Discover how they navigate rural rivers and bustling cities to reach those who need them most.
The efforts of health workers like Souza are particularly important at this time. Since 2015, vaccination coverage for children in Brazil under the age of 5 has been falling. That’s placing children at much greater risk of vaccine-preventable diseases like polio and measles. During the COVID-19 pandemic, the situation got worse. Families faced additional challenges when it came to accessing public health services and an increase in vaccine hesitancy has also been a factor. However, the country is showing some encouraging signs.
National coverage for the measles vaccine went from 73 per cent coverage in 2021 to 81 per cent coverage in 2022. That’s still short of the 91 per cent coverage mark that was achieved in 2019, prior to the COVID-19 pandemic.
On average, across different routine vaccines, Brazil is bouncing back and recovering The situation in Brazil reflects some of the trends that we’re seeing globally when it comes to making sure that children are protected from potentially deadly diseases with the routine immunizations they need to live healthy lives.
New data from UNICEF and WHO reveals that after the largest sustained decline in routine immunization in a generation – largely due to the COVID-19 pandemic – there are some signs of recovery. But the recovery is uneven. In a few countries, immunization rates are on the rise, but in most nations, particularly low-middle- and low-income countries, the rates are either stagnating or even worse, they continue to decline.
According to the new data, regions of Southeast Asia and the Eastern Mediterranean are experiencing resilient recoveries. But in parts of the Americas, which had experienced long standing declines in vaccine coverage prior to the pandemic, that trend has continued.
Reaching children in the city that’s the gateway to the Amazon rainforest
The latest global data reveals that during 2022 there were some positive trends, including a 2.5 million reduction in the number of zero-dose children worldwide. A zero-dose child is one that has not received a single dose of a diphtheria, tetanus, pertussis vaccine. But the reality is that about one in five children are still zero-dose or under-vaccinated, meaning that they’ve missed out entirely or partially on routine immunization. Those are levels we’ve not seen since 2008.
Reaching those children requires the development of vaccination campaigns and strategies that are unique to the circumstances facing specific communities. That’s the case in the city of Manaus, which lies on the banks of the Negro River in northwestern Brazil. The city is the capital of the vast rainforest state of Amazonas and while the city itself has a population of more than 2 million, it’s surrounded by incredibly remote areas. Therefore, reaching children with vaccines requires different approaches and creative modes of transport.
In addition to the field visits, which sees her traversing the waterways by canoe, Lindalva de Freitas also provides services at the Lago do Aleixo Health Unit in Manaus, where she’s worked for more than 20 years.
Health workers from that same facility have been providing care to 4-year-old Gabriel de Oliveira. When Gabriel was a baby, he was orphaned along with his brothers Kauan, 10, and Kennedy, 5. The three boys had no medical records at the time, and no vaccinations. Their grandmother, Elmira de Oliveira, took care of the boys, and for her, accessing health care for her grandchildren was paramount.
With these children vaccinated, they’re offered protection against dangerous diseases like measles, polio and diphtheria that were previously controlled but have recently been reemerging in different parts of the world.
We know that vaccines are the best way to protect every child against more disease outbreaks, epidemics and pandemics, so a continued, concerted effort globally to address the declines that have been witnessed in vaccination coverage worldwide is absolutely paramount.
Hard-to-reach riverside communities in Abaetetuba are getting access to essential health care services
The Active Vaccination Search initiative has also been operating in the municipality of Abaetetuba, in northern Brazil, which is formed by 72 islands.
Childhood immunization is starting to recover and this is what needs to happen next
Immunization initiatives like the Active Vaccination Search project in Brazil highlight how important it is moving forward that governments of countries that have been particularly affected by the decline of immunization rates among children continue to focus on the following:
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Repurpose available financial resources to increase vaccination rates, including leftover COVID-19 funds
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Renumerate and support community health workers as an essential step in reaching under-vaccinated and zero-dose children, preventing more catastrophic disease outbreaks
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Restore immunization services and catch-up the children who missed out on their routine vaccinations during the COVID-19 pandemic
By taking these steps, we can reach those children in remote villages, urban slums and conflict zones that are so often overlooked, ensuring they’re given the chance they deserve to live healthy lives, protected with the vaccines they need to thrive.
Read the photo story here.