Smallpox of monkeys makes Brazilians seek vaccine abandoned for more than 40 years

Even without registration in the country, the emergence of new cases of monkeypox in the world has led Brazilians to look for the vaccine and to look for old vaccination cards.

In a survey carried out by Abcvac (Brazilian Association of Vaccine Clinics) at the request of the Sheet, 73% of the associates responded that the demand for an immunizing agent has increased. Of the total, 25% stated that there is “a lot” of demand and 48%, that there is “some” demand.

Despite recent interest, no smallpox immunizer is available either in the private network or in the SUS (Sistema Único de Saúde).

“These vaccines today have very limited production. They are only used in military personnel who are going on expedition, laboratory professionals who handle the smallpox virus, vaccine producers. They are very specific groups. There is not enough production or use in any [outro] place on the planet”, explains the director of the Brazilian Society of Immunizations, Renato Kfouri.

The smallpox vaccine stopped being applied in Brazil in 1979 and, in May 1980, the World Health Assembly officially declared the eradication of the disease. The vaccination history became a joke — and a party — for those born before that.

“First advantage I’ve seen now in being old. I’ve taken [a vacina]!”, the psychologist and screenwriter Déia Freitas wrote on Twitter. “I didn’t check my vaccination card because I don’t have it anymore, but I was relieved to know that in 1975, the year I was born, everyone was still vaccinated,” she told the report.

Whoever kept the vaccination card makes a point of displaying the relic. Born in 1965, biomedical professor Mario Cesaretti took three doses of the smallpox vaccine: in 1966, 1970 and 1973. He says that when the subject of vaccination came up, he had no doubts that the card would be complete.

“My mother was a professor at the nursing school at what is now Unifesp (Federal University of São Paulo). She kept the vaccination card and left it with me. It’s even in a plastic bag. When the vaccine made a ball on the skin , as if it were a smallpox lesion, they wrote ‘positive’ on the card. [que tomei], the vaccine no longer reacted. Then they wrote ‘negative'”, she says.

Despite the celebration on social networks, the assessment of the president of the Brazilian Society of Virology, Flávio Fonseca, is that people who took the smallpox vaccine before the 1980s are no longer immunized. Fonseca is part of the advisory group created by the Ministry of Science, Technology and Innovation to monitor the progress of the disease.

“Studies show that immunity lasts about 30 years. It can vary more or less, depending on the person. The most certain thing to think is that it is no longer protected because an important component of protection is the re-presentation to the pathogen. [agente causador da doença]. In Brazil, with the eradication of smallpox, there was no new stimulation,” he explains.

Ethel Maciel, epidemiologist and professor at Ufes (Federal University of Espírito Santo), says that there are two vaccines capable of protecting against monkeypox.

“What is known so far is that the smallpox vaccine that we administered in Brazil is 85% effective against monkeypox. In 2019, we had the approval of a new specific vaccine for monkeypox, but it doesn’t exist on a large scale”, he says.

In addition to the increase in demand, Abcvac identified an apparent confusion between smallpox and chickenpox, the virus that causes chickenpox. “Many member clinics across Brazil have reported a search for a smallpox vaccine. People are also wanting to know if the varicella vaccine protects from monkeypox [vírus da varíola dos macacos]”, says the association’s president, Geraldo Barbosa.

“It is the role of each clinic, as a health establishment, to pass on the guidelines that the chickenpox vaccine does not protect against monkeypox and explain that the vaccine applied in the past against smallpox has not been used for years in Brazil”, says Barbosa.

“The interest in a vaccine against smallpox was proportional to the prominence given in the media and, unfortunately, the demand for available vaccines, such as the flu, is falling both in the public and private sectors. .

Kfouri says that, despite the emergence of cases in different countries, there is no reason to look for the immunizer. “We still have many doubts about how to use these vaccines. We have little information about the disease, the form of transmission, the risk groups. And we have little vaccine. Today there is no recommendation for a vaccination strategy, either for individual protection or for for public health.”

Disease

Monkeypox is of the Orthopoxvirus genus, the same as smallpox, and has symptoms similar to it, although less severe. Most patients recover in a few weeks, but there is a possibility of evolution to problematic cases.

The virus has two main variants: the Congo strain, which is more severe and has a mortality rate of up to 10%, and the West African strain, with a mortality rate of 1%. For now, the reported cases have been of this less deadly strain.

Brazil, so far, does not register suspected cases of the disease. The federal government set up a group of experts and issued an alert to states with guidelines for health professionals on the diagnosis and notification of the disease.

According to experts, transmission occurs through prolonged close contact, not necessarily sexual. The virus can enter the human body through the respiratory tract or through direct or indirect contact with contaminated fluids.

Symptoms include rash, fever, aches and chills.