Analysis: Bolsonaro Government’s Sluggishness Prompts State Race for Vaccine

RIO DE JANEIRO, BRAZIL – Faced with the federal government’s delay in closing purchase agreements or anticipating the vaccination campaign against Covid-19, scheduled to begin in March by the Ministry of Health, governors and mayors have been mobilizing on their own to secure immunizers.

Some of them are turning to São Paulo’s Governor João Doria for doses of the Coronavac, developed in partnership with the Chinese Sinovac group. The governor’s plan is to begin immunization on January 25th. Other local governments are planning to negotiate directly with Pfizer, whose vaccine proved to be 95% effective, should the agreement with the federal government fail.

President Bolsonaro’s government is betting on the Oxford University vaccine, which has a partnership with Rio-based Fiocruz (100.4 million doses). But scientists have acknowledged a number of errors and the need to extend trials to assess its efficacy, which should delay registration. The Ministry is also counting on doses of the Covax – a consortium led by the World Health Organization – for 10% of the population (42.5 million doses), but yet with no date set.

The government has been resisting the purchase of other vaccines, such as Pfizer’s, which has set a deadline up to this week for a reply. According to experts, local governments may implement their own immunization programs, as long as ANVISA endorses them. Doria said that four million doses for healthcare professionals will be offered to other states. However, the Coronavac has not yet had its Phase III trial results on efficacy published and it still depends on registration by ANVISA.

According to Doria, eight states have already expressed interest in the Coronavac. Governor of Ceará Camilo Santana wrote on social media that he has been in contact with Doria since November. Paraíba’s João Azevêdo said he cleared his team to negotiate with São Paulo. “It is a parallel plan to the Ministry of Health’s, to anticipate and begin vaccination as soon as possible,” he said.

Maranhão’s Secretary of Health Carlos Eduardo Lula confirmed that he should be supplied with doses. He failed to report on the total number of doses or the first groups to be immunized.

Curitiba Mayor Rafael Greca celebrated on video an agreement that guarantees “vaccine distribution to healthcare professionals” in the city earlier this year. The Porto Alegre Metropolitan Region’s consortium of municipalities scheduled a meeting this week in São Paulo. The group comprises mayors of the capital of Rio Grande do Sul and 15 surrounding cities.

“This decentralization of vaccine purchasing is not common, but it is nevertheless valid. The federal government’s plan to purchase vaccines is unclear,” said Natan Katz, Porto Alegre’s deputy Health Secretary.

Pfizer

Other states are preparing for direct negotiations with Pfizer Pharmaceutical company if talks with the Ministry do not progress. Espírito Santo has already estimated an investment between R$370 million and R$400 million for six million doses of the immunizer, which will be administered in Europe and Mexico starting this month.

This amount of doses would be enough to immunize the population of Espírito Santo (except children and youths), starting with the risk groups, which total one million. “We have established negotiations with Pfizer for the State. We haven’t advanced because of the Ministry’s prerogative”, said Nésio Medeiros, Health Secretary. “If the federal government fails to accept Pfizer’s proposal, it may be of interest to state governments.”

Bahia is considering quotations for one hundred special freezers to store the Pfizer vaccine, which must be kept at -70ºC. “If the commercial presentation is similar to influenza vaccines (flu), considering the 0.5 ml dose, each 10ml vial would contain 20 doses. Each freezer would store 1,500 vials, in a total of 30,000 doses each,” said Health Secretary Fábio Villas-Boas.

Pfizer, for its part, claims to have a storage solution: a package for 5,000 doses, with controlled temperature and dry ice. The vaccine would last 15 days. The need for very low temperatures is the main reason for the Ministry’s reluctance.

However, isolated negotiations are not the focus of all governments. Rio de Janeiro, Pernambuco and Tocantins said they were waiting for a federal decision.

Chamber president Rodrigo Maia said he expects to vote on a Provisional Measure by Thursday, under which the House will be able to participate in defining the vaccination strategy. He did not specify which provisional measure would be modified for this purpose, but among the measures awaiting congressional deliberation is MP No. 1,003, which authorizes accession to the international Covax consortium.

“We will advance in any case (in the debate about vaccination) also because the Federal Supreme Court will also advance. And I think that the best course of action is to do this together with the Executive, Legislative and then the Supreme Court’s final decision,” Maia added.

Source: O Estado de S. Paulo.