According to the Ministry of Health, the National Vaccination Campaign against the flu is expected to start in the first half of April across the country. Brazilians will be immunized free of charge with an updated version of the trivalent vaccine, which protects against two strains of the influenza A virus and one of the B.
However, in the private network, the option of quadrivalent immunizers is offered, which contains one more strain of influenza B, offering additional protection. The average price of the injection ranges from R$ 80 to R$ 130.
As of April, private clinics will also have Efluelda, a vaccine manufactured by the pharmaceutical company Sanofi, aimed at the population aged 60 years and over. The formula has four times more antigen compared to standard dose quadrivalent vaccines and is 24% more effective for the elderly compared to the standard vaccine. The option against influenza will hit the market for approximately R$ 162.
But if there are free immunizers in the Unified Health System (SUS), is it worth paying to get the flu vaccine in the private network? The director of the Brazilian Society of Immunizations (SBIM) in São Paulo Regional, Melissa Palmieri, believes so. “Whoever can take it will have an amplification of protection”, she says.
According to the SBIM, two aspects make additional protection especially important: the co-circulation of the two strains of influenza B in the same season, observed worldwide since 2000, and the history of the strain of influenza B contained in the trivalent vaccine not to have been predominant in 50% of flu seasons.
The infectologist considers that anyone who is unable to disburse the amount should be vaccinated in the Unified Health System (SUS), since the trivalent option, manufactured by the Butantan Institute, also offers protection against the disease.
“By vaccinating, people with comorbidities or who are immunosuppressed protect themselves from the occurrence of an acute illness, and prevent secondary complications related to infection and the worsening of chronic conditions,” says Melissa.
Difference between vaccines
All influenza vaccines in use in Brazil are manufactured with inactivated (dead) viruses, which are not capable of causing disease.
The trivalent option, offered by SUS, contains an A/H1N1, an A/H3N2 and a B strain of the Victoria lineage. The standard quadrivalent – available privately – contains all the viruses present in the trivalent plus a B strain of the Yamagata lineage. Both are intended for the general population, aged from 6 months.
“The composition of the influenza vaccine is revised every year, following the guidance of the World Health Organization (WHO), according to the strains of the virus that most circulated in the Northern and Southern hemispheres”, informs the Ministry of Health.
Efluelda, on the other hand, increases the immune system response of the elderly to the vaccine, particularly against the influenza A (H3N2) virus, which is more common and severe in this part of the population. It has a prescription in the package insert only for the public aged 60 or over.
“This group traditionally responds less to vaccines, compared to the others. The new technology places four times more antigen in relation to the standard dose and the elderly person produces a better response with increased effectiveness”, explains Melissa.
Will SUS offer the quadrivalent vaccine?
Not for the time being. But the trend is that in the coming years only quadrivalent vaccines will be produced. “As happened in the past, monovalent vaccines were replaced by bivalents, and bivalents by trivalents, according to epidemiology”, says SBIM, in a technical note.
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