Brazil needs to buy another 220 million doses to guarantee vaccination in 2022

The Ministry of Health plans to purchase 220 million doses of vaccines against Covid-19 for the 2022 immunization campaign. The estimated investment is R$ 11 billion.

There is still a forecast of a surplus of 134 million doses in 2021. In all, therefore, the plan involves 354 million doses, but the ministry estimates that 340 million vaccines will be needed — that is, there is a margin of 14 million — in the next year to expand the booster dose to the entire population.

The government prioritized Pfizer and AstraZeneca immunizations for the next year. According to the folder, contracts for the acquisition of vaccines are in the final stages of being signed.

The contract with pharmaceutical company Pfizer provides for the delivery of 100 million doses throughout 2022, with an option to purchase another 50 million.

A second contract also provides for the acquisition of 120 million AstraZeneca vaccines from Fiocruz (Oswaldo Cruz Foundation), with an option to purchase another 60 million doses.

The Ministry of Health asked the team of Minister Paulo Guedes (Economy) to increase R$ 1.4 billion in the 2021 budget to guarantee the purchase of 100 million Pfizer vaccines for the 2022 campaign.

The extra resource, which must be within the spending ceiling — a rule that limits the increase in public spending — would be used to pay 20% in advance of the R$ 7 billion contract with Pfizer, an imposition by the pharmaceutical in negotiating for doses.

Pfizer said in a statement that it does not comment on details of the negotiations it has with the government. Also sought after, Fiocruz had not responded until the conclusion of this report.

Even with the resources pending, the folder did not change the purchase plans for immunization against Covid next year, announced since the 8th of November.

The forecast is to distribute only one booster dose to the public aged 12 to 59 years, and one dose per semester for the population over 60 years of age and immunosuppressed.

The ministry also plans to vaccinate children against the new coronavirus next year. The forecast is that 70 million doses are intended for children.

“The possible need to apply more doses of Covid-19 vaccines is still being studied by the technical body of the folder”, said the Ministry of Health, in a note.

The immunization stage that involves the youngest depends on the approval of Anvisa (National Health Surveillance Agency). The agency recently received a request from Pfizer to immunize the 5- to 11-year-old group.

The Butantan Institute, responsible in Brazil for the production of Coronavac, had its request denied in August to vaccinate children and adolescents aged 3 to 17 years. Since then, the process has been stuck, without the formal submission of a new application for use by the São Paulo institute.

Last week, minister Marcelo Queiroga (Health) stated that there are guaranteed doses for next year. “Regarding 2022 we are completely safe, contrary to what is said that the ministry does not plan, if the ministry did not plan it would not be in the situation we are in here,” he said.

In an announcement made last Tuesday (16), the Ministry of Health released the booster dose of the Covid vaccine for all people aged 18 or over. The application of the new injection will be carried out five months after the basic vaccination schedule for all adults.

The extraordinary secretary of Covid-19 at the Ministry of Health, Rosana Leite de Melo, said that the booster doses of vaccines against the new coronavirus should help stop a new wave of the pandemic in Brazil.

According to Melo, the country will hardly reach a scenario of increase in cases and deaths, as occurs today in Europe, with the expansion of immunization.

The guideline is that the booster is applied, preferably, with the Pfizer vaccine. In the absence of this immunizing agent, AstraZeneca or Janssen can be applied.

For people who have already taken a heterologous vaccine between the first and second dose —that is, products from different manufacturers—, Pfizer’s vaccine should be applied.

The decision was taken after preliminary results of an Oxford University study on the booster dose, commissioned by the Ministry of Health, showed that the heterologous regimen significantly increases immunity.

“The vaccine to be used for the booster dose should preferably be from the messenger RNA platform (Pfizer/Wyeth) or, alternatively, the viral vector vaccine (Janssen or AstraZeneca), regardless of the primary vaccine schedule,” he said technical note from the ministry.

The announcement of the application of a second dose and a booster dose of the Janssen vaccine for Covid-19, also made by the Ministry of Health on the 16th, caught health managers, Anvisa and even the laboratory producing the vaccine by surprise.

According to the advertisement of the folder, the immunizing agent, which had been used in a single dose, now passes to the regimen of two applications, as already occurs with the injections of Pfizer, AstraZeneca and Coronavac.

The second dose should be given two months after the first in the adult population. The booster dose should be used after five months of the complete primary regimen. The recommendation is to use a different immunizer, preferably from Pfizer.​