- Raphael Parivos
- BBC News Brazil in Sao Paulo
Brazil has become an example to follow in this epidemic. The country has exceeded its target and vaccinated more than 88 million people.
When the campaign began, most of the doses needed were already in the hands of the federal government, which had concluded agreements to purchase three vaccines since the previous year.
The government also launched a campaign against rumors that called into question the efficacy and safety of vaccines.
The result: Over 45% of the population has already been vaccinated. He was not vaccinated anywhere in the world as much as here.
This was the case in Brazil in June 2010, three months after the start of the vaccination campaign against swine flu, a disease caused by a type of H1N1 virus that has caused a global crisis.
Brazil is now, in the fight against Covid-19, at the same three-month mark of vaccination, but in a completely different situation.
Just over 25 million people, about 12% of the population, have received at least one dose since January 17, and only 8.5 million, or about 4%, have taken the two necessary doses.
“We are still an example, only the worst, and we are no longer the best as we were,” says Cristina Bonorino, a member of the scientific committee of the Brazilian Society of Immunology.
The researcher says that this difference is due to the lack of vaccines. “Otherwise, we would definitely not have reached where we are today,” he says.
Renato Kfoury, director of the Brazilian Society of Immunization, thinks the same thing. “This is the only determinant,” he says.
It is believed that today more people can be vaccinated at this stage than it was ten years ago, because Covid-19 is a more dangerous disease than swine flu.
“What moves people is a sense of risk. There will be lines and lines. People will be vaccinated 24 hours a day. But we are in a vaccination campaign that does not have a vaccine.”
Epidemiologist Carla Domings, who coordinated the H1N1 vaccination campaign and led the national immunization program between 2011 and 2019, says the current campaign is more complex.
This is because vaccines are given today in two doses, rather than in a single dose like those for the H1N1 virus, and immunomodulators have different systems of administration.
But she believes the country has the potential to be in a better situation, because the population wants to be vaccinated and the whole structure was ready for this campaign.
“It is a pity. We have a reference program, but we are on the global stage, with countries that do not have the least capacity to vaccinate due to political issues and strategic mistakes that have led to the lack of vaccines,” Dominguez says.
The Bolsonaro government’s mistakes
The Brazilian government has long been betting on a single immunization device, the pharmaceutical company AstraZeneca, which was developed in partnership with the University of Oxford in the United Kingdom.
The institute, which is affiliated with the government of São Paulo, says that in July of last year it provided 160 million doses, but there has been no answer.
The President even rejected Major General Eduardo Pazuelo after the then Minister of Health announced in October that it had purchased 46 million doses of the Corona virus.
The President said: “It was canceled.” We will not buy a Chinese vaccine.
His argument was that he would only buy vaccines approved by the National Health Monitoring Agency (Anvisa), ignoring that his government had since July had an agreement to acquire an Oxford vaccine, which was not approved by the agency at the time.
The president also did not want to buy the vaccine from Pfizer. The US pharmaceutical company said it offered 70 million doses in August.
The president said in mid-December: “If you become a crocodile, that’s your problem. Damn it.”
But then the Oxford vaccine was delayed. Errors in the research forced scientists to conduct more testing, and AstraZeneca struggled – and still is – struggling to produce what it promised.
The Bolsonaro government ended up striking a deal with Botantan in January and with Pfizer in March, but it has already lost significant time.
But the Brazilian government, which had the option to require sufficient doses for up to 50% of the population, opted for coverage of a minimum of 10%.
“The government did not order vaccines when other countries were requesting them. It did not diversify vaccines because it thought they were not necessary. It had the wrong choice. It did not have the right choice. That makes it difficult.” Immunologist Christina Bonorino says.
We did differently ten years ago
The federal government acted very differently a decade ago.
Luís Inácio Lula da Silva, at the end of his second term, announced the purchase of an immunization device from the French laboratory Sanofi Pasteur, which was still in testing, in August 2009.
The new species was identified in April of that year in Mexico and the United States – in Brazil, the first cases were confirmed in early May.
The day after the World Health Organization declared the pandemic, the Swiss pharmaceutical company, Novartis, announced the production of a swine flu vaccine.
This was only possible because there were already vaccines against the common influenza, and laboratories only needed to develop copies that protect the new H1N1 virus.
The terms agreed upon between the Brazilian government and Sanofi provide for the import of 18 million doses. Then, an additional 33 million doses were manufactured by the Butantan Institute, which entered into a technology transfer agreement with that company.
Brazil bought another 40 million doses from Canadian company GlaxoSmithKlein in November 2009. A third contract closed in January 2010, with the Pan American Health Organization, the arm of the World Health Organization in the Americas, for another 10 million doses.
The federal government said at the time that it expected to have the most doses on hand to start vaccination, which did not actually begin until March 2010, six months after China became the first country in the world to be immunized against the H1N1 virus.
“In 2010, this was planned. More than 50% of the doses were already in the country when the vaccination began, and the amount reached all during the campaign,” says Carla Dominguez.
Chaos, confusion, and anxiety
The epidemiologist estimates that another difference between that time and today is that the vaccination schedule was released two months before the application of the first dose.
Since January, it has already been known when each of the six groups at high risk of swine flu will be immunized: health professionals, pregnant women, indigenous people, people with comorbidities, children 6 months to 2 years old, and healthy adults aged 6 months Between 20 and 29 years old. After that, adults between the ages of 30 and 39 were included.
Dominguez remembers that there was a nationwide campaign at the time to explain what vaccination looked like and that people should wait their turn.
“The residents understood that. There were no people going to another city to get vaccinated or trying to cross the line because they don’t know when they will be able to get vaccinated,” the specialist says.
This time, the Bolsonaro government released its draft Covid-19 vaccination plan in mid-December, but without a timetable – and even the Supreme Court charged it with it.
In response to a question, Minister Pazuello said that vaccination will begin “on D-day, at H”. Days later, he announced in a meeting with mayors that it would be January 20, Wednesday.
Captured by Doria, who ordered the application of the first dose of CoronaVac as soon as Anvisa approved the vaccine, on the 17th, the general advanced to start the national campaign until Monday.
Vaccination began with 6 million doses of the Coronavirus. The first batch of the Oxford vaccine did not reach the country until five days later.
“Today, what we’re seeing is the very definition of an unregulated plan,” Dominguez says. “The federal government has given up on setting policy and left every state and municipality to do what they like.”
While some places vaccinate people in the sixty-five-year-old, according to the epidemiologist, others still apply it to those in their seventy. Some actually vaccinate teachers and security professionals, while others do not.
“Look at the confusion this causes in people’s heads … a lot of people are anxious.”
The lies that tell about vaccines
Just as it is today, with the Coronavirus vaccine, the H1N1 vaccine has also been the target of lies that have been circulating online and in word of mouth.
The Ministry of Health said at the time that the rumors were “irresponsible” and launched a campaign to make clear that the vaccine did not cause autism, paralysis, fatal allergic reactions, neurological problems, or fetal malformations in pregnant women, among other things. .
There has been no such effort now, far from it. Bolsonaro himself has questioned the safety and efficacy of vaccines on more than one occasion, even after they have been approved by Anvisa.
He also said several times that he would not take it, because he was already infected, contrary to the recommendations of the main authorities on the matter.
Immunologist Renato Kfoury says: “The government’s big failure was to refuse all vaccines. They did not listen to the science. Now, we are without a vaccine at the worst moment of the epidemic.”
The climate in the country was drastically different at this stage of the tournament in 2010. In mid-June of the same year, the federal government announced that it had vaccinated 88% of the 92 million Brazilians who were part of the priority. Groups.
In doing so, I was able to overcome the original goal of applying it to 80% of this population. The Ministry of Health later announced that the end result was better and that more than 88 million people had been immunized in the three months of the campaign.
It was “the largest vaccination that has ever occurred (in the country),” Health Minister Jose Gómez Tempurao said at a press conference at the time.
The country can now exceed that mark, because the federal government says it has already purchased more than 562 million doses, which will be delivered by the end of the year.
A vaccination campaign against COVID-19 can go down in history like anything else related to this pandemic. But immunologist Christina Bonorino says she is not optimistic.
“How many times have the government’s expectations changed? They change every week. Can you trust that we will have 500 million doses by the end of the year?”
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