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BRASÍLIA – The preliminary immunization plan of the Ministry of Health foresees the application of the vaccine in four stages and a contingent of 109.5 million Brazilians immunized in two doses. Immunization of priority groups will be carried out according to the availability of doses. The expectation of the folder is to start immunization in March, this will depend, however, on the approval of a vaccine by Anvisa.
The priority vaccination groups will vary depending on the availability of doses. See here how the phases will be:
Phase 1
- people over 75
- Healthcare professionals
- people age 60 and older who live in long-term care facilities (such as nursing homes and psychiatric institutions)
- indigenous population
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Phase 2
Phase 3
- people with comorbidities that are more likely to make the disease worse (such as having chronic kidney and cardiovascular disease)
Phase 4
- teachers
- security and rescue forces
- officials of the prison system
- population deprived of liberty
The portfolio presents a general plan, but that takes into account the specificities of the vaccines that are in phase 3 of development, such as the one developed by Oxford in alliance with AstraZeneca, in addition to those that make up the Covax Facility consortium. Also in phase 3, CoronaVac, developed by Sinovac in association with the Butantan Institute, would be included.
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Vaccination rooms and supplies
GLOBO found that the ministry did not define, however, the amount of supplies (such as syringes) and vaccination rooms needed to carry out immunization in the population. The argument is that these points will depend on the amount of doses that is made available to the country. The Ministry currently has 100.4 million doses of the Oxford vaccine and 42.5 million from the Covax consortium.
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In a note, the folder indicated that it is in the “process of purchasing 300 million syringes and needles in the domestic market for application of doses and another 40 million in the international market.”
The ministry also said that a price survey and issuance of a technical note had already been carried out to prepare the purchase notice, which will be launched next week.
‘All (vaccines) are important’
The axes that make up the plan are: epidemiological situation, update of the vaccines under study, monitoring and budget, campaign operation, pharmacovigilance, post-marketing monitoring studies, information system; monitoring, supervision and evaluation; Communication; closing of the campaign.
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The portfolio defined the priority groups according to the guidance of the World Health Organization. The definition of who will be immunized first may still change, depending on the folder.
– It is a great challenge that lies ahead. But we have technical capacity, time, experience and people gathered with the desire to make the best plan in the world – said Minister Eduardo Pazuello during the meeting with the technicians.
The minister said again that all vaccines will be considered by the government:
– We are looking for all vaccines. They are all important.
First stage size
A rough count suggests that the first phase of vaccination should include at least 12 million people, possibly as many as 15 million.
Brazil has around 500 thousand doctors and the Federal Council of Nursing registers 2.4 million professionals in the categories of nurses, assistants, technicians and obstetricians. There are also other employees of the health system and teams in support areas, such as transportation and maintenance, for which the statement from the Ministry of Health does not detail the inclusion in the vaccination plan. In SUS alone, Fiocruz estimates that there are 3.5 million health professionals, which does not include the private sector.
Those over 75 years of age make up 3.6% of the population (around 7.6 million people), a group that is mostly above the average life expectancy in Brazil (76 years for those born in 2020 ).
In the last national census (in 2010), Brazil had about 0.5% of the population that declared itself indigenous. If the ratio remains, there are 1 million people in this population group today. To these are added the asylum population and the long-term care institution, which the IBGE did not estimate recently.
What vaccines
The statement from the Ministry of Health speaks of the acquisition of 100.4 million doses of AstraZeneca vaccine, enough to vaccinate between 50 million and 65 million Brazilians, depending on the dosage regimen (two doses or one and a half doses per person). . Another 42.5 million doses of vaccine would come through the Covax consortium, articulated by the WHO.
Fiocruz says it expects to produce up to 210 million doses of the vaccine by the end of 2021, with 30 million ready by March. Last month, the foundation estimated that by the end of 2021, if the AstraZeneca vaccine works even in fractional doses, it will be possible to vaccinate the entire eligible population of Brazil with this product alone, totaling around 130 million people. Neither vaccine has data on efficacy in children yet, a public that is less vulnerable to Covid-19.
The Ministry’s note does not mention at any time the 46 million doses of the Coronavac vaccine that the Butantan Institute plans to import and produce in association with China’s Sinovac. The only batch of vaccine that already exists on Brazilian soil is the first 6 million doses of Coronavac.
However, the vaccine developed in China still lacks preliminary efficacy data to allow its registration. Butantan estimates that it should have an effectiveness estimate by December 15, based mainly on the phase 3 clinical trial conducted in Brazil.
It is not clear from the Ministry’s statement which vaccine would enter the country through Covax. The only immunizers among the nine in the program that are already estimated to be effective are AstraZeneca (for which Brazil already has an acquisition agreement) and Moderna (which has closed agreements with the United States and the United Kingdom).
The ministry says it is still in talks with other labs testing end-stage vaccines. GLOBO contacted Pfizer, Janssen and Moderna today to find out what the delivery capacity of these other vaccines could be to Brazil, but has not yet received a response.
Raphaela Ramos and Rafael García collaborated
