Most capitals still haven’t reinforced against Covid in half of the elderly

Almost three months after the Ministry of Health authorized the application of booster doses of vaccines against Covid, only 11 of the 27 Brazilian capitals have already completed the immunization of 50% or more of their elderly.

The survey was carried out by leaf from the Ministry of Health’s vaccination data until last Saturday (4) and the most recent population estimates from the IBGE (Brazilian Institute of Geography and Statistics).

The analysis reveals a wide variation between coverages. Vitória leads the ranking, with 91.3% of its residents aged 60 or over already immunized with the booster, followed by Campo Grande (79.4%), Rio de Janeiro (73.9%) and Belo Horizonte (64, 1%).

Meanwhile, at the opposite extreme, Macapá and Rio Branco accounted, respectively, for only 10.7% and 14.3% of that target audience reached with the additional dose. Boa Vista, Brasília, Cuiabá and Palmas also appear at the end of the line, with coverage below 40% of the population aged 60 and over.

Teresina, Maceió, Porto Velho, São Paulo, Natal, São Luís, Curitiba, Aracaju, Recife and Manaus complete the list of 16 capitals — 12 of them in the North and Northeast regions — that have not yet reached the mark of half of the elderly protected with extra application.

One must consider the delays in the Ministry’s numbers in relation to municipal bulletins, due to the process of digitizing records in official systems. This leads to divergences between the data reported by the municipal secretariats and the federal folder.

The city of São Paulo, for example, reports having vaccinated the equivalent of 49.6% of the elderly with the booster by the end of November. Already the records of the ministry indicate that 42.5% of Paulistanos aged 60 years or more had received the extra dose.

The booster dose against Covid-19, first released for the elderly aged 70 and over and immunosuppressed people, began to be given in September.

Later that month, the folder expanded its target audience, also including those aged 60 and over and health professionals.

Vice-president of Abrasco (Brazilian Association of Collective Health) and professor at the Federal University of Ceará, epidemiologist Lígia Kerr recalls that the elderly were among the first priority groups of the campaign, which started in late January, and, therefore, they may have the lagged protection.

“The third dose of the vaccine in the elderly is necessary. Above 60 years of age, it is already known that there is a fairly intense drop in antibodies after four months [após a segunda dose]. So they may have this very old vaccine,” he says.

Research conducted in Israel with data on 843,000 people aged 50 and over, published this week in the New England Journal of Medicine, for example, suggests that the risk of death is 90% lower among those who received the booster dose of Pfizer/ BioNTech after an interval of five months, in comparison with those who had only completed the first vaccination schedule.

On another front, a report produced by Fiocruz researchers with data on hospitalizations and deaths by Covid in Brazil, cited in the PNO (National Plan for Operationalization of the Vaccination Campaign), concluded that the risk of death from the disease is twice as high from 60 years and increases progressively up to 18.3 times for those who are 90 or older.

“Older people over 70 years of age continue to be the most affected by severe forms of Covid-19, with signs of rising rates of hospitalization in this population,” says the latest version of the plan.

Given the uncertainties brought about by the emergence of the omicron variant, BioNTech and Pfizer reported this week that the third dose of their vaccine against Covid has neutralized the new strain of coronavirus in laboratory tests — with just two doses, however, there is loss of effectiveness against the variant.

The companies announced that, if necessary, it would be possible to develop a version of the immunizing agent, specific for the new mutation, by March of next year.

“Even with most governors having banned public parties, many people will persist and hold their private party, which could lead to increased circulation of the virus. It is very important that the elderly are taken care of, and the best way to take care of them at this time is get them vaccinated as quickly as possible,” Kerr warns.

In the evaluation of the vice president of Abrasco, mayors and governors should take advantage of the moment, which is more favorable in terms of the offer of doses, to accelerate the application of booster doses.

“We have an important supply, so it is essential that this third dose is actively taken to the elderly, or that they are called and taken to health units, so that they can be properly immunized”, recommends the specialist.

Nanci Silva, a consultant at the SBI (Brazilian Society of Infectology) and a professor at the Bahia School of Medicine and Public Health, is also demanding more encouragement from the health authorities.

“These rates are related to the level of education of the population, in general, but also, obviously, to the level of encouragement and information on the part of city halls. People need to be encouraged to take part in the vaccination process. It is necessary to create the right conditions. so that people can be vaccinated. Reaching out to these people, going to where the elderly person is”, adds Silva.

More recently, on November 16, the Ministry of Health extended the application of the booster dose to the entire adult population. So far, according to the analysis of the leaf, 5.3 million third doses were administered in capitals to people aged 18 years and over (including the elderly).

Vitória also leads the ranking with the highest percentage of people aged 18 or over already immunized with the booster dose (27.35%). Campo Grande, Porto Alegre and Rio de Janeiro are the only others that have already won the 20% mark.

Upon announcing the expansion to all adults, the Ministry of Health’s Covid Secretary for Covid, Rosana Leite, stated that the federal government’s forecast was to guarantee reinforcement to all Brazilians over 18 years of age by the middle of next year, totaling 103 million doses applied until May 2022.