Recommends That The Government Study The Possibility Of Including In The National Vaccination Plan Of Pneumococcal Or, Alternatively, Your Participation At Least At Step C

Original Language Title: Recomenda ao Governo que estude a possibilidade da inclusão no Plano Nacional de Vacinação da vacina pneumocócica ou, em alternativa, a sua comparticipação, no mínimo, pelo escalão C

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Parliamentary Group 1 Group DRAFT resolution No. 59/XI/1st Recommends the Government to study the possibility of including in the National vaccination Plan of pneumococcal or, Alternatively, your participation at least at grade C.
I-infant mortality is one of the main indicators of the development and well-being of a society. Portugal met in recent decades, an improvement in the indicators of infant mortality and neo-natal having, today, one of the lowest rates in the world. In 1970, died 53 live births in every 1,000 before reaching 1 year old and 62 before reaching five. For two decades, died 24 in every 1,000 live births before reaching 1 year of life. Currently, the rate stands at 3.3 per 1,000. Between 2004 and 2006 the mortality rate in Continental Portugal decreased 13.2%. For infant mortality and neo-contribute several factors, especially the bad conditions, malnutrition and newborn infectious diseases. Between us, the improvement of the indicators was the result of a combination between a 9-year plan started in 80 years, with the creation of the network of health centers, specialized transportation of newborns and the rise in vaccination rates. This development must, however, continue and we should accommodate to the results achieved. Only the constant pursuit of progress and the refusal of immobility achieve and maintain excellence. Will never be too much the principle contained in the National vaccination Plan, according to which "vaccines make it possible to save more lives and prevent more cases of disease than any medical treatment". Also the Portal of health states that "vaccines are the most effective and safe against certain diseases. Even when it's not total immunity, who are vaccinated have greater resilience in the event of the disease arise ". II-exists in the Portuguese market, since June 2001, a Pneumococcal conjugate Valances, seven "indicated for the active immunization of infants and children against invasive disease caused by Streptococcus Pneumoniae1". The vaccine, with the brand name Prevnar, "aims at the prevention of invasive disease (bacteremia, septicemia, otitis, pneumonia, bacteriémica) in particular, and meningitis caused by Streptococcus Pneumoniae."
1 source: Infarmed Infarmed Information Circular 2 033/CA Preferably should "be applied to the 3, 5 and 7 months of age and, after the 12 months, two doses with two months apart. 2" features serovars 4, 6B, 9V, 14, 18 c, 19F and 23F. It should be noted that the Streptococcus Pneumoniae is a bacterium responsible for most severe form of meningitis. The World Health Organization (who) recommends that the countries that include this vaccine in their national immunization plans. In 2006, the who declared that the application of this vaccine in the U.S. led to an exceptional fall in rates of pneumococcal diseases, including along the population immunized, because preventing limits the General contagion as well. In tests conducted in South Africa, there has been a reduction of 83% in the incidence of invasive disease caused by serotypes covered by Prevnar. 3 These indications of who are in fact, the same document that recommends the application of the vaccine against the human papilloma virus, more commonly known as a vaccine against cervical cancer. Several years ago that pediatricians recommend the vaccine against invasive pneumococcal disease that affects both children and adults. There are many elderly deaths resulting from contact with infected children. According to INE, in 2005 4,648 people died due to pneumonia, septicaemia and 825 due to 45, especially children with meningitis. The study group of Invasive Pneumococcal Disease (DIP) conducted a study pioneer in 28 hospitals. Identified 375 children with ILD: 196 came to have meningitis, pneumonia with bacteremia, 102 36 septicemia and 59 other diseases. Recalling also that in the long term, diseases due to pneumococcal bacteria can cause deafness, developmental delay, epilepsy and learning difficulties. On the occasion of the discussion of the amendments to the National vaccination Plan which came into force in 2006, the Portuguese society of Pediatrics suggested 3 updates: the introduction of the vaccine against meningitis, polio and vaccine Prevnar. This last was rejected. Prevnar has been on the market for about 75 euros each dose. Having regard to the dosage recommended by manufacturers, each child requires 4 doses to be immunized, making a charge of 300 euros for the family, did not receive any reimbursement from the State. III-in March 2008, the CDS-PP has submitted a draft resolution recommending the Government to adopt "measures to ensure equal access to the seven pneumococcal vaccine indicated for active immunization skills of infants and children. This initiative of the CDS-PP was rejected by the Socialist Party, on the grounds that was being prepared a new vaccine, with more skills and therefore made no sense include the heptavalent pneumococcal vaccine (Prevnar) in the National vaccination Plan.

2 source: the health Portal-Vaccination 3 source: Fact Sheet See WHO/289 3 very recently was put on the market a new Pneumococcal conjugate polissacárida (absorbed), with the trade name Synflorix. This vaccine has ten serotypes; three more than Prevnar-serovars 1, 5, and 7F. This vaccine is indicated for active immunization against invasive disease and acute otitis media (middle ear infection) caused by Streptococcus Pneumoniae in children aged between six weeks and two years of age. According to the European public assessment Report (EPAR), "the invasive disease occurs when bacteria spreads through the body, causing a serious infection, such as septicemia (blood infection), meningitis (infection of the membranes surrounding the brain and spinal cord) and pneumonia (lung infection)." Also according to the EPAR, "the Synflorix contains small amounts of polysaccharides (a type of sugar) extracted from the" Pod "which involves the bacterium of s. pneumoniae. These polysaccharides were purified and then "conjugated" (linked to) with a carrier that helps the immune system recognizes. The vaccine is also "adsorbed" (fixed) in an aluminum compound, to stimulate a better response.
The Synflorix contains polysaccharides of 10 different types of s. pneumoniae (serotypes 1, 4, 5, 6B, 7F, 9V, 14, 18 c, 19F and 23F). In Europe, it is estimated that these are responsible for about 90% of the 56 cases of invasive disease in children under the age of five years. " This vaccine is administered in four doses (three more booster) if the child was between 6 weeks and 6 months of age; in three doses (two doses more reinforcement) between 7 and 11 months of age; or two doses between 12 and 23 months of age. The vaccine is on the market for 57.48 euros each dose, which means for every household expenditure between EUR 114.96 (in the case of the child take only two doses) and EUR 229.92 (when are administered four doses), since it does not benefit from any reimbursement from the State. This value is obviously unobtainable to many budgets. Just remember that the national minimum wage for 2010 is EUR 475. IV – beyond the recent inclusion in the vaccine market of ten Valances is now made available a pneumococcal 13-Valances, with the trade name Prevnar 13. This new vaccine serotypes 1, 3 displays, 4, 5, 6A, 6B, 7F, 9V, 14, 18 c, 19A, 19F, and 23F, i.e. six serotypes than Prevnar and three more than the Synflorix. According to the experts, it is expected that, with the introduction of pneumococcal 13 Valances, between a period of stability in which pneumococcal vaccines concerned, not being predicted that in the next few years may arise any more. Thus, the pneumococcal 13 Valances brings, without doubt, a huge benefit to public health. The argument used by the Socialist Party to reject the previous initiative of the CDS-PP is therefore exceeded. The price of this new vaccine is of 75.99 euros not so far from the prices of the other vaccines available in the market. His administration must be made in three doses for children up to 2 years of age, another shot when the child reaches the age of 2 4. Now, the four make up a total of 303.96 euros. Once again, we are faced with a situation of social injustice, because prevention is still only available to households with more income, leaving out or excessively penalizing families with fewer resources. Each year are born in Portugal about 100,000 children and all should have to guarantee this immunization. To be included in the National vaccination Plan the application of vaccines becomes universal and free of charge to the public. With regard to the burden on the State, it is foreseeable that it will be possible to purchase about of 25% below RETAIL, bulk buying power. In addition to the obvious health and human advantages, the inclusion of the vaccine in the National immunization Plan, avoid NHS treatment costs later in the disease. You might want to also point out that the option for reimbursement of the vaccine would be an improvement of the situation of lawlessness existing, and that vaccines for less-lethal diseases such as influenza

and hepatitis a, are already subsidised by step C. Therefore, the Assembly of the Republic, in accordance with point (b)) of article 156 of the Constitution of the Portuguese Republic, decides to recommend to the Government:-to study the possibility of including in the National vaccination Plan of pneumococcal or, Alternatively, your participation at least at grade C.
Palácio de s. Bento, 14 January 2010.