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The vaccination plan against Covid-19 in São Paulo, which will be announced on Monday (7) by the governor João Doria (PSDB), provides for the start of immunization on January 25.
First, health professionals, people over 60 years of age and vulnerable groups such as indigenous people and quilombolas will be vaccinated.
There are several approaches to the plan, which is based on the obvious expectation that Coronavac, the Chinese vaccine to be manufactured locally at the Butantan Institute, will work and be approved by Anvisa (National Health Surveillance Agency).
The study on the effectiveness of Coronavac will be released until next week and, if everything goes as expected by the government, registration with Anvisa will be requested immediately.
Vaccination will be scheduled for the two necessary Coronavac applications, both free. The group of health professionals / indigenous / quilombolas will receive their first dose on January 25 and the second on February 15.
Those who are 75 years or older, February 8 and March 1. From 70 to 74 years old, February 15 and March 8. From 65 to 69 years old, February 22 and March 15. Finally, from 60 to 64 years old, March 1 and 22. Other phases of vaccination have not yet been announced.
In a politically relevant move, 4 million will be offered to immunize health professionals from other states, out of the 46 million doses the state expects to have available in January.
The cut-off line for the first round of vaccination, aged 60 and over, stems from the fact that 77% of the 42,500 deaths from Covid-19 in the state occurred in this age group. There are 7.5 million of the 46 million of São Paulo. Health professionals and vulnerable are 1.5 million people.
There are several approaches to the plan. One objective is to review each of the 4,700 Basic Health Units in the state, which are administered by the municipalities. The condition of vaccine refrigerators and their occupancy rate are a priority: Coronavac should be stored at temperatures of 2 to 8 degrees Fahrenheit.
There will be an expansion from the total of 5,200 vaccination sites in the state to 10,000, according to Doria, with the use of credentialed pharmacies, Military Police barracks, schools (on weekends), bus terminals and the adoption of a system drive thru (depending on the availability of each municipality).
The vaccination hours will be from 7 to 22 hours from Monday to Friday and from 7 to 17 hours on weekends and holidays, all in charge of the municipalities.
The plan foresees 18 million doses of vaccines and the use of 54,000 health professionals. There will be 25 distribution stations and 5,200 cold rooms, in addition to 30 air-conditioned trucks.
In addition, there is the issue of supplies. The purchase of PPE (Personal Protective Equipment) is planned, such as surgical masks and disposable gloves, in addition to ensuring the stock of syringes for the application of the immunizer.
The capital, for example, has already gone ahead and bought 10 million syringes, to use in its 468 UBS. The state plan provides for the purchase of 27 million syringes and needles.
There is significant inflation in this market, courtesy of the demand created by the new coronavirus. To give a good example, the box with one hundred surgical gloves was found in the São Paulo market for R $ 20 at the beginning of the year. Today it costs almost four times as much.
The central fear of the Palácio dos Bandeirantes is to repeat the logistical nightmare that was the emergency purchase of Chinese respirators at the beginning of the pandemic, with shipments stopped at airports in other countries, which caused the cancellation of deliveries.
The high cost of the plan made the states of Consud, a consortium that groups the states of the Southeast and South, talk about the possibility of joint purchases and request help from the Ministry of Health.
The portfolio headed by General Eduardo Pazuello showed no interest in the talks, according to people with access to the talks. São Paulo, which has a budget of R $ 23.7 billion for next year in health, decided to pay its share, but there is still the possibility of cooperation.
The plan, finalized over the past three weeks, aims to get the state ready to distribute two doses of Coronavac, a vaccine developed by the Chinese laboratory Sinovac.
Of the 46 million doses in the government’s hand in January, 6 million are arriving ready from China and the rest will be formulated from Chinese supplies in Butantan, something that begins this Monday. Then another 15 million doses should arrive in March.
The immunizer has already had its safety and ability to produce an immune response attested in phases 1 and 2 of its clinical trial, which occurred with 50,000 volunteers in China. Phase 3 is being completed in the Asian country, in Brazil and in places like Indonesia, Turkey and Bangladesh.
In the Brazilian case, the study with 13,500 volunteers coordinated by Butantan already reached the minimum number of infected to stipulate its efficacy: those who received the immunizer and those who had applied a placebo were separated among the patients.
Doria estimates that the result of the Brazilian study and the submission of the registration request to Anvisa will occur on the 15th. As I said in an interview with leaf Last week, the fear is that the agency is politically.
The toucan is the main governor of the opposition to President Jair Bolsonaro (without a party), and is a virtual candidate for Planalto in 2022. Both leaders diverge on handling the pandemic, with Doria associating his image with responsibility in health and Bolsonaro seeking minimize disease.
The new front is the vaccine. Bolsonaro even celebrated when a voluntary suicide led Anvisa to stop testing Coronavac without warning, which was seen in the São Paulo government as a political act.
Before he had criticized the “Chinese vaccine” and his network of sympathizers on the Internet insists on the thesis that “São Paulo will be guinea pigs”, which does not make sense if the tests are positive and the immunizer is approved.
As Coronavac must request the definitive registration, for which a new factory is being installed in Butantan, the São Paulo government fears that Anvisa, with a Bolsonarista leadership, will look for “the egg” to delay Doria’s schedule.
The lethargy of the Ministry of Health, which plans to start vaccinating only in March and has not specified which drug, worries the states – at least eight have already sought Doria for a possible purchase of Coronavac, but the advice of the secretaries of the area is concerned about decentralization.
Doria’s offer of vaccines to other states reinforces the nationalization of the issue. The governor himself said in his interview last week that his name could be favored if Coronavac is successful, noting that the search for the immunizer was a matter of public health priority, not political.
The federal government, despite Bolsonaro’s attitude, invested R $ 2 billion in a partner to bring the AstraZeneca / Oxford University vaccine, which is delayed due to problems in its testing phase.
Pazuello admits to having bought any immunizer, but favors the British because he already has a signed agreement in which it is sold at cost ($ 3.75 per dose, before $ 10.4 from Coronavac and up to $ 25 from others). .
In addition to the test suspension episode, made without speaking to the state, a signal concerned health officials last week. Anvisa estimated that it would approve Sinovac’s contributions between late December and early January, but later issued a note without committing to deadlines.
