EPIDEMIOLOGICAL BULLETIN (01/06/2020)
Vaccination Bulletin: February to March 2021
On February 16, 2021, the Special Indigenous Health District of Maranhão (DSEI / MA), linked to the Special Secretariat for Indigenous Health (SESAI), released data on the vaccination of indigenous people over 18 and indigenous health professionals against Covid-19 in the state. The Bulletin contained data such as: total vaccinations requested (18,951), total doses applied (9,036) and number of refusals (5,365). This same bulletin brought vaccination data by poles, such as Amarante, Arame, Barra do Corda, Bom Jesus das Selvas, Grajaú, Krikati, Santa Inês, Viana and Zé Doca, in addition to applications at the Casas de Saúde Indígena (CASAI) in São Luís , Imperatriz and Teresina. This bulletin also contains the percentage of the number of vaccines applied in relation to the number of doses requested (48%) and the percentage of refusals in relation to the population quantity (28%).
Two days after the release of this first bulletin on February 16, a second bulletin was circulated, dated February 18, 2021. In it, the number of vaccines requested, which was 18,000, nine hundred and fifty-one (18,951 ) on the 16th, it reduces to eighteen thousand, nine hundred and nineteen (18,919). This reduction is noticeable in the number of doses requested in Zé Doca (dropped from 903 to 881) and in Casai São Luís (dropped from 110 to 100), totaling 32 doses requested less between the first and the second bulletin. We were unable to identify the reasons for this reduction in all the situations listed above. However, with regard to CASAI, we believe that the fluctuating length of stay of indigenous patients in this location may be one of the possible causes of the reduction.
In this same bulletin of February 18, the number of doses taken increases to nine thousand, one hundred and forty-seven (9,147), one hundred and eleven (111) doses more than the numbers of the bulletin of February 16 (9,036) and the number of refusals remains the same (5,365). An important data of this second bulletin are the numbers of the application of the second dose, which account for 23%. At first, we could say that the quantity of 111 doses more would correspond only to the number of applications of the second dose, since the percentage of the first dose remains at 48%, as in the February 16 bulletin. However, we will see in Table 1, shown below, with yellow highlights, that there was a small increase in the application of the first dose in the centers of Amarante (from 31 to 33%), Krikati (from 40 to 41%) and in Zé Doca (from 62 to 67%). If the DSEI registers an increase in the numbers of the first dose, how can it be explained, then, the permanence of applications referring to that dose in 48%?
At Casai São Luís and Casai Teresina, with red highlights, there is a reduction in the percentage of the first dose, which may imply a new update of the data based on the hypothesis that we raised above, about the floating time of indigenous patients in these places , justifying the reduction.
It is also interesting to highlight the presence of Viana among the poles presented. Viana, in this case, contemplates the Akroá Gamella, who are in the process of fighting for the recognition and retaking of their territories, being characterized as “people not inhabited” by the DSEI-MA. Throughout 2020, the Gamella stood out in the process of struggle and resistance, along with other peoples in the state (Anaparu Muypurá, Cariri, Tremembé da Raposa, Tremembé do Engenho and Tupinambá), to be assisted by the indigenous health agency in treatment against Covid-19, which refused support on the grounds that people in non-demarcated territories and in an urban context are not the responsibility of DSEI-MA / SESAI. In 2021, the struggle process of these peoples also converged towards their inclusion in the national immunization plan as priority groups.
We also highlight that the format of the two bulletins presented above (16 and 18/02), although it does not present the data in a specific and differentiated way, by people or territory, brought the number of refusals and applications separately by pole. However, we chose to record with gray highlights, in the table above, the percentage of those immunized (1st and 2nd doses already applied). The analysis of the number of refusals and applications by centers that appear in the bulletins mentioned above, will be done at another time, together with the qualification of the people who are assisted by these centers.
The bulletins that were published in the sequence, after the bulletins of February 16 and 18, have a smaller format called a vaccinometer, which date from February 23 and 26, and March 5 and 16, 2021. We were unable to identify them the numbers by poles, only the percentage and quantity of doses applied, be it the first or second dose. Only in the first vaccinometer, on February 23, is there information on a total number of indigenous people over 18 years old and indigenous health professionals who want to be immunized (18,929). This number implies a total of ten more than the number of vaccines requested in the February 18 bulletin (18,919), which we have highlighted above. Let's look at the numbers of the vaccinometers.
If we compare the evolution of vaccination between 16 (first bulletin with a broader format) and February 26 (vaccinometer), an interval of ten days, we have an increase from 48% to 55%, with more than 1,200 first doses. In this same interstice, the percentage of application of the second dose is more than double, from 23% to 50%, implying the immunization of more than five thousand indigenous people and health professionals. In a month of vaccination, from February 16 to March 16, more than 2,600 first doses were performed (from 9,036 doses to 11,657), with a total of 7,319 indigenous people who have had both doses of the vaccine so far and are immunized .
On March 23, we had access to a new bulletin in a wider format than vaccinometers, which brings the total number of 1st and 2nd doses applied in general and by pole, in addition to the total number of refusals. The bulletin presents a total of twelve thousand and thirty-two (12,032) first doses applied (62%) and seven thousand, nine hundred and forty-eight (7,948) second doses (66%). The number of refusals decreased by 32%, from five thousand, three hundred and sixty-five (5,365), which represented 28% of the total in the first bulletin of February 16, to three thousand, six hundred and forty-eight (3,648) , in this latest bulletin, representing 19% of the total. We compared the latter (03/23) with the bulletin of 02/18, when the percentage of the second doses applied were disclosed for the first time. In this comparison, we can also identify the number of refusals, being able to assess, by pole, where there was a reduction or increase.
In the chart below, we can follow the immunization process between February 16 and March 23, 2021.
In view of the current scenario of the Covid-19 pandemic in the country, which is going through the worst phase since the first case of contamination in March 2020, continuing to make the health situation of indigenous peoples in the state visible and mapping the Covid-19 pandemic continues being a challenge. In a context of dissemination of fake news and denials that have reached the indigenous people and made it impossible to immunize the different peoples spread across the state, with a very high number of refusals, present the vaccination data and invest in their publication, in a specific and differentiated way. , is synonymous with love and appreciation of life.