Brazil’s Vaccination Plan Raises More Questions Than Answers

Brazil’s coronavirus immunization plan released over the weekend did little to assuage concerns that the government is stumbling in its efforts to inoculate 212 million people, with no timeline and vague supply agreements.

The 93-page document published by the health ministry says Brazil has already secured 300 million doses of Covid-19 vaccines, mostly from AstraZeneca Plc. But approval for the Astra shot globally is pending more trials. Other vaccines will be sourced from the Covax facility, organized by the World Health Organization, and some 70 million doses from Pfizer Inc. are “in negotiation.”

Medical professionals criticized the release of the plan with epidemiologist Ethel Maciel saying on Twitter that researchers hadn’t seen the document that was published with their names and only learned that it was released through the press.

The Supreme Court gave the government 48 hours to provie more details on the plan.

At stake for Latin America’s biggest economy is a prolonging of the pandemic that has already killed more than 180,000 people, infected nearly 7 million and is re-surging across the country. President Jair Bolsonaro, who has downplayed the risks from the respiratory illness all year and fended off a bout with Covid-19 himself, said last week that Brazil is at the very end of the pandemic, without providing any evidence.

Brazil is under its third health minister during 2020 alone and the health regulator Anvisa has been accused of making certain decisions more out of political considerations than science.

In a note Monday, Anvisa set a deadline of 10 days to rule on requests of emergency use of vaccines that have ongoing tests in the country, adding that none have been filed yet. The regulator is “working full time” to decide on imports, monitor any adverse reactions along with other vaccine matters, it said.

The list of planned vaccines doesn’t include China’s CoronaVac, the shot being developed by Sinovac Biotech Ltd which has been at the center of many of the political spats around vaccines in Brazil. Bolsonaro has said he doesn’t trust a Chinese cure against coronavirus “due to its origin” and scrapped plans announced by the ministry to acquire the shot.

Phase 3 results on the Chinese-developed vaccine were expected to be presented on Dec. 15. But on Monday, the Butantan institute, which has a deal with Sinovac to produce the shot locally, delayed the filing to Dec. 23. Sao Paulo has pledged to start immunizing its 46 million people in late January.

The decision to postpone was taken together with Sinovac and an international committee that follows clinical tests, Sao Paulo officials said at a press conference Monday. The delay was first reported by newspaper O Globo.

Butantan will request the vaccine’s registration, not its emergency use, according to Dimas Covas, head of the institute. That strategy “should speed up the registration process with regulatory agencies,” he said, adding that Sinovac wants to distribute 500 million doses worldwide in the first half of 2021.

In theory, Brazil should fare better vaccinating than it did containing the disease. Its five-decade-old immunization program, which operates 35,000 outposts, is in sturdy shape, reaching 90% of the people it intended to with the annual flu shot even amid the pandemic. But concern about a lack of preparation, constant political infighting and resistance to vaccines is growing.

Over the weekend, a Datafolha survey showed half of Brazilians wouldn’t be willing to take CoronaVac, the highest rejection rate among those polled. About a third of the people said they wouldn’t take shots developed by Russia or the U.K. either, and 22% of respondents said they don’t plan to get vaccinated at all, more than double the amount seen in an August poll. Bolsonaro said he doesn’t plan to take a vaccine either.

For the vaccination to work, at least 70% of the people have to receive a “highly effective shot,” according to the health ministry’s plan. It lists health care workers, people over 75 years old and indigenous populations as first priorities.

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