Brazil records 4 times more deaths of children from 0 to 4 years old by Covid than of those over 5

Children aged 0 to 4 years are more vulnerable to the new coronavirus than children aged 5 to 11, the age group that entered the national vaccination plan against Covid-19.

Officially, Brazil has recorded 1,544 deaths of children aged 0 to 11 years from Covid-19 since the beginning of the pandemic. Of the total, 324 of them had from 5 to 11. Between 0 and 4, the number of deaths reached 1,220, which represents almost four times more occurrences than in the range above 5.

A survey by Vital Strategies — a global organization made up of experts and researchers working with governments — also assesses that there is underreporting of data and projects the omission of 2,537 deaths in the Covid balance sheet.

This is because, as there is no diagnosis of the reason for death in some SARS (severe acute respiratory syndrome) cases, deaths enter the statistics as SARS for an unspecified cause.

With this, the estimated total can reach 4,081 deaths of children by Covid. The numbers would then reach 3,249, from 0 to 4 years, and 832, from 5 to 11 years.

Asked about underreporting and estimates by Vital Strategies, the Ministry of Health did not respond.

The epidemiologist and senior specialist at Vital Strategies Fatima Marinho explained that there are different reasons that lead to the lack of a diagnosis, such as low testing, collapse in the health system and unequal access to care.

SARS is a patient condition that can be caused by both the new coronavirus and other respiratory viruses, such as H1N1, the infectious agent of Influenza A (flu). Data were collected in the Sivep-Gripe (Influenza Epidemiological Surveillance Information System), of the Ministry of Health.

Marinho said that to arrive at this projection, a redistribution of unspecified SARS deaths was carried out considering the historical series of years prior to the pandemic – in the case of 2018 and 2019.

The excess number was reclassified as Covid and also by other respiratory viruses, such as Influenza. There was an explosion of cases of unspecified deaths by SARS in 2020 and 2021, which points to the preponderance of the new coronavirus.

“Children have a lower diagnosis of Covid because of the different clinic [sintomas]. Often the symptom of Covid in children is diarrhea, abdominal pain, cough, often not having some classic symptoms such as fever, shortness of breath. In parallel, there is the low testing that contributes to the non-identification of Covid-19”, said Marinho.

Data show that Covid-19 has impacted more children aged 0 to 4 years. Age group that, according to experts, will continue to be more vulnerable to the disease because they still cannot receive vaccines. In some countries, there is already authorization to immunize children aged 3 and 4 years.

In Brazil, there are two immunizing agents approved by Anvisa (National Health Surveillance Agency). Pfizer’s is available for children from 5 years old, and Coronavac, for children from 6 years old.

Renato Kfouri, president of the Immunization Department of the SBP (Brazilian Society of Pediatrics), agrees that there is underreporting in Brazil. According to him, a greater number of deaths in the age group of children under 5 years old also occurs in other countries.

According to the doctor, the immune system of these children is more immature and does not respond to infections like the older ones. Therefore, vaccines for other diseases start in the first months of life.

“Children in this age group will continue to be more vulnerable [para Covid]. Because of this, eligible persons [crianças mais velhas, adolescentes e adultos] should take the vaccine to help reduce the circulation of the virus, keep wearing a mask, wash their hands,” he said.

Housewife Adriana de Godoy Zaniolo, 41, had her third child during the pandemic in Rio Claro, in the interior of São Paulo, at the beginning of the Covid vaccination campaign in Brazil. As a result, she had not yet been immunized.

In the first hours of life of Matheus de Godoy Marangoni, Theusinho, on March 10, 2021, the child was transferred to the ICU (Intensive Care Unit).

Adriana said that she had a smooth pregnancy, and her son was born healthy. That day, the baby started to moan as if he wanted to cry and couldn’t. In addition, oxygenation was low.

The prediction was that he would soon return to his parents’ arms, but with each visit the boy showed worsening. According to the mother, procedures were carried out in an attempt to find out what he had. Only on the third day was the family informed that he had Covid.

From that moment, the doctors isolated the baby and asked Adriana to also take a test, which was positive. The next day, Theusinho died.

“Everything that happens seems unbelievable, it seems that the chip still hasn’t sunk in. All ready waiting for my son, he was born so perfect and out of nowhere it seems that the world collapses. Every time we went to the ICU the doctor didn’t have a diagnosis. thing I know is that I changed medication all the time”, said Adriana.

To avoid the incidence of deaths among minors, Flávia Bravo, director of Sbim (Brazilian Society of Immunizations) said she believes that vaccines against Covid should not take long to arrive for age groups below 5 years.

However, while there is no immunization for this public, it is necessary to focus on greater coverage among those who can be immunized to control the disease and transmission.

According to the doctor, the studies began focusing on people who die the most, which in this case are adults. Not long ago, the gaze was extended to this group of children and, now, it is necessary to wait for the time of science, she says.

There are several factors taken into account before starting vaccination, such as defining the correct dose, the vaccination schedule, understanding the expectation of adverse events. “We cannot underestimate the numbers, and science is looking for a solution for these ages. Even if it takes time, it will come. In the meantime, it has to protect the unvaccinated by vaccinating the others”, said Bravo.

The Butantan Institute’s request to Anvisa was to use the doses in children from 3 years of age. However, the agency understood that there is not enough data to reduce vaccination against Covid-19 until that age.

The institute is now awaiting results from Chile’s survey of children aged 3 to 5 years to forward them to the regulatory agency. It is expected to take place later this year.

In an interview with leaf, Pfizer’s president in Brazil, Marta Díez, said that the pharmaceutical company intends to present to Anvisa the request for authorization to use the Covid-19 vaccine in children aged 6 months to 5 years this year. In a note, the laboratory stated that there is still no date for submission.

The Ministry of Health provides in a contract with Pfizer the possibility of acquiring doses for children aged 0 to 4 years if the vaccine is approved by the regulatory agency.

Not only deaths are underreported, according to Vital Strategies — so are hospitalizations. Data from the Ministry of Health indicate 18,326 hospitalizations in the public aged 0 to 4 years and 6,802 in children aged 5 to 11 years.

However, Brazil may have already reached 92,837 hospitalizations in children aged 0 to 4 years, and 39,584 in children aged 5 to 11 years.

Marinho, from Vital Strategies, said that an effective testing policy is essential to control cases in children. However, she pointed out that, almost two years after the pandemic, there is still no consolidated strategy on the subject.

The doctor, however, considered that children who will not be able to take the vaccine will remain vulnerable and following the curves of the pandemic – as the number of cases and deaths from diseases grows, this also occurs among children, but in a smaller proportion. than that of adults.

“Vulnerability occurs mainly among the poorest and black children. Many already have many respiratory problems because of the environment in which they live, precarious housing, without basic sanitation, many people per room, which increases the risk of communicable diseases, especially respiratory ones”, said Marinho.