Ageism in the dengue vaccine

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By MAURÍCIO VIEIRA MARTINS*

The leaflet for the most recent dengue vaccine prescribes it only for individuals aged 4 to 60 years.

From the final third of the 20th century onwards, news began to circulate with greater intensity regarding contemporary Japan's lack of appreciation for its older population (a trend that, in fact, follows the well-known previous steps of countless other capitalist societies).

Contrary to a widespread image in the West – that the Japanese maintain an unshakable respectful relationship towards the older population –, the press reported, for example, the increase in the percentage of Japanese elderly people who steal small objects and medicines from stores. and pharmacies. What draws attention to these illicit acts is the fact that their practitioners, instead of trying to hide them, explicitly seek to cause their own imprisonment.[I]

Interviewed by journalists, they claim that within prison bars they will be able to get at least three meals a day, a possibility that is made difficult for them by the extremely low value of their pensions paid by the State. Along with imprisonment, suicide rates have also increased in this segment of the population, who feel ashamed of being a burden to their children.[ii]

Such carelessness towards the older population now presents a new, equally worrying face, related to access to health services. Anyone willing to read the leaflet for the most recent dengue vaccine will see that the Japanese laboratory responsible for its production prescribes it only for individuals aged 04 to 60.[iii] The fact is even more surprising when one takes into account that in Japan the rate of inhabitants aged 65 or over is the highest in the world (29,1%). But is this vaccine age restriction due to a supposed immunity of the older population to the dengue virus?

Far from it. Statistics show that this is precisely the segment where dengue fever manifests itself with greater virulence and generates the highest number of hospitalizations.[iv], making the ageism that excludes older people from vaccination protection a priori evident. It can always be said that the concept of “immunological bridge” – used to expand the limits of the age group originally tested by the vaccine – would not allow it to be extrapolated to the highest age groups in the population. But what this brief piece of writing aims to make transparent is that the decision not to investigate the viability of a particular immunizer for the elderly population falls within a much broader social and ideological context.

A context that relegates the elderly, to use the words of sociologist Zygmunt Bauman, to the condition of human waste,[v] which becomes added to the other categories of “failed consumers”, and as such does not deserve the attention of the public authorities.

Furthermore, we have as an example of contrast the recent Covid 19 pandemic, when different vaccines were also studied for the older population. Even laboratories operating in the United States and England – countries strongly aligned with the values ​​of neoliberalism, with their refusal of universal policies – announced broad age coverage for their vaccines. And, in the vaccination schedule to be followed, it was precisely the older age group that deserved special attention, for the obvious reason that deaths were higher in them. This measure saved the lives of significant populations.

With regard to Brazil, documents produced by the Federal Senate already predict the possibility of Brazil facing “in 2024 the worst dengue epidemic in history”[vi], recording that in the first 45 days of this year alone, 524 thousand sick people were recorded. As for positive news, the Butantan Institute[vii] admits the possibility that its dengue vaccine could be used in 2025[viii], apparently with some advances in relation to those currently available on the market (such as the application in just a single dose, and the promise of the formation of protective antibodies in a more balanced way against the four serotypes of the virus).

It is to be expected that the Butantan Institute will honor its traditions of social inclusion, also promoting research among the older population, so that they can have access to vaccination protection that in some cases will guarantee their own life. Otherwise, this illustrious Institute will engrave in its institutional biography the sin of having refused to expand its immunizations to the most fragile population stratum due to simultaneously biological and social injunctions.

*Mauricio Vieira Martins He is a senior professor at the Department of Sociology and Methodology of Social Sciences at UFF. Author, among other books, of Marx, Spinoza and Darwin: materialism, subjectivity and critique of religion (Palgrave macmillan).

Notes


[I] BBC Brasil – “Retirees in jail: the elderly Japanese who struggle to be arrested”. Available in: https://www.bbc.com/portuguese/geral-47086935

[ii] In fact, it is possible to go back countless decades to see this specific change in customs in Japanese society. Just as an example: in 1953, filmmaker Yasujiro Ozu released his classic Once Upon a Time in Tokyo (Tōkyō Monogatari): in this film, we follow the story of an elderly Japanese couple who decide to visit their adult children in Tokyo. But the visit turns into a bitter frustration: the children no longer have time to pay attention to their parents, causing the latter to anticipate their return to their hometown.

[iii]https://assets-dam.takeda.com/image/upload/v1688371996/legacy-dotcom/siteassets/pt-br/home/what-we-do/produtos/Qdenga_Bula_Profissional.pdf

[iv] https://agenciabrasil.ebc.com.br/saude/noticia/2024-02/casos-provaveis-de-dengue-se-aproximam-de-400-mil-no-pais-em-2024

[v] Bauman, Zygmunt. Wasted lives. Rio de Janeiro: Jorge Zahar, 2005.

[vi] https://www12.senado.leg.br/noticias/infomaterias/2024/02/dengue-clima-agua-parada-e-falhas-do-poder-publico-causaram-explosao-de-casos#:~:text=Tudo%20indica%20que%20o%20Brasil,mil%20infec%C3%A7%C3%B5es%20a%20cada%20dia.

[vii] https://butantan.gov.br/noticias/vacina-da-dengue-do-butantan-tem-eficacia-%E2%80%9Cmuito-satisfatoria%E2%80%9D-mas-ainda-esta-em-desenvolvimento-e-precisa-de-aprovacao-da-anvisa

[viii] https://g1.globo.com/saude/noticia/2024/02/01/vacina-do-butantan-contra-dengue-e-eficaz-e-deve-ser-enviada-a-anvisa-neste-ano-uso-pode-comecar-em-2025.ghtml


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