Since 2018, Rio Grande do Norte has not reached the vaccination coverage target recommended by the Ministry of Health for any of the routine vaccines recommended for children up to one year of age. Data from the State Department of Public Health (Sesap/RN) analyzed by the Santos Dumont Institute (ISD) reveal that the state's childhood vaccination coverage has been on a downward trend since before the pandemic, which worries health experts given the possibility of the return of diseases that were already considered eradicated, such as polio, as reported by the ISD's infectious disease preceptor, Carolina Damásio. 

“The refusal in vaccination has been associated with outbreaks of chickenpox, pneumococcal disease, measles and whooping cough. Recently, we have been seeing reports of the return of diseases that were controlled several years ago, such as polio,” says Damásio. According to data from Sesap, of the 11 vaccines included in the children's calendar up to 1 year of age, only BCG and Hepatitis B reached the recommended targets of 90% in 2018. After that year, none of the mandatory vaccines reached the percentages indicated by the Ministry of Health, which vary from 90% to 95%. 

Like other countries in the Americas, Brazil was certified by the World Health Organization (WHO) as polio-free in 1994. However, the disease, also known as polio or infantile paralysis, is at risk of being reintroduced into the country. Polio is a contagious disease caused by a virus that can infect children and adults and lead to paralysis of the lower limbs in the most severe cases. The only form of prevention is vaccination, which is mandatory for all children under 5 years of age. However, polio vaccine coverage has had one of the lowest coverage rates in recent years in Rio Grande do Norte, having failed to reach more than 801,000 children since 2019. 

Another disease that has shown high vaccination coverage rates that concern health professionals is measles. In April, the Ministry of Health began a national campaign to encourage immunization. However, despite having been extended twice and already being normally available as part of routine vaccinations, only 36% of children up to 4 years of age had been vaccinated by the beginning of August, according to data from the RN + Vacina platform. Low vaccination coverage rates are not exclusive to Rio Grande do Norte. According to the Brazilian Society of Pediatrics, Brazil has recorded one of the lowest vaccination coverage rates in recent years. Vaccination coverage against polio reached 1,00% in 2013; it was 84,74% in 2017; and last year it plummeted to 67,71%. Three out of ten children have not been vaccinated, according to DataSus. 

“Decreases in childhood vaccination rates can pose serious risks to public health, such as the return of controlled or already eradicated diseases, causing unnecessary suffering to younger children (including permanent sequelae) and wasting resources that are usually already limited in healthcare. Recently, several campaigns have been carried out by the Brazilian Society of Immunizations, with the aim of debunking fake news related to childhood vaccination and encouraging vaccination,” says infectious disease preceptor Carolina Damásio.

The doctor also emphasizes that the individual decision not to vaccinate children can have collective consequences and represents a risk to public health. “Vaccines are one of the greatest achievements in the history of science, protecting millions of lives every year from serious infectious diseases. The decision not to vaccinate has consequences not only for the individual or the family unit, but for the entire community, especially for people who are more vulnerable to infections, such as children and adults with chronic diseases, the elderly, or people who have less access to health services. This has been exemplified in the current moment with the pandemic, and the difficulty of controlling it due to unequal access to vaccines”, he adds. 

Polio Vaccination Campaign 

On August 8, the National Vaccination Campaign against Poliomyelitis and Multivaccination to Update the Vaccination Booklet for Children and Adolescents began. The campaign will continue until September 9, and the expectation is to reach the vaccination coverage target of 95%, recommended by the Ministry of Health. 

Numbers

See the updated vaccination coverage of RN for the main vaccines on the calendar for children up to 12 months of age.

BCG:

Recommended – 90%

2018: 107,7%

2019: 85,2%

2020: 80,3%

2021: 81,7%

2022: 65,5%

Rotavirus

Recommended – 90%

2018: 86%

2019: 84,5%

2020: 73,2%

2021: 72%

2022: 40%

Hepatitis B:

Recommended – 95% 

2018: 101,3%

2019: 83,3%

2020: 77,7%

2021: 80,4%

2022: 62,2%

Meningococcus C:

Recommended – 95% 

2018: 84,3%

2019: 85,2%

2020: 74%

2021: 71,8%

2022: No information 

Pentavalent:

Recommended – 95% 

2018: 89,4%

2019: 68,8%

2020: 67%

2021: 70,4%

2022: 38,6%

Pneumococcal 10:

Recommended – 95%

2018: 94,5%

2019: 89,3%

2020: 77,3%

2021: 74,9%

2022: 42%

Polio:

Recommended – 95%

2018: 90,3%

2019: 80,7%

2020: 69,7%

2021: 69,8%

2022: 36,3%

Hepatitis A

Recommended – 95%

2018: 77,2%

2019: 81,4%

2020: 71,6%

2021: 63,7%

2022: 34,3%

Triple Viral

Recommended – 95%

2018: 88,7%

2019: 93,7%

2020: 77,6%

2021: 70,9%

2022: 38,4%