People only die of COVID-19?: Seven forgotten vaccines during the pandemic
In a state of health and sanitary emergency, is there an essential vaccine? One on which the medical services can focus their efforts until everything passes?
While the world remains in tension in the face of the expansion of the COVID-19 pandemic and in the desperate search for vaccines against the disease that has already affected more than 20 million people and caused almost 750,000 deaths, half of them — in both figures — recorded in America, there is another batch of viruses and lethal diseases that attack the region and also the rest of the world without causing alarm in the public opinion.
Among these deadly diseases are dengue, different types of flu, HIV-AIDS, venereal diseases, cancer, diabetes, among other chronic diseases. But, there are also a series of preventable diseases that have had vaccines for years but have been overshadowed and left in the background due to the crisis generated by the new coronavirus.
The pandemic has managed, in addition to the generalized health and sanitary crisis, to have left lagging behind seven other preventable diseases, which put more than 80 million children under one year of age at risk.
In the first instance, tuberculosis, polio and hepatitis are some of the lagging vaccines. Similarly, rubella, yellow fever, polio and measles also stand out on that list.
A report by the World Health Organization (WHO), the United Nations Children’s Fund (Unicef), the Vaccine Alliance (Gavi) and the Sabin Vaccine Institute warned that quarantine measures and the hospital crisis hindered immunization in at least 68 countries.
According to the document, the pandemic increased the risk in approximately 80 million children under the age of 1, who can now contract a preventable disease that, in many cases, can be serious.
Unfortunately, with the health resources of many countries focused on fighting COVID-19, the number of deaths totally preventable with a vaccine has rebounded, as has the multiple risks of having an unvaccinated baby at home.
The risk of not vaccinating against preventable diseases
Dr. Francisco Álvarez, coordinator of the Vaccine Advisory Committee of the Spanish Association of Pediatrics (AEP) — quoted by the BBC — explained that a child under one year of age “can become seriously ill if he acquires a vaccine-preventable disease, such as measles or meningococcal disease; or develop a disability, because in addition to death they can cause deafness, amputations or neurological deficits|.
In addition, the child becomes a pathogen with a high virulent capacity to pass the infection to vulnerable people in the home if they are not protected.
In the case of Latin America, “this was already a problem, because precisely in previous years the impact of a lower vaccination coverage for certain diseases, especially measles, was observed”, explained Alfonso J. Rodríguez-Morales, vice president of the Colombian Association of Infectology, to BBC Mundo.
He added that in areas with less health coverage there have been outbreaks of these diseases due to the non-vaccination of newborns.
Saturation of health systems and fear of hospitals
The Pan American Health Organization (PAHO) attributes the lower vaccination in the region to various “bottlenecks” that emerged after the arrival of the new coronavirus.
Countries have had to “reorganize health systems to cope with an influx of positive COVID-19 cases, including the redeployment of human resources, and have also encountered difficulties importing vaccines”, the organization adds.
Other obstacles have been the delay in routine vaccination services due to confinement and the concern or fear of the population about having to go to health care services during a pandemic.
“The population does not go to consultations, nor to child and vaccination controls, which increases the possibility of transmission and outbreaks of preventable diseases”, says Rodríguez-Morales.
An example case was what happened to Ana María Cárdenas in Colombia, according to the BBC. Ana’s son, Federico, had to get several vaccines when the coronavirus arrived in Bogotá. “We didn’t want to take him to any medical care facility. We were scared and decided to delay it as long as possible”, she says.
“We even contemplated the possibility of hiring a company that goes to the people\s house and puts the vaccines, but we discarded it because the cost was very high”, said Cárdenas, who is a living example of social inequality and poverty in Latin America, an element taken into account by the WHO, which adds the delay in vaccinations precisely to these precariousness, as well as to political turmoil and the years of weak economic growth in Latin America.
Latin America among the worst in the world
These political, social and economic factors contributed, for example, to Brazil, Bolivia, Haiti and Venezuela being among the 20 countries with the worst marks when examining how many children received the third dose of the triple vaccine against diphtheria, tetanus and whooping cough between 2010 and 2019.
In the case of Venezuela, it is necessary to highlight that the political crisis and the sedition plans against the Government of that country, to which is added a strict economic blockade that prevents it from importing medicines, food, medical treatments and vaccines, have worsened the situation and leave its population vulnerable, despite the efforts made by the Nicolás Maduro administration with the UN, WHO, PAHO, Unicef and the International Red Cross.
Mexico and Honduras also appear on the list, according to the United Nations report that analyzed the figures for 195 countries.
The regression in Brazil in that period is the worst, with 26%. Bolivia and Haiti follow with a fall of 16% each in those nine years, Venezuela with 14% less, Mexico with 13% and Honduras with a loss of protection of 10%.
The text adds that the region never went beyond a global average coverage of 81% in the mentioned vaccines, a percentage in which it was in 2019, before the coronavirus crisis. The figure places it below the global average, which is 85%.
For the WHO, the data is aggravated when taking into account that in 2019 Brazil had 542 thousand children who have not received any dose of the triple vaccine; and Mexico had 348 thousand infants in the same condition as Brazil.
Other vaccines
The loss of protection is also repeated in other vaccines in Latin America and the Caribbean. With the data provided to the BBC by PAHO, if in 2017 the tuberculosis vaccine had been administered to 97% of children in the region, the figure fell in 2019 to 84%.
The same pattern is repeated with the vaccine that completes the cycle of hepatitis B. It reached its maximum coverage peak with 92% in 2012, and from there it has fallen to 86% in 2019.
The polio vaccine reached 94% of Latin American or Caribbean children in 2011, but fell to 86% in 2019.
“It is vital that immunization programs continue, safely and whenever possible, to prevent outbreaks of vaccine-preventable diseases and avoid overwhelming health systems”, PAHO said.
In a state of health and sanitary emergency like the one posed by COVID-19, is there an essential vaccine? One in which the medical services can focus their efforts until everything passes? The BBC asked Rodríguez Morales, and he responded: “The truth would be difficult and it will depend on the age of the child as well as its location. For example, if you are a newborn and you are in Colombia, you need to have the tuberculosis and hepatitis B vaccines”.
“But if you were two months old, in the same country, the most valuable vaccine, theoretically, could be the pentavalent, because it simultaneously protects against hepatitis B, meningitis, diphtheria, pertussis and tetanus”, he explained.
However, remember: “In immunization schedules, all vaccines are important and must be applied in a timely manner”.
Rebound diseases and anti-vaccines
The UN recognizes that the income level of the country plays a very important role in whether children are vaccinated or not. Disinformation also plays a fundamental role.
“An estimated 95% of children living in high-income countries were vaccinated against diphtheria, tetanus and pertussis in 2019, compared to approximately 74%” of those with low income”, indicates the report.
It adds that, “this gap in coverage has been stable since 2010”. However, the agency detected that the decision of parents not to give their children vaccines that are mandatory because they do not believe in them, does not understand social classes.
“Vaccination concerns have to be combated among the high-income population, as well as the low- and middle-income, through effective communication and community engagement approaches”, the report reads.
Finally, it states that although most of the world continues to trust the use of vaccines, the growing distrust of public opinion towards them by the so-called “anti-vaccines” is generating a setback in the fight against infectious diseases that, although they are deadly, they could be prevented.
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