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LETTER TO THE EDITOR • An. Acad. Bras. Ciênc. 95 (suppl 1) • 2023 • https://doi.org/10.1590/0001-3765202320220924 linkcopy

Open-access Vaccines such as the MMR (Measles-Mumps-Rubella) against COVID-19 in Brazil: a missed chance?

AuthorshipSCIMAGO INSTITUTIONS RANKINGS

    On 19 June 2020 a publication in mBio, by the American Society for Microbiology, suggested that the (Measles, Mumps and Rubella) MMR and polio vaccines could activate non-specific defence cells of the innate immune system, even against the current coronavirus. In addition, the polio and MMR vaccines have been associated with reduced mortality from influenza (Fidel & Noverr 2020). The use of the MMR vaccine against COVID-19 would be justified due to its potential for efficacy in adults (Kolla et al. 2022, Taheri Soodejani et al. 2021, Chumakov et al. 2021, Gold 2020). In this context, evidence of a reduced risk of COVID-19 in adults by using the flu vaccine has been reported by Tayar et al. (2022).

    In July 2020 a Brazilian clinical trial began to test the effectiveness of the MMR vaccine in reducing the severity of COVID-19 at the Teaching Hospital of the Federal University of Santa Catarina (Fedrizzi 2021). A short time later, in January 2021, a technical note was published, showing a 54% reduction in the chance of symptomatic COVID-19 and a 74% reduction in the chance of hospitalisation (FAPESC 2021). In September 2021 these preliminary outcomes were updated: ‘Participants in the MMR group, compared with those in the placebo group, had a 48% risk reduction in symptomatic COVID-19 (RR = 0.52; 95% CI: 0.33 – 0.83; p = 0.004) and a 76% risk reduction in COVID-19 treatment (RR = 0.24; 95% CI: 0.06 – 0.88; p = 0.020) with one dose, and a 51% risk reduction in COVID-19 symptoms (RR = 0.49; 95% CI: 0.31 – 0.78; p = 0.001) and a 78% risk reduction in COVID-19 treatment (RR = 0.22; 95% CI: 0.06 – 0.82; p = 0.015) with two doses’ (Fedrizzi et al. 2021).

    On 01 February 2021, the month following the release of that same technical note (FAPESC 2021), Brazil reached the number of 1.4 million people aged ≥ 20 and ≤ 59 years old vaccinated against COVID-19, out of an estimated 107 million. However, from October 2020 to May 2021, a period in which Brazil experienced its peak in deaths from COVID-19 (Brazil 2022), the Brazilian Federal Government, mainly through the Ministry of Health, prescribed ‘early treatment’ anchored in (hydroxy)chloroquine. In the fight against the current pandemic this measure was maintained even after several clinical trials had demonstrated the ineffectiveness of ‘early treatment’ in preventing infection or inhibiting severe symptoms of COVID-19, while increasing side effects.

    Therefore, more resources (direct and large-scale investment, through public funding grants) were not allocated to promising initiatives, such as those coordinated by Fedrizzi (2021), which illustrates the possible loss of a therapeutic opportunity. This immoral fact contradicts Article 196 of the Brazilian Constitution by not fully striving to ‘reduce the risk’ of an infectious disease pandemic (Brazil 1988). The Brazilian society’s poor support for studies capable of evaluating the MMR or influenza vaccines as possible protective factors against COVID-19 may have caused, within the margins of the Federal Constitution of Brazil, a deficit of effectiveness in public management and epidemiological control of the current pandemic, thus preventing a decrease in the corresponding hospital admissions.

    ACKNOWLEDGMENTS

    This study had the support of the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior — Brasil (CAPES) — Code 001.

    REFERENCES

    • BRAZIL. 1988. Constitution of the Federative Republic of Brazil. Presidency of the Republic. Available: http://www.planalto.gov.br/ccivil_03/constituicao/constituicao.htm
      » http://www.planalto.gov.br/ccivil_03/constituicao/constituicao.htm
    • BRAZIL. 2022. Coronavirus Panel. DataSUS-SVS/MS. Available: https://covid.saude.gov.br/
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    • Chumakov K ET AL. 2021. Old vaccines for new infections: Exploiting innate immunity to control COVID-19 and prevent future pandemics. PNAS 118(21): e2101718118. Doi: https://doi.org/10.1073/pnas.2101718118.
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    • Fapesc - Foundation for Support to Research and Innovation of the State of Santa Catarina. 2021. Preliminary study indicates that MMR vaccine halves the risk of symptomatic Covid-19. Government of the State of Santa Catarina. Available: https://www.sc.gov.br/component/acymailing/listid-8/mailid-10758-estudo-preliminar-indica-que-vacina-triplice-viral-diminui-pela-metade-o-risco-de-ter-covid-19-sintomatica?tmpl=component&tmpl=component.
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    • Fedrizzi E. 2021. Phase IV Efficacy Study of MMR Vaccine in Preventing or Reduction of Severity of COVID-19 in Healthcare Workers Adults. Brazilian Registry of Clinical Trials. Available: https://ensaiosclinicos.gov.br/rg/RBR-2xd6dkj
      » https://ensaiosclinicos.gov.br/rg/RBR-2xd6dkj
    • Fedrizzi E ET AL. 2021. Efficacy of the Measles-Mumps-Rubella (MMR) vaccine in the reducing the severity of COVID-19: an interim analysis of a randomised controlled clinical trial. medRxiv (preprint). Doi: https://doi.org/10.1101/2021.09.14.21263598
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    • Gold J. 2020. MMR Vaccine Appears to Confer Strong Protection from COVID-19: Few Deaths from SARS-CoV-2 in Highly Vaccinated Populations. Researchgate 7(3). Doi: https://doi.org/10.13140/rg.2.2.32128.25607.
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    • Kolla E, Weill A, Desplas D, Semenzato L, Zureik M & Grimaldi L. 2022. Does Measles, Mumps, and Rubella (MMR) Vaccination Protect against COVID-19 Outcomes: A Nationwide Cohort Study. Vaccines 10(11): 1938. Doi: https://doi.org/10.3390/vaccines10111938.
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    • Taheri Soodejani M, Basti M, Tabatabaei S & Rajabkhah K. 2021. Measles, mumps, and rubella (MMR) vaccine and COVID-19: a systematic review. Int J Mol Epidemiol Genet 12(3): 35-39. PMCID: PMC8310886.
    • Tayar E ET AL. 2022. Effectiveness of influenza vaccination against SARS-CoV-2 infection among healthcare workers in Qatar. medRxiv (preprint). Doi: https://doi.org/10.1101/2022.05.09.22274802
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    Publication Dates

    • Publication in this collection
      17 Feb 2023
    • Date of issue
      2023

    History

    • Received
      25 Oct 2022
    • Accepted
      28 Dec 2022
    Creative Common - by 4.0
    This is an open-access article distributed under the terms of the Creative Commons Attribution License
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