Brazil misses the target for vaccination against HPV – 03/13/2023 – Health

Vaccination against HPV (human papillomavirus) in Brazil ended last year with coverage below the target of 80%.

Among girls, the first and second dose had, respectively, 75.91% and 57.44% adherence, according to a balance sheet released this year by the Ministry of Health. Among boys, the numbers are even smaller: 52.26% in the first application and 36.59% in the second.

The vaccine was introduced by the ministry in 2014 and is currently offered in two doses for girls and boys aged 9 to 14 years.

Immunizer is also offered to people aged 9 to 45 years living with HIV/AIDS, transplanted and cancer patients, a group at greater risk of developing complications related to the papillomavirus.

The low rates are of concern to the folder and health professionals due to the association of HPV with cancer of the cervix, penis, vulva, anal canal and oropharynx, in addition to genital warts.

According to the WHO (World Health Organization), the virus is responsible for more than 95% of cases of cervical cancer, a disease that kills about 340,000 women each year.

In Brazil, the Inca (National Cancer Institute) estimates 17,010 new cases in 2023, which positions cervical cancer as the third most incident in the female population. Here, neoplasia is the cause of more than 6,620 deaths per year.

Despite this, the survey by the Ministry of Health shows that in several states coverage is far from 80%.

Of the 5,570 Brazilian municipalities, 1,001 (18%) had coverage of less than 50% in the second female dose and 3,251 (58%) in the second male application.

Vaccination coverage against HPV in 2022 (%)
state	Girls		boys
	dose 1	dose 2	dose 1	dose 2
B.C	37.22	26.35	14.65	10.44
AL	72.16	49.98	42.60	26.94
AM	81.52	61.94	56.83	40.00
AP	61.24	43.16	30.55	19.70
BA	68.14	50.99	44.45	30.24
CE	80.04	60.23	48.47	33.55
DF	78.47	58.89	56.68	37.26
ES	83.31	66.74	71.12	52.01
GO	71.65	52.03	50.09	31.38
BAD	67.67	50.21	39.71	27.35
MG	85.33	69.24	62.79	47.99
MS	76.13	55.87	53.83	34.72
MT	78.67	58.94	46.07	38.79
SHOVEL	62.86	45.43	35.74	23.38
PB	80.65	59.23	50.56	34.32
FOOT	71.01	52.95	45.96	30.97
IP	74.90	56.99	54.25	36.96
PR	94.64	78.56	77.08	62.42
RJ	62.59	42.89	38.81	24.42
RN	67.25	47.16	45.55	28.95
RO	70.30	51.24	50.33	31.72
RR	88.21	54.24	58.58	30.66
LOL	78.18	57.90	59.23	38.66
SC	91.27	71.38	75.56	53.54
IF	72.43	53.96	34.62	32.84
SP	78.31	59.75	55.48	38.43
TO	78.87	61.57	59.11	40.23

“I’ve been researching HPV since the late 1990s. I thought that by 2023 we’d already have a whole generation protected and we still haven’t”, laments gynecologist Cecilia Maria Roteli Martins, president of the Febrasgo vaccine commission (Brazilian Federation of Gynecology and Obstetrics Associations). ).

Among the factors that contribute to the low rates, the doubts of parents and adolescents, religious aspects, the difficulty of attending health centers and fake news stand out.

“Many parents still have difficulties indicating vaccination for their children and say: ‘But my daughter or my son is not sexually active yet. There is no need'”, says Martins.

The fact that the diseases that HPV causes are not visible and the interruption of vaccination in schools also impact the numbers.

“In the beginning, we had a very large adherence because we carried out the vaccination based on the school. At the health center, there is the difficulty of working hours, nobody wants to leave homework to take their son or daughter, the teenager does not want to interrupt the activities he has at regular hours. off to get a vaccine”, says the gynecologist.

Another aspect is the confusion between psychogenic reactions and adverse reactions. Episodes recorded in 2014, with 11 girls in Bertioga (SP), and between 2014 and 2017, with 74 girls and boys in Acre, caused controversy and led to an association of the vaccine with fainting, generalized pain, difficulty walking and seizures.

Analysis of the cases by specialists, however, showed that there was no biological cause linked to the vaccine. They were psychogenic reactions, a phenomenon defined by the WHO as a set of symptoms that develop in response to stress (fear, anxiety) associated with vaccination and that result from a combination of biological, social and psychological factors.

“The most frequently observed adverse events in the different countries where this vaccine is applied are pain at the application site, inflammation, fever, some gastric discomfort and diarrhea. There is no record of death”, clarifies Martins.

As a way of changing the picture, the ministry’s report points out strategies such as intensifying campaigns; monitor fake news and present content in clear language; train health workers and offer alternative schedules in immunization rooms.

“We have an excellent vaccine and it is offered for free. We have no excuse to continue seeing cases of cervical cancer in the next generations”, emphasizes the researcher.