Intended for healthcare professionals


Covid-19: Brazil is recording a fifth of all deaths of under 5s

BMJ 2022; 378 doi: (Published 01 July 2022) Cite this as: BMJ 2022;378:o1634
  1. Luke Taylor
  1. Bogotá

Covid-19 is killing on average two children under the age of 5 years each day in Brazil, a study by the children’s health observatory Observa Infância has found.1

The number of fatalities in the country equates to around one in every five deaths among under 5s worldwide.

Observa Infância researchers Cristiano and Patricia Boccolini studied data from Brazil’s national mortality information system and found that 599 children under 5 died from covid-19 in 2020.

That number rose to 840 in 2021, when SARS-CoV-2 infections surged, overwhelming hospitals, and the lethality of the disease increased. Almost half of those deaths were recorded in the north east of the country, one of Brazil’s poorest regions, where healthcare access is below the national standard and people have been hit hardest by covid-19.

The average of two under 5s dying from covid-19 each day has not dropped despite the rollout of vaccines, the researchers said. Brazil recorded a total of 291 deaths from covid-19 in children under 5 between 1 January and 13 June this year, show preliminary data released by the epidemiological bulletin of the Ministry of Health.

The deaths recorded by the researchers included all those in which covid-19 was listed as either the underlying cause of death or where it was a cause exacerbating a pre-existing condition.

A breakdown of the data showed that the youngest children—aged 29 days to 1 year—were the most vulnerable. That age group makes up nearly half of all the deaths in the young children studied.

“It takes speed to bring vaccine protection to babies and children, especially (when they are aged) from 6 months to 3 years,” Patricia Boccolini said. “Every day that we go without a vaccine against covid-19 for children under 5, Brazil loses two children.”

Brazil began vaccinating children aged 5-11 in January this year but does not administer them to younger age groups.2

The country has reported more than 32 million covid infections and 671 000 deaths to date— the second highest tally after the US.

Not all countries report data on covid related deaths broken down by age group, but data collected by Unicef ​​in 91 countries show that as of June 2022 covid-19 was the underlying cause of death in 5376 children under 5 years of age worldwide.

Brazil accounts for about a fifth of those deaths and is the latest example of how the covid-19 pandemic has hit poorer nations hardest.

A review study published in BMJ Global Health last month found that a 20 year old was nearly three times as likely to die early on in the pandemic in a low or middle income country than in a high income nation.3

The higher fatality rates in low income countries is likely to be due to worse access to good quality healthcare, the authors concluded. The unequal impact of covid-19 along wealth lines may not have reduced, as so far only 14% of people in low income countries have been fully vaccinated against covid-19, which compares with around 76% in high income nations.

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