Vaccines of the national vaccination program The national vaccination program (PNV) is financed by the Portuguese state and establishes vaccines and the vaccination schedule for the entire population from birth. PNV vaccines are free and vaccination is a duty of all citizens. Currently, PNV incluedes vaccines against: Diphtheria; Invasive disease by Haemophilus influenzae type b; Invasive disease by Neisseria meningitidis B and C; Hepatitis B; Streptococcus pneumoniae infections; Epidemic mumps; Polio; Rubella; Measles; Tetanus; Whooping cough; Human papilloma virus (HPV). For some years now, vaccination against tuberculosis (BCG) is indicated only to groups at risk. Since October 1 2020 vaccine against acute rotavirus gastroenteritis is also available for risk groups. New vaccines in the PNV in 2020 The PNV is not static, changes are introduced whenever justified. Since October 1, 2020, the PNV includes the following 3 new vaccines: Vacinne against Neisseria meningitidis serogroup B (vaccine MenB) Is available in the PNV for all children born from January 1, 2019, and the vaccination schedule can be started or completed, according to the individual vaccination history. For children born before January 1, 2019, vaccination with Bexsero® or Trumenba® does not belong to the PNV. This vaccine protects against meningococcal invasive disease, including meningitis caused by the bacterium Neisseria meningitidis serogroup B. The transmission of this disease is made person to person from the respiratory secretions of a patient or carrier. Most cases of Neisseria meningitidis meningitis occur in winter and spring, in infants and adolescents. Vaccine against human papilloma virus (vaccine HPV) in boys Vaccination against infections by human papilloma virus (HPV) is now available in the PNV for boys born after January 1, 2009. The vaccine protects globally and indirectly against cervical cancer in the female gender, but also against ano-genital conditions, genital precancerous lesions and cancer of the anus in both genders. HPV is considered the second most important carcinogen after tobacco. It is associated with 4.5% of cancers (8.6% in women and 0.8% in men) and it is estimated that there are about 630 thousand new cases per year in the world. Vaccine against acute rotavirus gastroenteritis (vaccine Rota) Extension of vaccination against acute rotavirus gastroenteritis in groups at risk defined by the Direção Geral da Saúde. Acute gastroenteritis is a very common disease in the first 2 years of life. Most often it has a viral cause and, in temperate countries, rotavirus is the most important agent. In developed countries, most cases of acute rotavirus gastroenteritis do not require hospitalization, but this disease has an important impact on public health. Vaccines not included in the PNV There is another group of vaccines, commonly referred to as vaccines not included in the national vaccination program or extra-PNV vaccines , which physicians, most often pediatricians or general practitioners, also indicate following the recommendations of the vaccine commission of the Sociedade de Infecciologia Pediátrica of the Sociedade Portuguesa de Pediatria, based on scientific knowledge and the epidemiological characteristics of diseases in our country. Extra-PNV vaccines are not free, some may be reimbursed. The main vaccines that are not part of the national vaccination program and that can be recommended by pediatricians are: Vaccine against the varicella zoster virus that causes chickenpox Chickenpox is a highly contagious disease. In unvaccinated populations, it is mainly a disease of childhood and is generally benign. However, serious complications can occur, particularly when it is complicated by a bacterial infection. In addition, serious complications are more common in adolescents, adults and immunocompromised people. The most frequent indications for vaccination with Varilrix® or Varivax® are adolescents with no previous history of the disease, children with atopic eczema, children who are usually in contact with immunosuppressed patients or who are proposed for immunosuppressive treatment. Hepatitis A virus vaccine Hepatitis A is an acute infection of the liver caused by the hepatitis A virus, which is a picornavirus. In children, the disease is often asymptomatic and liver failure is rare. However, in adults and some risk groups, the disease can have significant morbidity and mortality. Transmission of the hepatitis A virus is mainly by oral contact with faeces (fecal-oral route), so improving sanitary conditions and hygiene practices significantly reduces the number of cases. Currently, Portugal is considered a country of very low endemicity. Physicians usually recommend vaccination with Havrix® 720 Junior (GSK) or Vaqta® (MSD) between 12 months and 17 years of age when there is close contact with patients with hepatitis A, to adolescents with risky behaviors for disease transmission, to travelers to countries where the disease is epidemiologically important and in specific disease cases and circumstances. Vaccine against Neisseria meningitidis serogroups ACWY Infection with Neisseria meningitidis from serogroups Y and W has increased in Europe, so in addition to the recommendation for vaccination against Neisseria meningitidis from serogroups ACWY (with Nimenrix® or MenVeo® vaccines) to travelers to countries at risk and to risk groups (patients with sickle cell anemia, splenectomized or immunodepressed), it can be proposed individually to any child in the plans provided. For children born before January 1, 2019, vaccination with Bexsero® or Trumenba® does not belong to the PNV as of October 1, 2020. Vaccine against acute rotavirus gastroenteritis This vaccine is included in the PNV from October 1, 2020, but only for risk groups defined by the Direção Geral da Saúde. In other circumstances, physicians may recommend vaccinating children with RotaTeq® or Rotarix®, being mainly indicated for children to whom is expected in the first 2 years of life a regular contact with other children (in day care center). Vaccine against human papilloma virus in boys For boys born before January 1, 2009, Gardasil 9® vaccination continues to not belong to the PNV. Author : Marta Cabral Meet the Pediatrics team of Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
