Over the past three years, since the outbreak of the Covid-19 pandemic, the world has experienced an uncomfortable seesaw — to the extraordinary and very rapid leaps of science towards the development of vaccines against the new coronavirus, there has been added an opposite movement, of incapable denialists. to see the relevance of immunization, transforming medicine into ideology. Fortunately, common sense won out. About 64% of the global population received at least two doses of immunizers – a very good figure, although still far from the 70% established by the World Health Organization (WHO) as the ideal level. “Humanity has never come together so much to think about a vaccine, but we had a infodemia, the misinformation pandemic,” says Isabella Ballalai, director of the Brazilian Society of Immunizations. “There was, as a result, more interest, but also more fear.”
Immunization, the achievement of civilization, was to be treated as a commonplace event—and it was until the current pandemic coincided with global political polarization. And then, as a response to those who close their eyes to the leaps made in the laboratory, the release of new protective substances began to be celebrated with deserved fanfare. It’s like there’s a vaccine revolt.
There is a wave of substances being launched or in the final phase of clinical trials. In Brazil, in the last two weeks, the Japanese pharmaceutical company Takeda’s vaccine against dengue was approved for a wide audience and the most potent version against HPV, the human papillomavirus, related to cases of cancer of the cervix, throat and anus, in addition to flu for people over 60 years old. The Butantan Institute seeks more protection for Influenza A and B. Doses for chikungunya will be announced soon (see details in the chart below). The vast list of immunizers is an indication that there is a gear in progress. It is fundamental, when fueling vaccination campaigns.
There has been, in the last ten years, a drop in vaccination coverage, the index that measures the percentage of the population properly protected. It is a phenomenon that has also arrived in Brazil, unfortunately, and needs to be reversed urgently. In 2022, after so much screaming, there was some improvement in the range indices, after a considerable retreat. Since 1973, with the creation of the National Immunization Program (PNI), the country has gained international respect for achieving auspicious vaccination goals, to the point of having managed to eradicate polio, congenital rubella and measles. Today, for example, 76% of the population has defenses against polio in their bodies — in 2013, 100% were vaccinated (track the curve of other vaccines on the board). The picadinhas and the drops — families from all social classes know — are part of the daily life of Brazilians, like Shrove Tuesday of Carnival, the night of São João and the family together at Christmas. From generation to generation, going to the health center has become a habit linked to infant crying, which is synonymous with well-being. Therefore, it should not be news. But it is, and it is now up to vigorously encourage the resumption.
It is a challenge, for example, to get parents to take their pre-adolescents to receive vaccine doses against HPV. In 2019, 87% of girls aged 9 to 14 years received their first dose of the vaccine. Last year, it dropped to 76%. Among boys, the rate plummeted from 61% to 52% in this period. It is worrying, especially since the vaccine is offered free of charge by the Unified Health System, the SUS. In dealing with the gap — ideally, 95% adherence — support from the private sector is also relevant. Last week, the American pharmaceutical MSD put Gardasil-9 on the private network, in clinics, a turbocharged option of immunizer against HPV, which protects against nine subtypes of the virus. “Brazil has history, structure and confidence to increase vaccination”, said VEJA Rob Davis, the company’s global CEO, who was in the country for the launch and inauguration of the Vaccine Museum, inside Butantan, in São Paulo.
The existence of a museum, by the way, is another evidence of the importance of understanding how we got here, in extraordinary advances, despite the setbacks. There have been recent setbacks such as the manifestations of anti-vaxxers that proliferated in Europe, especially in England and France, and in the United States during Donald Trump’s White House tenure. It is also crucial to remember an episode like the Vaccine Revolt, in 1904, in Rio, in five days of fury against mandatory immunization to fight smallpox and the entry of health professionals into homes to eliminate foci of Temples of the Egyptians.
The back and forth in time, between the disdain made of stupidity and the celebration of knowledge, sheds light on one certainty — the importance of the vaccine for humanity. The WHO estimates that immunization prevents 3 million deaths a year. “Vaccination is one of the great resources to prevent deaths, along with basic sanitation and the supply of drinking water”, says Claudia Cavalcante França Valente, from the Brazilian Association of Allergy and Immunology. That’s why researchers don’t get down. It is always a case of remembering a well-known phrase by the sanitarian and epidemiologist Oswaldo Cruz, the scientist summoned by President Rodrigues Alves at the beginning of the 20th century to deal with diseases in the then Federal Capital: “Knowledge against ignorance, health against disease, life against death… A thousand reflections of the permanent battle in which we are all involved”.
Published in VEJA on March 22, 2023, edition no. 2833