Salta is the first province in the country to vaccinate against dengue as a public health policy. There are nearly 10 thousand doses that were distributed. “We have been an endemic area since 1997”; Adriana Jure, head of the Immunization program of the Ministry of Health, contextualized. The disease that was already part of local epidemiological records reached the entire country and is now also national news. However, the new national authorities marked a position that little by little spreads towards even health professionals: questioning the effectiveness of the vaccine. Jure assured that a lot of misinformation circulates through the networks and stressed that its effectiveness is assured. In that order, she indicated, those most willing to apply it are those who “already experienced the disease and had a very bad time.”
Regarding records, Salta reached 6 thousand confirmed cases, although Jure assured that about 30% of the cases are registered since they are the ones that go to the health system. While the rest usually go through it “with mild symptoms.” That is to say, there are many more infections than the patients who are overwhelming hospitals and clinics today.
How is the application of the vaccine developed?
We have been applying it based on a strategic plan that took into account how dengue developed in the most affected departments, the incidence and historical evolution. With recommendations from the CONAI (National Commission on Immunizations) the age is decided. It began with the northern departments: San Martín, Orán and Rivadavia and later the towns of Los Toldos and Islas de Cañas were added. The age is from 25 to 39 years of age, which are the ones with the highest incidence, the most affected. The vaccine is the only one that is available from Takeda Qdenga with the two-dose schedule, later. Anta will continue in that plan. The start of vaccination is for the most vulnerable population; at the same time, progress has been made recently with health personnel of the same age and later with security and education personnel.
The entire strategy is based on an integrated dengue control management strategy, where vaccination, and this following recommendations from the PAHO (Pan American Health Organization), becomes a tool that adds to the integrated control management of dengue. dengue that is related to epidemiological surveillance. A clarification is that those vaccinated must also take care of themselves.
Will it be applied in Capital?
It is not contemplated in this operational plan. The operational plan has the strategy of placing people from the northern zone, since they probably had dengue at some point in their lives. Dengue began in 1997. The first records of dengue are from that year and we would have better effectiveness.
How many doses were given?
We started with one action per shift, estimating a high demand, but vaccines are already being vaccinated on free demand within the age group and with health agents also in the population they assist. That allowed us to move forward. We have distributed about 10 thousand doses and they are being applied. Then there is another precaution, that people who had dengue have to wait approximately 6 months for it to be effective or effective. In many cases there are people who have recently had dengue, and it would be ineffective to administer it, because it stops the effect, the vaccine covers the 4 serotypes, but when one has dengue, it gives immunity to the serotype that was contracted. For example, if I acquired serotype 1, I would acquire immunity to that type. That is to say, there are 4 types of serotypes, I can get sick up to four times from dengue.
Was there an opening for the application?
We are talking about a population that young people are the most difficult to vaccinate, and there was a good response, mainly in those who had dengue and who had a bad time.
For whom is the vaccine approved?
Since November of last year, it has been approved for people 4 years and older, with some contraindications, in pregnancy, lactation, and immunocompromising diseases.
What is approved is the efficacy and it is approved, and the safety. Anmat approves it from 4 years old onwards, and the WHO recommendation is based on a public health strategy: vaccinations for people from 6 to 16 years old, but considering the countries that have the greatest problem in that age group. But in our region the highest incidence is among young adults.
When a vaccine or medication comes out for use, what is demonstrated in studies is its effectiveness; it may then be more or less than what has been demonstrated. The effectiveness of a vaccine is seen when you apply it en masse in the real world. We can have a vaccine that says that the effectiveness will be such a percentage, but then the effectiveness, when applied massively, can be greater.
Why do you think it is questioned?
More than the debate of efficacy or effectiveness, it seems to me that what is being debated at a macro level is a public health strategy, and here the Province is very focused on the decision that was made to start as one of the places that historically We have dengue, it is not a random, capricious strategy.
Is there misinformation or intentionality?
What is done in public health is based on evidence, for better or worse, we all have access to information, some is good and others not so good. Suddenly audios circulate where people speak very severely and people can believe, and the immune system is so complex that more and more is known. Sometimes these issues that are published, I wish they were as simple as some audios that say “if you do this you won’t get infected.” The greatest strategies eradicated diseases that younger people today don’t even know about. Although now with measles we have a high risk, due to not getting vaccinated, due to low coverage in different parts of the world, and that has an impact.
Now a super important vaccine has been approved, since March 1st, the one for the respiratory syncytial virus that causes bronchiolitis, it is for pregnant women. We are not only working with dengue, but we are also preparing for winter. In Salta alone, 18 thousand cases of bronchitis were registered per year, where the respiratory syncytial virus is the main one.
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Mainly, you have to prevent, if you have dengue, drink plenty of fluids and pay attention to the warning signs. A person who has a fever, the first few days is when the mosquito bites that person and acquires the virus. A person who goes through the first days does have to be, in some way, careful so that they do not get bitten. He must use repellents. People who live with the patient should also be careful not to be bitten by mosquitoes.
When does bleeding occur?
Today we no longer divide the classification into hemorrhagic dengue, but rather into mild or severe dengue, because there are many forms of complications. The most important thing to know is when to be alert and when to go quickly to the consultation. We know that a good part of dengue cases, around 70 or up to 75% of cases, may have dengue with mild symptoms, headache or muscle pain because it may be associated with physical activity. But there are 30% of those who have symptoms and are those who are reliably diagnosed, and among them a percentage is serious, which is lower.
2024-03-29 04:54:00
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