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Since last Sunday (17), Brazil already has vaccines against covid-19. Now, the form of vaccination is the problem to be faced. Today, there are no scheduled dates for the phases of the immunization plan, let alone sufficient doses of immunizers to serve the entire population.
Consulted by Twitter, the Ministry of Health says that the expectation is that the Brazilian population will be vaccinated only next year.
But in the statement sent, the most common word is “it depends.” There is no certainty about when all Brazilians will be immunized against the new coronavirus. At best, this is expected to occur in the second quarter of 2022.
The uncertainties led the STF (Federal Supreme Court) minister Ricardo Lewandowski, last Monday (18), to ask the Ministry of Health to present a vaccination schedule.
Plan for 50 million
At the moment, even without the clarifications requested by Lewandowski, the “National Plan for the Operationalization of the Vaccine against Covid-19” gives the indication of three phases, which comprise just under 50 million people from risk groups; that is, approximately one out of every four Brazilians.
The three phases together are expected to last four months. Only after its closure would the Ministry’s 12-month projection to vaccinate the population outside the priority groups begin to count.
“The Ministry of Health estimates that, in the 12-month period, after the initial phase, the vaccination of the general population will be completed, which will depend, concomitantly, on the amount of immunobiologicals available for use,” said the folder in a note to Twitter.
The note raises another concern: There is no vaccine for everyone. The Health Ministry anticipates 210 million doses of Oxford vaccine and another 100 million of CoronaVac this year. Since two doses are needed per person, the sum of these amounts would not serve the entire population, of some 212 million Brazilians.
Today there is no dose, not even for the first phase
Phase 1, which began this week, is expected to initially last five weeks. But, with the number of doses available in Brazil, it is difficult to know if this deadline will be met. In total, the country has 6 million doses of vaccine against covid-19. But it takes 31.1 million to carry out the planning.
“The term to finalize each phase depends on the number of doses delivered by the supplier laboratories and approved by Anvisa [Agência Nacional de Vigilância Sanitária]”says the ministry.
In addition to the 6 million doses already distributed, there are another 4.8 million in national territory, which Anvisa should release soon. Brazil is also awaiting the arrival of the IFA (active pharmaceutical ingredient), necessary for the production of CoronaVac and the Oxford vaccine.
The president of the SBIm (Brazilian Society of Immunizations), Juárez Cunha says that he believes that it is “very likely” that the country will enter 2022 with people who have not yet received the covid-19 vaccine. “It is very ambitious for us to think that we will have a vaccine and we will have enough supplies to vaccinate the entire population.”
I hope this is feasible, but the scenarios are too uncertain for us to make predictions. The beginning of the campaign already shows us the difficulty we are having even to implement the initially planned strategy.
Juárez Cunha, president of SBIm
Objectives of phase 1:
- healthcare professionals;
- people aged 75 or over;
- people age 60 and older who reside in long-term care facilities;
- disabled persons over 18 years of age living in inclusive households;
- indigenous population living in demarcated lands,
- traditional riverside towns and communities.
But at this first moment, with only 6 million doses, only health workers and the elderly in institutions will be immunized, according to the ministry. The 3 million people expected to be immunized are equivalent to approximately 1.5% of the Brazilian population.
For now, the vaccine against covid-19 will not go to health centers. The São Paulo government launched a website for pre-registration. The other groups in phase 1 will be notified later through an advertising campaign about when they can receive the immunizer.
Health professionals are at the forefront of the covid-19 immunization plan
Image: Jan. 18, 2021 – Marcelo Justo / UOL
And then?
In phase 2, still without a start date, the government plans to vaccinate people between 60 and 74 years old. For them, almost 46.5 million doses are needed.
But phase 2 will have two stages. In the first, within five weeks, the proposal is to immunize 60% of the 22.1 million elderly in this age group. The remaining 40% will then receive the vaccine in four weeks.
The plan, however, does not indicate the criteria that are adapted to people in each of the stages of this phase.
The next phase is for people who have health problems, such as diabetes, hypertension, cancer, among others. For this group, approximately 26.6 million doses are expected to be delivered over five weeks.
Phases 2 and 3, however, do not need to wait for the previous phase to start rolling out. Other people, however, may enter them, depending on the ministry:
- education workers;
- workers of other essential services (security and rescue forces and employees of the deprivation of liberty system, among others);
- population deprived of liberty,
- quilombolas (in SP, they are in phase 1)
- homeless people.
“While vaccines, availability and delivery schedule are approved, it will be possible to evaluate in what phase these groups will be inserted,” said the ministry in the Vaccination Plan.
12 months after phase 3
The rest of the population should receive immunization against COVID-19 after the three phases, within that 12-month period. But the ministry indicates that, “as the laboratory makes new lots of vaccine available, the National Immunization Program will have new distribution grids and vaccination schedules for priority groups.”
The SBIm agrees with the vaccination strategy proposed by the Ministry of Health. “These groups are the ones most at risk and where we should start vaccinating,” says Cunha.
In a technical report, sent to state health secretariats on Monday, the ministry said that the start of vaccination is aimed at reducing mortality from covid-19, “as well as maintaining the functioning of the health services workforce. and maintaining the functioning of essential services. “
The ministry hopes to vaccinate 90% of the target population in each group, “as a small portion is expected to have contraindications for vaccination.”
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