Influenza vaccination in Brazil: rationale and caveats

Abstract

Mass vaccination campaigns against influenza in the elderly have been conducted in Brazil since 1999. A search of the literature on influenza in Brazil indicated that data on disease burden are still scarce and inaccurate. Published data seem to indicate that vaccination has produced some impact in the southern and southeastern regions but not in other regions of Brazil. A discussion of the technical and scientific rationale for mass immunization against influenza is presented and it is argued that the current strategy has not taken into account potential differences in disease occurrence in different areas. It is suggested some epidemiological surveillance actions needed to address major concerns regarding mass influenza vaccination and its impact in Brazil.

Effectiveness of the Brazilian influenza vaccination policy, a systematic review

“…Finally, we included one review article, published in 2005, which addressed part of the issues we intend to discuss in the present paper, when the number of published papers on these issues was much smaller 10 .…”

“…The only review article included in the present selection discussed the caveats of influenza vaccination of the elderly in Brazil 10 . The authors recognize the paucity of data on influenza burden the country, especially for Northern regions, where influenza seasonality is not so evident, and also the limited number of studies on the impact of vaccination campaigns.…”

2010 A(H1N1) vaccination in pregnant women in Brazil: identifying coverage and associated factors

“…In Brazil, vaccination campaigns against the seasonal flu have been implemented since 1999, particularly among the elderly, and have been based on previous experience with the National Immunization Program for children 15 , which was introduced in 1973. After the A(H1N1)pdm09, following World Health Organization (WHO) recommendations, Brazilian authorities launched a major vaccination campaign before the winter of 2010.…”

Ecological study on mortality from influenza and pneumonia before and after influenza vaccination in the Northeast and South of Brazil

“…In the elderly population, acute respiratory infections are an important cause of morbidity and mortality. Among these infections, an important proportion is caused by the influenza virus, frequently presenting complications from bacterial infections, resulting in pneumonia and exacerbation of chronic pulmonary and cardiac diseases, leading to hospitalization and even death 2,4 . In the North of Brazil, mortality attributable to influenza was estimated at 9.2 per 100,000 persons-year in the elderly (60 years or older).…”

“…Brazil is the country with the highest investment and coverage for vaccination of the elderly, surpassing the 70% target set by the Ministry of Health 14 . However, few studies have specifically assessed the measure's effectiveness 2,15 .…”