Ministry of Health data from March to May show that only 55% of older adults were vaccinated this year through the National Influenza Vaccination Campaign compared to the same period in 2022 last year.

Older people received fewer flu shots in 2023 – Photo: Marcelo Camargo/Agência Brasil/ND

“The numbers are below the estimate like never before,” Dr. Rosana Richtmann of the Emilio Ribasa Institute of Infectology told Agência Brasil agency this Friday (30). “This is the lowest coverage rate since the start of the flu vaccination campaign,” the infectious disease specialist said. Influenza vaccination was included in the PNI (National Immunization Program) in 1999.

“Today, the numbers show that 56% of the elderly population over 60 years of age are vaccinated against the flu. This is also a historically low record,” Rosana emphasized. Traditionally, it has always been harder for children and pregnant women to achieve goals, which has not been the case for older populations and health care workers. “This time, 56% is something very far from what it was in our history.”

A worrying issue is that, according to the Continuous National Sample Household Survey (Continuous PNAD), the population under 30 is declining not only in Brazil, but worldwide, while the proportion of people over 30 is declining. increases significantly at age 60. Continuous Pnad was released this month by IBGE (Brazilian Institute of Geography and Statistics).

“We are completely against the grain in terms of getting older. This means that there is a population in Brazil that is much more susceptible to influenza and all that the disease brings, compared to the past when the immunization campaign achieved 95% vaccination coverage. There is such a paradox in terms of coverage and increase in the population at risk, ”said the infectious disease specialist.

respiratory syndrome

According to the Ministry of Health, the number of cases of SARS (severe acute respiratory syndrome) due to influenza in the elderly increased by 4.5 times in 2023 compared to the same period in 2022, and by May, 96.1% of these cases required hospitalization . this year. Older people remain at increased risk of stroke (stroke) for up to two months after being infected with the influenza virus.

Rosana Richtmann stressed that the link between viral diseases – “and the flu is one of them” – is increasingly seen with cardiovascular complications. “You have had the flu and are at increased risk of heart attack and cardiac arrhythmias in the weeks ahead. You’ve had Zoster, you’re at greater risk of stroke, stroke in the next few weeks.” A direct link is being established between a viral infectious phenomenon and a trigger for the occurrence of cardiovascular complications, the doctor explained. “When you talk about flu prevention, you don’t have an acute infection with the influenza virus and, on the other hand, you have indirect prevention for other conditions, such as respiratory.”

The doctor noted that with age, people do not realize that the likelihood of other complications caused by the flu is much higher. Problems such as diabetes, hypertension, and respiratory conditions, including asthma and chronic bronchitis, can speed up this process.

The Ministry of Health indicates that about 70% of older people have chronic diseases and an increased risk of exacerbating infections. This is because with age, the defense system of the human body begins to show a decrease in its functions; This process is called immunosenescence. As a result of this progressive decline in the immune system, a person becomes more susceptible to certain diseases and infections.

However, older people who have been vaccinated against influenza are less likely to get the flu (between 60% and 65%) or have a less severe form of the disease. There are specific targets for vaccinating this population.” Rosana warned that the flu virus is still circulating in the country, causing respiratory complications, so this group needs to be vaccinated.

fiokruz

InfoGripe newsletter coordinator from Fiocruz (Fundação Oswaldo Cruz) Marcelo Gómez confirmed the declining commitment of older people to the vaccination campaign and said that this is ultimately having a negative impact on this group. According to the researcher, the actions taken since 2020 to reduce the impact of covid-19 have had a positive effect in reducing other respiratory viruses, including with a much greater impact on covid itself. “It was a very significant decline, but now that the situation has returned to normal, the viruses are taking advantage of this moment in some way,” Gomes told Agência Brasil.

He noted that perceptions of the risk associated with influenza viruses have decreased, which may have helped shorten the search for an influenza vaccine. Like infectious disease specialist Rosana Richmann, Gomez warned that the influenza virus continues to circulate, “seizing the moment” when it has weakened in every sense. “Both in behavior and in vaccinations.”

As a result, people do not have adequate immunity, and behavior contributes to the transmission of infection. “Then the influenza virus came back with force.”

Another major factor this year is the return of the H1N1 virus, as opposed to what happened in 2022 when H2N2 was more prevalent. Although it also causes hospitalizations, H2N2 does not have the same impact in terms of hospitalizations as H1N1, which has a higher risk of worsening. This year, the H1N1 virus reappeared with a larger presence in a situation where little to no precautions were taken. “Even people who have some signs of the flu, who sneeze, cough, relax,” said Marcelo Gomez.

Mask

A Fiokrusa researcher has warned that people with flu-like symptoms who cannot rest and need to go outside should wear protective masks, especially if they use public transport. In his opinion, the Brazilians are missing a great opportunity to draw public attention to the fact that the mask is an extremely valuable tool in specific situations.

With the cold snap of covid-19, it seems that the mask is no longer needed. Gomes stressed that this is not about wearing a mask all the time, but about specific situations, as other countries have done in the past and created this custom as protection against the flu. “We are missing a great opportunity to make this behavioral change that could give us protection when combined with a vaccine.”

Lethal outcomes

From 2021 to 2022, the number of influenza deaths in Brazil increased by 135%. In this situation, people over 60 years of age are most seriously ill, the Ministry of Health indicates. Respiratory infections are now the fourth leading cause of death for older people in the country.