Without vaccines, São Paulo defers start of vaccination for seniors over 80

RIO DE JANEIRO, BRAZIL – Seniors over 90 years of age and, later, over 85 years of age began to be immunized with the covid-19 vaccine last week in the state of São Paulo. However, the government announced the start of immunization for seniors between 80 and 84 only for March 1st. According to the former state immunization plan, this would have been the date when seniors over 75 would be taking their first shot.

The reason for the delay? The shortage of vaccines, according to the state government, which joined the national immunization plan in January. So far, almost 12 million doses have been distributed throughout the country – enough to immunize only 6 million people, less than 3% of the Brazilian population.

“We schedule [the dates] according to the amount of vaccines. There aren’t enough vaccines. If we get them, we’ll move forward, as we have been doing, but everything depends on the amount of available vaccines,” said São Paulo State Health Secretary Jean Gorinchteyn.

The Ministry of Health claimed to have guaranteed 354 million doses, through agreements with Fiocruz (212.4 million doses), Butantan (100 million doses) and the W.H.O.’s Covax Facility (42.5 million doses). However, the body has not provided a schedule for their delivery. The Ministry further said that it signed memoranda of understanding with Pfizer, Janssen, Sinopharm, Bharat, and Gamaleya manufacturers.

The start of vaccination in the state, planned by the state immunization plan for January 25th, was brought forward to January 17th, when the CoronaVac, produced by the Butantan Institute in partnership with China’s Sinovac, was approved by ANVISA, the Brazilian Health Regulatory Agency. Since then, the state has been scheduling vaccination dates based on the production of doses, abandoning the state plan introduced in January.

“When we schedule seniors aged 85 or older, that’s the population we are able to immunize at this time with the amounts we have. We know how many people are aged 60 or over, it’s around 7 million. We need more vaccines to send municipalities for immunization,” said Regiane de Paula, head of Disease Control in the São Paulo Health Secretariat.

Some municipalities in São Paulo began vaccinating other age groups – seniors older than 80 or 75 – because they had stocked doses. But these are exceptions and cannot guarantee the next age groups, for the time being.

In total, almost 12 million doses of the two approved vaccines – the CoronaVac and the Oxford/AstraZeneca – have been distributed in Brazil. Up to last week, Butantan had delivered 9.8 million doses in three shipments to the country, and the Ministry of Health distributed 2 million doses of the Oxford/AstraZeneca immunizer in late January.

The states are now waiting for the production of new doses or the purchase of another vaccine by the Ministry of Health. Due to a shortage of raw materials from China, Butantan halted production of the CoronaVac vaccine for almost 20 days.

Production was restarted on February 4th, when 5,400 liters of raw material were delivered (enough for 8.6 million doses). Last Wednesday, February 10th, Butantan received another 5,600 liters from China (a further 8.7 million vaccines). According to the institute, production will not stop and distribution to the Ministry of Health will be restarted on February 23rd.

Fiocruz also began producing the Oxford/AstraZeneza vaccine with the delivery of 900 liters of raw materials (enough for 2.7 million doses) last weekend. Vaccine delivery is expected to begin in March.

Both state governments and experts assess that Brazil needs more vaccine options – or a larger amount of those already present.

“I also worry if I think that [the] 80-year-old population will only begin to be immunized in twenty days. But we need more vaccines. There’s Pfizer, Moderna, Sputnik… The Ministry of Health should act, coordinate,” says pneumologist Paulo Menezes, coordinator of the São Paulo Coronavirus Contingency Center.

Up to now, only the CoronaVac and Oxford/AstraZeneca vaccine have been approved by ANVISA. On February 6th, Pfizer applied for registration of its vaccine produced in partnership with BioNTech. The agency has up to 60 days to analyze the application, but has already promised greater speed.

The Ministry of Health has claimed to be interested in buying “all vaccines with proven safety and efficacy and registration with ANVISA.”

Nevertheless, in August, the federal government refused a pre-contract with Pfizer for 70 million doses to be distributed as soon as the pharmaceutical company secured authorization in Brazil. As a justification, it said that, despite the amount of doses, which would guarantee the immunization of 35 million Brazilians, the agreement “would cause frustration to everyone.”

Last week, Ministry officials met with representatives of the Gamaleya and Bharat Biotech, to move forward in the procurement of another 30 million vaccine doses.

Source: UOL