RIO DE JANEIRO, BRAZIL – The rate of administration of the first dose of the vaccine against Covid-19 fell 17% in the past week, according to data from health secretariats collected by the media outlet consortium. With respect to the second vaccine dose, the drop reached 23%.
Between May 13 and May 19, an average of 453,000 Brazilians were vaccinated with the first dose each day. The figure is almost 90,000 doses lower than registered in the preceding week, the peak of vaccination in the month of May.
As for the second dose, there was a reduction of about 53,000 administrations in the period under comparison. The average stood at 179,000 people immunized per day this past week, against 231,000 in the preceding week.
For comparison purposes, the week between March 25 and April 1 registered the highest daily average: 644,000 daily immunizations with the first dose (42% more than now).
The peak period for immunizations with the second dose occurred between April 23 and 29, with almost 542,000 people immunized per day, on average (203% more than this past week).
Among the states, Pará was the one which reduced the administration of doses the most, where the immunization rate with the first dose dropped 88% in the period. By Thursday, May 20, 21.4% of Pará adults had been immunized with the first dose (1.3 million people).
The state of Espírito Santo, in turn, increased the administration of the first dose by 91%. Since the beginning of the campaign, over 860,000 people (21% of adults) were administered the first dose, and 325,000 the second dose (8%).
Regarding the second dose, Santa Catarina reduced the average number of immunized people by 79% and showed the largest drop compared to the week of May 12. By Wednesday, May 19, when the health secretariat released the latest balance, 691,000 people in Santa Catarina were fully vaccinated (about 10% of the population).
Mato Grosso do Sul more than doubled the administration of second doses. It is the state with the highest proportion of immunized citizens, with 15% of the adult population protected.
In Brazil, over 40 million have been administered the first dose (about 25% of people over 18), and more than 20 million the second dose (13%).
There are approximately 30 million doses that have been delivered to the Ministry of Health to be administered.
Fiocruz, which produces the AstraZeneca/Oxford vaccine, was expected to deliver 5.3 million doses on Friday, May 21, reaching a total of 40.2 million doses transferred to the Ministry of Health.
The Butantan Institute, which manufactures the Coronavac, has delivered 47.2 million, and Pfizer, 2.8 million doses. Although 90.2 million doses have been delivered, about 60 million doses had been administered by Friday.
The numbers show that Brazil could have millions more people vaccinated with at least one dose, but the lack of continuous flow in the delivery of doses generates uncertainties among local authorities, and the government’s failure to communicate causes prompts distrust among the population.
Experts point to a lack of national coordination by the federal government as the main cause for the disorganization in the campaign.
Each city decides how it will direct the administration of doses and, to prevent the shortage of second doses, some decide to reserve bottles for boosters rather than vaccinate new people, points out Ethel Maciel, epidemiologist and professor at the Federal University of Espírito Santo.
This is the case in Porto Alegre, which received more than 32,000 doses of the Pfizer vaccine early this month and decided to use half for the first dose and reserve the remainder for the second shot, with a 21-day interval between them, following the Brazilian Health Regulatory Agency’s (ANVISA) initial recommendation and the package insert.
However, the Ministry of Health now recommends a 3-month interval , so as to prioritize the first doses. The same strategy is used in the UK.
An article published on May 12 in The BMJ showed that adopting a 3-month interval between Pfizer vaccine doses can prevent deaths, since a single dose of the immunizer provides very high protection (about 80%) during the period until the booster is administered.
Distrust of AstraZeneca’s vaccine is another factor that begins to disrupt the vaccination schedule, according to Maciel. On May 10, ANVISA suspended the use of the immunizer in pregnant women while it investigates the death of a pregnant woman that may have been related to the substance.
“There are more reports of people who come to get vaccinated, but give up when they learn that the vaccine is AstraZeneca’s. This suspension of use without a communication strategy to explain that these are very rare cases and restore confidence in the vaccine, leaves people feeling insecure,” Maciel says. “I received messages from desperate pregnant women who had been administered the vaccine. The population doesn’t read the technical note. The lack of communication is inhumane.”
A very low number of immunizer-associated blood clots have been recorded in Europe, but health authorities on the continent have said that cases are very rare and that the benefits it provides far outweigh the risks.
Because it has experience with large vaccination campaigns, Brazil could mobilize a structure to vaccinate a larger number of people daily than it is currently doing.
The AstraZeneca and Coronavac vaccines depend on raw material from China. The Fiocruz and Butantan plants are waiting for the arrival of more raw materials for new shipments, which have been delayed in their release.
In a statement, the government of São Paulo says that issues concerning the diplomatic relationship between Brazil and China may directly interfere in the release schedule of new raw material batches. “Everyone knows, we have a diplomatic obstacle, the result of disastrous statements made by the federal government against China,” said Governor João Doria.
President Jair Bolsonaro has implied that the Asian country has benefited economically from the pandemic and claimed that Covid-19 may have been developed in a laboratory. An investigation by an international group of scientists concluded that the assumption that the virus had “leaked” from a laboratory is “highly unlikely.”
Representatives from at least 13 countries and scientists have publicly called for further investigation.
The Ministry of Health has not taken a position on the progress of vaccine administration, nor has it said if it intends to take any actions to expedite the process. In a statement, it only said that the pace of vaccine delivery is increasing and that this month it should reach over 30 million doses transferred to states, enough to vaccinate 1 million people per day.