CURITIBA, PR (FOLHAPRESS) – A senior scientific adviser in Fiocross and one of the country's leading vaccination references, Akira Homma, in an interview with Folha de S.Paulo, talked about the possibility of a new yellow fever epidemic during the summer, and advocated vaccination as one of the key measures to combat the disease.
"We are the victim of our own success, the population feels secure, thinks there is no epidemic," said the doctor, who works in Fiokruz production unit for Bio-Manguinhos vaccine production and was the president of the foundation between 1989 and 1990.
Homma warns that yellow fever is progressing in the south of the country in recent years, citing a recent study by Fiocruz that showed the virus spread about three kilometers a day through the southeast region during the past year.
For him, there is no risk of vaccine scarcity, and Brazil can safely apply fractionated doses. "There is no vaccination of low quality, we have the data: it protects the same way because the strong strength of our vaccine is very high," he said.
What is the chance that Brazil will face a new outbreak of yellow fever this summer?
– There is a potential for that. Last year, a yellow fever went to Espirito Santo, Rio de Janeiro, in Sao Paolo. And he immunized himself in those regions. But the problem is that the virus looks to the south at a speed of three kilometers a day [referência à taxa média de dispersão do vírus na região sudeste, durante o surto de 2017, segundo pesquisa recente da Fiocruz].
And this region was not the subject of a vaccination campaign. There is a possibility that a large contingent of the population will be subject to yellow fever. Now, with the summer weather, the temperature will rise and the rain will rain. Opportunity [de um novo surto] is set up.
What should be the strategy of vaccination in the country, in your opinion?
– It must be very well planned and very well transferred to the population. The population needs to know the real facts. For example, there was a big problem with broken vaccination last year because the ministry did not adequately inform the population. Our vaccine, at a normal dose, has many more vaccines, much more antigens than needed.
Does this mean that fractional vaccination is safe?
– We did a studio that was published; We have scientific data and evidence. We diluted the vaccine. Even diluted ten times, the vaccine still had seroprotection similar to a full dose. But in order to apply this, I would have to prepare a different vaccine formulation, and for this I need Anvisina's authority [Agência Nacional de Vigilância Sanitária].
In order not to change anything, we suggested that instead of using a 0.5 ml dose, for example, use 0.1 ml, which is one fifth of the dose. One-fifth of the power. But we did not change anything in the vaccine. Everything is the same. Reconstitute the vaccine in the same way; is the same quality. It's just shared.
Does it work the same way?
– Because of. The production of the antibody takes place at the same level as the full dose. We delivered more than 40 million doses this year [de vacina contra a febre amarela]. If we adopt partial doses, it will be 200 million doses. So, I have the security: if we do exactly, organized planning, first vaccinating regions with higher risk, there will be a vaccine for everyone.
Last year, Brazil experienced a re-eradication of diseases like yellow fever and smallpox. What happened? Vaccination failed?
"I told you: we are the victims of our own success, because vaccination is a very successful program in Brazil, we have eliminated polio and malignant diseases from the country." The population feels safe, thinks that there is no disease, we no longer had an epidemic, we no longer have frequent diseases of the measles, mumps, rubella.
But there are other reasons [para a queda nas taxas de vacinação]. For example, the difficulty of accessing health jobs. Everyone has to work, there is nobody to take children to vaccinate. There is also a financial issue: municipalities have a lot of difficulties and often do not provide vaccination services in an efficient and proactive way. It's a complex question.
Check out the latest vaccinated campaign for the goddess and polio: there is a lot of information about the media in the media. I've never seen so much publicity every day. But the answer of the population was not what we expected. We had to reach 95% of children. In Rio de Janeiro, we received that percentage only two months later. Two months!
In 1980, when a national immunization program was launched with a massive vaccination for polyomyelitis, we got it in two days.
But what prevents people from getting a vaccine?
– It's a complex problem. It is no longer the priority of the population to be vaccinated. We need to find ways to convince these people to vaccinate. They talk about unwanted reactions: "Oh, why should I take a vaccine if I have a reaction?" However, the vaccination is much higher than the vaccine vaccine costs.
Fever, pain and other minor reactions are reversed in two, three, four days. And the cost-benefit is much higher than the illness. The cost of treatment, emotional load … is much better if you are vaccinated. Doubtless.
What is the impact of anti-virus movements on this issue?
"It must have some impact, because people who no longer want to vaccinate use this information. But they are false news.
It should be informed of the benefits of vaccination, the need for vaccination. Vaccination provides individual protection, but collective protection is only achieved if you have a high degree of vaccination. It is therefore important that everyone is vaccinated. It protects not only you, but also the family, the collective.
Is the vaccine the main way to prevent yellow fever?
– The vaccine is the only way to protect it individually, but we also have to control Aedes aegipti mosquitoes in the city. This is absolutely important because you reduce the chance of contamination.
Akira Homma, 79
He completed veterinary medicine at Universidade Federal Fluminense (1967), soon joined Fiokruz in the Laboratory for Polyomyelitis.
He earned a Doctor of Science from the Bailor College of Medicine (1972).
From 1991 to 1997, he co-ordinated the Special Program for Vaccines and Immunization of the Pan American Health Organization.
He was the supervisor and director of Bio-Manguinhos (1976-1989), and president (1989-1990) Fiocross Technology