Hospitalizations of young children by Covid are almost double those of the elderly

Two out of five people hospitalized for Covid-19 are children under five years old, an age group that currently represents 44% of hospitalizations for the disease and that continues without access to the vaccine. Until June, this proportion did not reach 8%.

From July until September 10, the total number of hospitalizations for Covid among children under five years old became almost double that of people over 60 years old (2,205 against 1,175), according to an unprecedented analysis by Observa Childhood, a Fiocruz project (Fundação Oswaldo Cruz) that monitors child indicators based on data from the Ministry of Health.

Although there has been a significant reduction in hospitalizations and deaths from Covid in all age groups in recent months, the speed of this decline continues at a slower pace among young children.

This year, until September 10, there were 12,100 hospitalizations and 439 deaths of children under five years old by Covid. So far, only 2.5% of the public between 3 and 5 years old have taken the two doses of the Coronavac vaccine (Butantan), approved in July by Anvisa (National Health Surveillance Agency).

Immunization had been taking place only in municipalities that had the vaccine in stock. On the 19th, Butantan delivered 1 million new doses to the Ministry of Health, which should be aimed at children.

The Pfizer vaccine, indicated for children from six months, was approved by Anvisa this month. Sought, the ministry did not say when the immunizer will be available in the public health system.

“Every day that we go without a vaccine in this age group, we are condemning a child to death by Covid, which today could already be avoidable”, says Cristiano Boccolini, a public health researcher at Fiocruz and author of the analysis.

The vaccination schedule for this public would be discussed at a meeting of the technical advisory chamber on immunization of Covid of the PNI (National Immunization Plan) on Friday (30), but the matter was removed from the agenda because there is still no official position from the ministry. about the amount of doses that will be available and not even the deadline for this to happen.

According to pediatrician Renato Kfouri, member of the technical committee of the PNI and president of the immunization department of the SBP (Brazilian Society of Pediatrics), this indicator is necessary for the group to define, for example, which are the priority groups to receive the vaccine.

“This decision is urgent. Every month there are more than a thousand hospitalizations of children under five years old. We have already had more than 12 thousand hospitalizations and more than 400 deaths this year. This is not residual. of the children’s calendar, more than pneumonia, meningitis, hepatitis, measles, than all together”, he says.

In the contract that the ministry has with Pfizer, there is a clause that allows adjusting the type of vaccine to be received. It is estimated that today the country has a balance of about 35 million doses. But neither the government nor the pharmaceutical company inform how these negotiations are going.

Brazil has about 13 million children between 6 months and 4 years old and, according to the vaccination schedule planned for this population, three doses will be needed (a total of 39 million doses).

However, as children between the ages of 3 and 5 can also be vaccinated with Coronavac, the number of doses needed of Pfizer’s vaccine would drop to 21 million, according to estimates by ministry technicians.

It is not the first time that the federal government has created obstacles and delayed the vaccination of children against Covid. 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.

The Pequeno Príncipe Hospital, in Curitiba (PR), the largest pediatric institution that serves the SUS in the country, last month recorded 50 hospitalizations and outpatient visits for Covid-19 of children between 1 month of life and 4 years old. In July, there were another 79.

From the beginning of the year until September 10, there were 940 consultations in this age group, almost half of the sum of all age groups (1,890). In total, 21.5% of the children were fully vaccinated against Covid. Among their mothers, coverage is at 67% and, among fathers, 63%.

According to pediatrician Victor Horácio de Souza Costa Junior, deputy technical director of Pequeno Príncipe, the number of child hospitalizations for Covid has dropped a lot in recent months, and cases are now concentrated in the age group under five years old not yet vaccinated.

Respiratory symptoms such as cough, fever, cough and wheezing, often associated with pneumonia, are the most frequent. “In general, children do not have comorbidities, are hospitalized for five to six days and all are progressing well”, explains the doctor.

Costa Júnior says that among children under one year old, most parents report being vaccinated, but when they are infected with Sars-Cov-2 and have mild symptoms, they end up transmitting the virus to their babies.

While the vaccine for babies over six months does not reach the public network, Costa Júnior advises that parents who have respiratory symptoms, such as runny nose and cough, wear masks at home and intensify hand hygiene with gel alcohol.

“This prevents transmission to babies. We see that the situation has improved a lot, but the pandemic is not over yet.”