Babies up to 1 year old should be given priority in Pfizer’s Covid vaccine

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The technical chamber of the PNI (National Immunization Plan) of the Ministry of Health should recommend next week the immunization of children between six months and four years of age against Covid-19 with the Pfizer vaccine, approved by Anvisa (National Health Agency). Health Surveillance) last Friday (16).

Children under one year of age should have priority in vaccination, according to pediatrician Renato Kfouri, member of the PNI technical committee and president of the immunization department of the SBP (Brazilian Society of Pediatrics).

This child group is the most vulnerable to Covid, accounting for more than half of hospitalizations and deaths from the disease among children, according to data from the Ministry of Health.

There are about 12 million children eligible for the Pfizer vaccine, and the recommendation is three doses of 0.2 mL (equivalent to 3 micrograms). That is, 36 million doses will be needed.

The two initial doses should be given three weeks apart, followed by a third dose given at least eight weeks after the second, according to Anvisa. To differentiate it from the others, the vaccine aimed at the new age group will be identified by the bottle with a wine-colored lid.

For children aged five to 11 years old, the lid is orange and, for the public over 12 years old, purple.

According to Kfouri, as there is already a previous purchase agreement between the ministry and Pfizer, which provides for the exchange of products, that is, vaccines for adults already purchased can be exchanged for pediatric doses, it is possible that this will speed up the acquisition of vaccines for this new age group.

But among experts there are doubts as to whether the government of Jair Bolsonaro (PL) will fund the vaccination of babies against Covid, even more so on the eve of the presidential elections.

In December 2021, when Anvisa gave the green light for the use of the Pfizer vaccine in children from five years old, Bolsonaro criticized the decision, and attacked the agency, which triggered a wave of threats to its technicians and directors. At the time, the president also minimized the number of child deaths from the disease.

In 2020 and 2021, there were 1,439 deaths of children up to five years old, of which 48% were babies between 29 days and an incomplete year (post-neonatal), an average of 1.9 per day.

Data from the consortium of press vehicles this Friday (16) show that only 35.86% of children between three and 11 years old are fully immunized against Covid and about 53% are partially (they were vaccinated with the first dose).

“We hope that [a aprovação para bebês a partir de seis meses] cheer up the parents of older children. In all age groups, the number of cases of Srag [síndrome respiratória aguda grave] by Covid continues to fall, except in children from zero to 11 years old”, says pediatrician Isabella Ballalai, vice president of Sbim (Brazilian Society of Immunizations).

She claims that the action of anti-vaccine groups in spreading fake news has destroyed parents’ perception of risk in relation to Covid. “If I tell parents that the vaccine is dangerous, that it can cause myocarditis, which is not true, will they want to give it to their children? No, right?”

The lack of campaigns by the Ministry of Health to clarify parents and alert them to the risks of lack of vaccination is also another factor that contributes to the low coverage, according to the pediatrician. “Covid has already surpassed the respiratory syncytial virus, which until then was the one that most caused Srag in children up to five years old.”

For Renato Kfouri, in addition to these factors, there is no vaccine available for the age group of three to five years. Coronavac (Butantan) has been authorized since July by Anvisa, but the immunization of this age group was only started by municipalities that already had the vaccine in stock. As with adults, two doses are required 28 days apart.

Data from Observa Infância, a Fiocruz project, show that less than 2% of children aged three and four have completed the vaccination schedule against Covid-19 in Brazil. “If we had a vaccine, it is possible that we would have 50% coverage of the first dose, not more,” says Kfouri.

Coronavac production restarted in August at the Butantan Institute, using imported raw materials. According to the institute and the Ministry of Health, the distribution should be normalized by September 30.

Kfouri says that another topic to be discussed in the technical chamber of the PNI is the recommendation of an additional dose of the vaccine against Covid in pregnant women, with the intention of protecting babies under six months.

“Some studies have already shown that, in babies whose mothers were vaccinated at the end of pregnancy, the risk of having a severe Covid drops by 80%. protect the baby.”

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