The Brazilian National Immunization Program: 46 years of achievements and challenges
The Brazilian National Immunization Program: 46 years of achievements and challenges
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DOI：
10.1590/0102-311x00222919
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发表时间：
2020-01-01
期刊：
影响因子：
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通讯作者：
Domingues, Raissa A. S.
中科院分区：
文献类型：
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作者：
Domingues, Carla Magda Allan Santos;Maranhão, Ana Goretti K.;Domingues, Raissa A. S.
巴西国家免疫计划（PNI，葡萄牙语）由卫生部与州和市卫生部门合作协调。自1973年制定该方案以来，它已成为该国最相关的公共卫生干预措施之一，取得了重要成果，如巴西被认证为无野生脊髓灰质炎病毒传播，消除风疹病毒传播，以及疫苗可预防疾病的病例和死亡人数大幅减少。巴西是向民众免费提供疫苗最多的国家之一，为儿童提供了15种疫苗，为青少年提供了9种疫苗，为成人和老年人提供了5种疫苗。该方案的扩大和高疫苗接种覆盖率的保持导致疫苗可预防疾病的迅速减少，彻底改变了巴西过去四十年来这些疾病的流行病学情况。目前，该国没有适当接种疫苗的人口比例越来越大。正是由于疫苗接种率高，特别是自2000年代初以来，这些疾病不再流行，其中许多疾病现在不为人口所知。因此，许多人对这些疾病所代表的危险没有概念。因此，我们需要了解造成这种覆盖率下降的多种因素，这造成了巴西已经控制或消除的严重疾病死灰复燃的风险。
The Brazilian National Immunization Program (PNI, in Portuguese) is coordinated by the Ministry of Health in cooperation with state and municipal health departments. Since the program's creation in 1973, it has become one of the country's most relevant public health interventions, having produced important results such as certification of Brazil as free of wild poliovirus circulation, the elimination rubella virus circulation, and an important reduction in cases and deaths from vaccine-preventable diseases. Brazil is one of the countries that offers the most vaccines free of cost to the population, with 15 vaccines for children, 9 for adolescents, and 5 for adults and the elderly. The program's expansion and the maintenance of high vaccination coverage rates led to a rapid decrease in vaccine-preventable diseases, completely changing the epidemiological scenario of these diseases in Brazil in the last four decades. The country is currently witnessing an increasing share of the population without adequate vaccination. To the extent that these diseases are no longer circulating, precisely because of the high vaccination coverage rates, especially since the early 2000s, many of them are now unknown to the population. As a result, many people have no notion of the danger these diseases represent. We thus need to understand the multiple factors contributing to this decrease in coverage, which has created the risk of resurgence of serious diseases that had already been controlled or eliminated in Brazil.