The shortage was of three types of vaccines. Although the report does not specify on what dates the events occurred, only that they occurred during 2022.
“El Salvador, by 2022, is the Central American country with the lowest vaccination coverage in children under five years of age,” declares infectious disease doctor Iván Solano Leiva, during a television interview; basing his statement on the recent WHO and UNICEF report on the application coverage of vaccines in 2022.
The international recommendation of the World Health Organization (WHO) is that 95% of the target population of each country should be vaccinated; hence the importance of the doctor’s statement, who explained that in the case of El Salvador coverage is 76%, well below Costa Rica, which has 98%, according to updated data.
you can read | Low vaccination coverage puts El Salvador at risk due to a possible outbreak of diseases
Alarms and alerts due to the decrease in vaccination coverage have sounded from international organizations for months.
Last April, the United Nations warned that 67 million children were totally or partially deprived of routine vaccinations between 2019 and 2021, due to closures and interruptions to medical care caused by the covid-19 pandemic.
Vaccination against poliomyelitis in El Salvador. Photo/ Courtesy Ministry of Health
In the case of the country, the report “El Salvador: WHO and UNICEF estimates of immunization coverage: 2022 revision”, published less than a month ago on the official WHO website, makes one more point: “The program reports a national vaccine shortages of one month” in the case of BCG (tuberculosis), DTP1 (first dose of the vaccine against diphtheria, tetanus and pertussis in the first year), DTP3 (third dose of the vaccine), Pol3 (third dose of vaccine containing poliomyelitis).
Tuberculosis
The tuberculosis vaccination path has had many downfalls over the past decade. In 2012 coverage (with government data reported to WHO) was 90%. That is, out of every 10 infants, nine were immunized. By 2019 it dropped to 78%.
And in the context of the pandemic, the percentages went from 79% for the year 2020 to 77% in 2021, and last year 75% in the case of the BCG vaccine.
The international report emphasizes that last year, El Salvador “reported shortages of vaccines for a month at the national level.”
At the beginning of July of last year, the population denounced the lack of vaccinations against tuberculosis, tetanus and influenza, through social networks, where the parents of the infants labeled the Minister of Health, Francisco Alabi, with the hope that he would solve their problem. problem. In specific cases, the complainants received a response from the ministry, but the institution denied that there was a general problem. BCG is part of the national vaccination scheme and is applied to newborns.
Diphtheria, Tetanus and Pertussis (DPT)
Last year, 24 out of 100 children missed their first dose of the diphtheria, tetanus, and pertussis (DTP1) vaccine, as coverage was 76%.
As happened with immunization against tuberculosis, here too there was a “shortage of vaccines for a month at the national level,” according to the WHO.
In this case, the affectation was not only for infants who should receive their first dose at two months of age; but also for those who should receive the third dose at six months of life.
Since July, Salud launched a nationwide vaccination campaign. According to health doctor Ricardo Lara, it will not be enough to cover the vaccination gap. HRE Photo/ File
In the case of DTP3 (that is, the third dose of the vaccine), the coverage percentage was 75%.
In 2020, the vaccination rate was 72%.
The DTP3 is applied at two, four and six months of life, according to the National Vaccination Scheme.
Poliomyelitis
On April 12 of last year, interviewed on the morning program TCS, the Minister of Health, Francisco Alabí, assured that there is vaccine coverage against polio.
you can read | Polio, the paralyzing disease that threatens again
“Yes, there are vaccines, they exist at the moment, the oral polio vaccine is one of the most widely used. There are campaigns for its application,” Alabí pointed out, in the question segment of such an interview program, when answering a user’s concern. However, on social networks the population exposed the difficulties in accessing this immunization.
A month ago, in the international report of the WHO, with data from 2022, the shortage of the biological was exposed for a period of one month at the national level, for the third dose of said vaccine.
The report reports that coverage last year was 72% for the third dose of the polio vaccine. Which means that 28% of the target population was left unimmunized. This vaccine is applied at two, four and six months of age.
Present
“This year, the first six months there were no vaccines; they have just entered. When the ministry began to make a fuss about being able to go to vaccinate, then on that date they had already entered. That statement by the minister that we have never had a shortage of vaccines is a lie ”, declares the infectious disease doctor, Iván Solano Leiva, with a confident tone.
“If the vaccination scheme for children under five years of age is terrible, how will the vaccination scheme for the elderly and patients with chronic diseases be? The latest data I have on influenza vaccination coverage in people over 60 years of age, data of 2021, it was 33% ”
Iván Solano Leiva, infectious disease doctor
A month ago, the Ministry of Health announced the new National Vaccination Scheme, where the incorporation of four immunizations to the previous scheme was highlighted. The new coverages are against hepatitis A, chickenpox, the hexavalent vaccine and the 23-valent pneumococcal vaccine. As well as expansion of the coverage against the Human Papilloma Virus, since before it only applied to girls, but after the announcement it included boys.
This recent announcement and the existence of immunizations brings with it the challenge of reaching its target population, both to access the new benefits and to catch up with those who have an incomplete vaccination schedule.
make up time
Dr. Solano Leiva explains: “there are dose recovery schemes, for example the child who is immunized against polio at two months, but when it was four or six months there was no vaccine, and he also reached the age of one year; So, there they give the four-month dose, even if they are one year old. Then they continue with the scheme. Obviously in that period from two months to twelve months this child was unprotected, that is why we must have the vaccines in all the health centers at the times that the agent requires them”.
Doctor Iván Solano Leiva, specialist in infectious diseases. Photo HRE/ File.
To the above we must add that only a quarter of the Salvadoran population has access to medical services, according to the preliminary report of the 2022 Multipurpose Household Survey (EHPM).
The specialist doctor adds other factors to the challenge of improving vaccination coverage and strategies to overcome the figures.
“There are the data that reflect terrible vaccination coverage and that this translates into many causes. We can mention shortages that do not allow health promoters to bring the vaccine on time to their group, to their geographical area of influence. We have been, as a public health strategy, investing less in primary health care, the role of local health teams has been greatly underfunded, therefore there are fewer health personnel dedicated to that. That means that the primary care system is not working properly, among other reasons. And the local systems should be activated”, says Solano Leiva.
Unlike developing countries, where anti-vaccine movements have permeated the population and therefore coverage is low; in developing countries like El Salvador the cause is different. “In our country, the low coverage is explained by shortages, by not having the vaccine when it is requested by the people,” explains Solano Leiva.
Post-pandemic
In the context of the pandemic there were 67 million children whose vaccinations were “severely interrupted”. Of that total there were 48 million who did not fully receive routine vaccinations, according to UNICEF.
“Definitely the covid pandemic affected vaccination coverage worldwide because all governments focused on containing the pandemic; but pharmaceutical companies always continued to produce their vaccines. In the private system, these vaccines have always continued to be administered, with a pandemic as well (…) when one makes a global analysis, most of the countries, such as Costa Rica, the coverage has dropped, but now it has risen again. Costa Rica has levels at 98%. El Salvador continues to be the last (in the region) with 76%”, explains the infectious disease doctor.
future challenge
Both UNICEF and the WHO warn of the risk of possible outbreaks of diseases that had been controlled or eradicated in the past, due to low vaccination coverage rates.
“In El Salvador, we have not had autochthonous cases of measles since the 1990s. Around 2001 or 2002 there were imported cases, from people who acquired it abroad and were diagnosed in the country. But with low vaccination coverage, we find that in 2022 only 56% of children under 5 years of age had received both doses against measles. So we are at risk. And measles in the Americas has re-emerged due to low coverage, ”he analyzes.
Before the introduction of a vaccine in 1963, measles killed an estimated 2.6 million people each year, mostly children. By 2021, that number had fallen to 128,000.
But between 2019 and 2021, the percentage of children vaccinated against measles fell from 86% to 81%, and the number of cases in 2022 doubled compared to 2021.
2023-08-22 02:32:00
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