Low vaccine coverage and varicella outbreaks in Brazil - 2019-2022

Dennis Minoru Fujita; Luiz Henrique da Silva Nali; Rafael Rodrigues da Costa; Heitor Franco de Andrade Júnior; Expedito José de Albuquerque Luna

doi:10.1016/j.vaccine.2024.04.021

Low vaccine coverage and varicella outbreaks in Brazil - 2019-2022

Vaccine. 2024 Apr 24:S0264-410X(24)00435-3. doi: 10.1016/j.vaccine.2024.04.021. Online ahead of print.

Authors

Dennis Minoru Fujita¹, Luiz Henrique da Silva Nali², Rafael Rodrigues da Costa³, Heitor Franco de Andrade Júnior⁴, Expedito José de Albuquerque Luna³

Affiliations

¹ Depto de Patologia, FMUSP, São Paulo, Brazil; LIM-49, HCFMUSP, São Paulo, Brazil; Instituto de Medicina Tropical de São Paulo, São Paulo, Brazil. Electronic address: d.fujita@fm.usp.br.
² Universidade Santo Amaro, São Paulo, Brazil.
³ Instituto de Medicina Tropical de São Paulo, São Paulo, Brazil.
⁴ Depto de Patologia, FMUSP, São Paulo, Brazil; LIM-49, HCFMUSP, São Paulo, Brazil; Instituto de Medicina Tropical de São Paulo, São Paulo, Brazil.

PMID: 38664072
DOI: 10.1016/j.vaccine.2024.04.021

Abstract

The persistence of varicella outbreaks in Brazil has underscored the high concern with the low vaccine coverage in the last 4 years. Using publicly available data from the Brazilian Health System (SUS), this study analyzed varicella vaccine coverage and incidence trends from 2019 to 2022 in Brazilian States. Vaccine coverage decreased nationally in 2020, possibly influenced by the COVID-19 pandemic's initial phase. In Bahia State, we have the persistence of varicella with an incidence rate of 3.0 cases per 100,000 inhabitants (higher incidence compared to other States) in 2023. Under 15 months children and young children (4-6 Years old) faced the highest risk, urging the importance of vaccination. Despite a monovalent varicella vaccine being available through Brazil's National Immunization Program (NIP), Bahia fell short of achieving the ≥95 % disease control target for coverage. The study highlight the importance of vaccines to prevent some infectious diseases, as varicella, in poor tropical regions. Addressing vaccine hesitancy and misinformation, and augmenting awareness campaigns, are important to achieve and sustain high vaccine coverage over 80% as WHO guidelines to obtain a safe rate of protection for Brazilian population (Brazil's national immunization program has a target of 95% coverage).

Keywords: Brazil; Outbreaks; Vaccine coverage; Varicella.