With Delta variant rising, São Paulo assesses reducing wait for 2nd injection

RIO DE JANEIRO, BRAZIL – The government of São Paulo said, Wednesday (7) that the Delta variant, originally from India, is circulating in the state.This variant is already pushing the São Paulo state government to reevaluate the three-month interval between vaccine doses like those of Pfizer and AstraZeneca.

“We have a variant (Delta) that is already autochthonous, that is, it is already circulating in our midst in people who have not had a history of travel or who have had contact with someone who has been to India, for example, and therefore we must have a special attention,” said Wednesday the Secretary of State for Health, Jean Gorinchteyn, during a press conference to announce the news about the vaccination.

Asked if there is community transmission of Delta in the state of São Paulo, the secretary said, “If we identify a patient who tested positive for Covid, without any history of travel or contact with someone who came from an area where this strain is more common, he clearly receives the designation.

Three relatives of a man who contracted the delta variant of coronavirus in São Paulo showed symptoms of Covid-19, including fever, arm pain, headache, loss of smell and taste. However, the government has not yet disclosed whether the relatives’ symptoms were from Delta infection. The infected patient, whose identity has been kept confidential, has not traveled abroad.

Because of the risk of spreading the variant, the São Paulo state government considers reducing the usual interval between doses, three months between the first and second injections. In Brazil, AstraZeneca and Pfizer vaccines follow this interval time. Coronavac, on the other hand, is applied with only a 28-day interval between one dose and the next.

“This Delta variant is worrisome. It is the one that has penetrated most countries, surprising countries like Israel, the United Kingdom, where it is already present in high percentages,” said Butantan Institute Director Dimas Covas.

“The possibility of bringing forward the second dose for these vaccines should be considered, yes, because although the vaccines generally do not respond well to the Delta variant, full immunity helps substantially. That is why many are considering changing the schedule to include advancing the second dose. This must be taken into account and is the right thing to do,” Covas added.

Nevertheless, the president of Butantan reiterated that the Coronavac vaccine produced by the institute showed good protection against variant Delta in a laboratory study. Specialists of the Center for Continence against Covid-19 of the State of São Paulo should meet this Thursday, July 8, to decide on reducing the interval between doses.

For the senior coordinator of the Continence Center, João Gabbardo, there are great concerns about the Delta variant. But the specialist recalls that although the infection rate has increased in the United Kingdom, where the variant circulates, this increase has not increased the number of deaths in the European country.

“At this moment, it makes the most sense to accelerate vaccination. And in terms of reducing the time between d1 (first dose) and d2 (second dose) from AstraZeneca, it might be more interesting to vaccinate more people with the first dose than to prefer someone to receive the second dose,” Gabbardo said.

“There’s no magic: If we bring forward the second dose for some people from 90 days to 60 days, that means we’re moving the first dose for a portion of the population,” he added.

The shortage of doses may create barriers to changes in the vaccination schedule, according to Gorinchteyn. “We also need to have more doses of these other vaccines (Pfizer and AstraZeneca) so that this interval can be established. If you don’t have that encouragement through the seal of the ministry (of health), however, that decision comes about, there will be obstacles operationally.”