Throughout the country, the health secretariats are working hard to reach the polio vaccination goal of 95% of the target population. But, as of October 31, only two Brazilian states managed to reach the goal: Paraíba (100%), in the Northeast, and Amapá (99%), in the North. Of the nine states that make up the Legal Amazon, Amapá has a significant difference from the others, followed by Maranhão, with 76.13%. What explains the success of these two states?
According to Angélica Oliveira, coordinator of the Immunobiologicals Unit in Amapá, the result is not a coincidence. Amapá and Paraíba were the states chosen for the pilot plan of the "Project for the Reconquest of High Vaccination Coverage", a partnership between the Brazilian Society for Immunization (SBIm), Oswaldo Cruz Foundation (Fiocruz) and the National Immunization Program (PNI).
Launched in 2021, the project seeks to integrate three axes to achieve greater vaccination coverage. The first is the collaboration with managers, specialists, and health professionals to qualify teams, improve the infrastructure of vaccine rooms, and ensure that the entire population has access to vaccines and is vaccinated. The second is to evaluate and improve the information systems on immunization, and the third is to focus on communication and education, so that the population and professionals have more clarity on the importance of vaccination.
The project also aims to articulate a permanent network of partners, including the private sector, to raise financial and human resources for the actions. "In this campaign we showed that the strategy has been working and the main lesson learned is that we can't work alone in the Health Department, we need partnerships," says Angélica Oliveira. According to the coordinator, in each municipality in the state a support network was created, including the Public Ministry and the Education Departments, to promote actions that were more common in the past, such as vaccination in schools and daycare centers.
"It is true that the population is no longer seeing these diseases the way they used to and has stopped prioritizing vaccination, but here in the state we had no resistance. We saw that the important thing was to facilitate access. Those who didn't have their calendar up to date weren't because they didn't want to, it was because they didn't have time to go to the Health Unit at the available times," says Oliveira.
Challenges - Even though the state average has exceeded the 95% target, there is still one municipality in Amapá that has not reached the desired rate: Itaubal, which has 66.73% of immunized children. "We found failures in the Family Health Strategy, which did not do the active search, the community visits to identify who had not been vaccinated, and there are places of difficult access that demand a certain resource that the municipality did not have available, to make boats available and take the teams to the riverside homes," says the coordinator.
The challenge of reaching each resident is what, according to Oliveira, stands out the most when talking about vaccination in the state. "Reaching these communities is very costly, especially when there are multiple vaccines, because you have to go back to each place several times and each time you go there is an extra cost. This is why dialogue with the state and other partners is so necessary. The Brazilian Air Force, for example, sends a helicopter once a year to access areas where there is no river or land access," he highlights.
Poliomyelitis - Known as "infantile paralysis" or simply "polio", polio is transmitted by viruses and affects mainly children under five years of age.
According to the World Health Organization (WHO), one in 200 infections leads to irreversible paralysis, usually of the legs. Due to massive vaccination, since 1994 the country received and maintains the certificate of eradication of the disease, issued by the WHO.
On a national average, only 72.57% of children aged 6 months to 4 years were immunized in the country during this year's campaign, until October 31. According to the Ministry of Health's communication department, this data is preliminary, because states and municipalities have months after the end of the campaign to send updated data to the Ministry.
