The Ministry of Health had to urgently order 1,200 doses of diphtheria treatment from an international laboratory because of problems in the production of the raw material by Instituto Butantã, the only national manufacturer. The drop in serum stocks comes at a time when Venezuela is experiencing an outbreak of the disease and Brazil has recorded, in the last three years, successive declines in vaccine coverage rates.
Since the late 1990s, bacterial disease that mainly affects the tonsils, pharynx, larynx and nose, which may cause difficulty in breathing, did not require alertness. For the last five years, for example, there have been only 32 cases in the country.
The threat returned in 2016, when the crisis in Venezuela intensified and caused controlled diseases to reappear. After that, the neighboring country has already registered 1,688 cases and 284 deaths from the disease. At the same time, in Brazil, the coverage rate of the DTP vaccine, which protects against diphtheria, tetanus and whooping cough, fell from 95% to 80%.
With only 12 bottles in stock, the Ministry of Health began the process of buying the 1,200 ampoules through a partnership with the Pan American Health Organization (PAHO), which brokered the purchase with the international manufacturer. But the ampoules should only reach the country in the second semester.
According to Juarez Cunha, president of the Brazilian Immunization Society (SBIm), although the number of cases of diphtheria has not yet increased in the country, the situation is worrying. "The return of measles, with 10,000 cases last year in the Northern Region, showed us what can happen when vaccination coverage falls," he says.
The ministry said it reinforced the importance of routine vaccination with the states and offered all the vaccines of the national calendar to Venezuelans who arrive in Brazil along the border with Roraima. Asked about the problems in the production process, Instituto Butantã stated that it continues to provide the input for the requested cases, according to an agreement with the Ministry of Health, which provides that, although the entity is not in a position to produce all the demand can deliver phials directly to the on-demand states. Butantã also stressed that "it has been making efforts to expand its production to meet all the demand of the Ministry of Health and eventually even supply to other countries."
The diphtheria vaccination schedule should be done with three doses at 2, 4 and 6 months of age and two boosters (1 year, 3 months and 4 years). What many do not know, however, is that the immunizer requires reinforcements every ten years until the end of life. They are made with the double adult vaccine. "Few people will get these boosters. Most just find the vaccine when they are exposed to some risk and have to take the tetanus, which is given in the same vaccine," says Cunha. He explains that the vaccinated adults, who did not take the booster, are still partially protected, but not ideally.