Death of young children by Covid is triple that caused by 14 diseases in ten years

In two years, the deaths of children up to five years old by Covid-19 were more than triple those caused, in a decade, by 14 other diseases that can have mortality avoided by vaccination and other health actions.

In 2020 and 2021, 1,508 children died from Covid. The diseases that make up the Brazilian List of Avoidable Deaths added up to 44 deaths in this period. Between 2012 and 2021, there were a total of 498 deaths.

The list, prepared by specialists from different areas related to child health and coordinated by the Ministry of Health, includes the following diseases: neurotuberculosis, miliary tuberculosis, neonatal tetanus, tetanus, diphtheria, whooping cough, polio, measles, rubella, hepatitis B, mumps, congenital rubella, congenital viral hepatitis, and meningococcal meningitis type B.

The list includes diseases that can kill, but that are preventable through SUS interventions, such as vaccination, adequate prenatal care and access to basic health care, childbirth and post-birth care.

The analysis is from the Childhood Health Observatory – Observa Infância, from Fiocruz/Unifase, based on data from the Ministry of Health’s SIM (Mortality Information System).

On the 13th, Anvisa released the emergency use of the Coronavac vaccine, from the Butantan Institute, for children aged three to five years. However, those aged between six months and two years remain uncovered and have twice the risk of death compared to the former.

In two years, 539 children died from Covid in this age group. For comparison, between 2012 and 2021, the other 14 diseases with vaccine-preventable deaths totaled 144 deaths.

According to Cristiano Boccolini, a researcher at Observa Infância, if the pace of deaths from Covid remains at the same level observed in the last two years, in the next three months the country could lose another 76 children in this age group.

“This is the price that Brazil can pay while waiting for the approval of the vaccination for this group. In the most optimistic scenario, we could have the vaccine in the arms of our babies in three months”, he says.

At least 13 countries already vaccinate children under five against Covid-19, including the United States and Israel, which have approved the application of doses from six months of age.

In Brazil, so far, no pharmaceutical company has requested authorization from Anvisa to use the vaccine after six months. Both Pfizer and Zodiac, Moderna’s representative in the country, say they should place the order soon, but did not set a date.

Vaccination against Covid already released for children between three and five years old also encounters obstacles. There is an eligible audience of 5.6 million people — which is 11.2 million doses, as Coronavac requires two applications.

But municipalities only have about 1.5 million doses and are creating different strategies to deal with the shortage. São Paulo, for example, started vaccinating children aged 3 and 4 with comorbidities and disabilities and indigenous people.

The Ministry of Health reported that the federal government plans to reallocate doses of Coronavac between states. The government of São Paulo requested the Butantan Institute to import 8,000 liters of API (active pharmaceutical ingredient) for the production of 10 million doses of the vaccine.

In the midst of this, the country also faces resistance from parents to immunize their children against Covid.

“What we see most are mothers worried about meningitis, for example, but Covid kills much more and there is not all this awareness”, says Boccolini. Between 2012 and 2021, 29 children died from meningitis B in the country.

For the researcher, this is largely due to campaigns against the vaccine at the end of last year and to a continuous lack of effort by the federal government to encourage immunization.

The Jair Bolsonaro (PL) government even distorted data and discouraged child immunization against Covid. The president even threatened to expose the names of Anvisa employees who approved the use of Pfizer vaccines in younger people.​

In virtual groups of mothers, there is great resistance in the immunization of children against Covid, sometimes with the approval of pediatricians. This is the case of massage therapist Silvia (who asked not to have her surname disclosed), 32, from São Paulo, mother of a four-year-old boy who has sickle cell anemia.

According to her, the child’s pediatrician did not recommend vaccination on the grounds that Covid hardly kills children and that the safety of the immunizer is not proven.

Pediatrician Renato Kfouri, who chairs the immunization department of the SBP (Brazilian Society of Pediatrics), says that some doctors were impacted by fake news about vaccination against Covid in the same way as part of the population.

“We continue in this political polarization, which is a disgrace to public health”, he says. He also notes a reversal of values ​​among parents. “We’ve seen parents wanting to protect their children with vaccines all their lives and only then think about them. Now we see parents with two, three doses, and who don’t want to give their children any.”

According to the pediatrician, the risk is that this type of behavior will be repeated for other vaccines in the children’s calendar, which are already facing a drop in coverage in Brazil and in other countries.

This year, 300 more children under the age of five died from Covid. “That’s not little. And the suffering, the hospitalizations, the consequences of the disease, like the long Covid?”

Patrícia Boccolini, also a researcher at Observa Infância, says that in groups of parents, this resistance to the Covid vaccine has opened up space for questions about other vaccines already established.

“It seems that a gate was opened. They are questioning newer vaccines, such as pneumococcal [contra pneumonia] and rotavirus, and old ones too, like polio and measles.”

For her, however, the current drop in vaccine coverage goes beyond the parents’ hesitation due to false information. It would go through issues such as the inflexible hours of health centers and the fact that people no longer see the sequelae of diseases that have already been eradicated, such as polio.

In the most vulnerable populations, another factor that has influenced is the increase in food insecurity. “What are we going to eat tomorrow? It’s a more immediate issue for these families than the issue of vaccination.”