalities of Mazagão and Santana, with two each. “We are offering the MMR vaccine at all posts, as we need to advance in vaccine coverage and protect especially children,” said the coordinator of the State Immunobiological Unit, Angélica Oliveira.
This Thursday, 28, the State Department of Health of Roraima confirmed a positive case of measles in a baby of one year and one month of age. The folder issued an alert for municipalities in the state to strengthen actions against the disease. According to the coordinator of Health Surveillance, Valdirene Oliveira, the notification of the case was made on March 25 and now the test results are out. The patient’s family has no history of out-of-state travel.
In addition to São Paulo, suspected measles cases are being investigated in states that have not yet registered the disease this year. In Ceará, until April 27, 23 suspected cases were reported, 16 of which were discarded and seven under investigation. Because of suspicions, the vaccination campaign for children, which was supposed to start on May 2, was brought forward to the last 20.
Bahia reported 36 suspected cases this year, but of these 21 have already been discarded. The other 15 are under investigation. Last year, the state recorded no positive cases of measles. In Piauí, the Health Department monitors two suspected cases, including a two-year-old child. The state has 70% vaccination coverage, but in the capital, Teresina, the rate is 40%.
In other states, the concern is with low adherence to vaccination. In Santa Catarina, the group of health workers had, until Thursday, 28, vaccinated only 30% of the target audience. In Minas Gerais, the vaccination of children started on April 4, reached only 14% of the expected children. Among health workers, the rate was 24%.
Adherence to vaccines has been falling in the last ten years in the country. Although the ideal immunization rate is above 90%, overall rates have been below that value since 2012, reaching 50.4% in 2016, according to Datasus, a data system from the Ministry of Health. In 2021, the percentage was 60.7%.
According to doctor Gustavo Furtado, an infectious disease specialist at HCor, vaccines are still the best way to prevent viral diseases, such as measles, which can leave sequelae and even cause deaths. “The National Immunization Program was a great advance in the control of endemic diseases in Brazil and we cannot go back. It is very important that people follow the vaccination schedule. Recently, we have seen the impact of the vaccine in controlling the pandemic”, said the doctor.