Coronavac vaccine use in Brazil drops to less than 10%

The vaccine that started immunization against Covid-19 in Brazil and reached 85% of doses applied in March, now has less than 10% of applications — and should not be purchased by the federal government next year.

Coronavac reached the Brazilian arm in January. It was the most administered immunizing agent until April against Covid-19, with almost 40 million doses applied in that period.

This means that the elderly, health professionals, indigenous people and other priority groups were the main people vaccinated with the immunizing agent produced by the Butantan Institute through an agreement with the Chinese pharmaceutical company Sinovac.

As of May, however, Coronavac began to lose participation in vaccines applied in the country against the disease caused by the coronavirus.

Now, according to the Ministry of Health, the immunizers elected to fight the pandemic in 2022 are Pfizer and AstraZeneca — and nothing from Coronavac.

“The two vaccines were chosen because they have definitive registration with Anvisa (National Health Surveillance Agency) and approval by Conitec (National Commission for the Incorporation of Technologies in the SUS)”, says the federal folder in a note.

To put it mildly: the federal government does not intend to buy Coronavac for application next year — which has been worrying specialists.

The main issue is that the Butantan vaccine may be an option for the immunization of children under 12 years of age, which should start next year after approval by Anvisa.

“If Coronavac licenses for children, will the federal government stop buying?”, asks virologist Maurício Lacerda Nogueira, a professor at the Faculty of Medicine of São José do Rio Preto.

For now, only the Pfizer vaccine was approved by Anvisa for children over five years old, last Thursday (16). The dosage will be lower than that already used for people over twelve years old. The vaccine will have vials differentiated by color.

But the doses for children have not yet been purchased by the administration of President Jair Bolsonaro (PL). On Friday (17) the government of São Paulo even sent a letter to Pfizer communicating its interest in purchasing the vaccines, but the company said that it is only negotiating with the federal government.

Coronavac, on the other hand, is being evaluated by Anvisa for application in the age group from three to 17 years old. Butantan submitted a new request to the agency on Wednesday (15). The agency has 30 days to evaluate the request.

The previous order, made in July, was stuck due to lack of data. Countries like China, Chile, Ecuador and Indonesia use Coronavac for children and teenagers.

For immunologist Gustavo Cabral, a researcher at USP with investigations into the development of vaccines against Covid-19, we cannot “retire” Coronavac precisely because of the demand for immunization of children and adolescents.

“In the fight against the pandemic, the more we add, the better the result,” he says. “Pfizer is a great vaccine, but it’s never good to rely on a single weapon if you can have several that complement each other.”

In addition to not buying more Coronavac for next year, the Ministry of Health recently refused 15 million doses, which have been stopped at the factory at the Butantan Institute. After the federal denial, the government of São Paulo announced that it would reserve part of this surplus for application to children and adolescents — when this is approved.

According to the Ministry of Health, the Butantan Institute has already fulfilled the contractual delivery of 100 million doses of Coronavac vaccine. By the end of November, 82.4 million doses of Coronavac had been applied in Brazil to the population over 18 years of age. That’s 28.63% of all doses — first, second and single doses — given since January.

In May, Coronavac was surpassed by Astrazeneca, which reached 70% of immunizations that month. Later, it also lost to Pfizer, who became the main immunizer against Covid-19 as of August.

To give you an idea, in November, 8 out of 10 doses against Covid-19 applied in Brazil were from Pfizer (considering the first and second doses, in addition to a single dose). Janssen, which began to be applied in June with a single dose in the country —and had a peak of doses in the following month—, does not reach 2% of all applied against Covid-19 until the end of November.

In note to leaf, the government of the state of São Paulo says that “Coronavac is a safe and effective vaccine and is part of a group of fundamental immunizing agents to save lives”, but did not comment specifically on the announcement that the vaccine will not be purchased by the federal ministry in 2022.

He also states that “in the face of the federal government’s inertia, it mobilized strategies with Butantan to guarantee immunization and immunization of Brazilians. Also in a pioneering way, the vaccination of priority groups in Brazil was started in January, which was only possible due to an effort by the Government of São Paulo immediately after approval by Anvisa for the emergency use of Coronavac.”

Of all the states, São Paulo had the largest participation of Coronavac from January to the end of November: the vaccine represented 34.1% of the applied doses.

Butantan said, in a note to leaf, that “the production of vaccines will follow a plan that will be agreed with the Ministry of Health in accordance with the demands of the country”.

It also reinforced the announcement made last Tuesday (7), at an international event with Sinovac, that Coronavac will be updated against the omicron variant. The idea is that the new version of the vaccine will be available in three months.

The picture of the distribution of vaccination against Covid-19 by manufacturer was tabulated by leaf directly in DataSUS (information system of the Ministry of Health). This was done before the system went down this Friday (10) because of a hacker attack.

DataSUS identifies all immunized people with an individual code, accompanied by information on age, vaccination priority group, immunization date and batch of vaccine received.

All the first and second doses and single doses applied since the beginning of the vaccination campaign in the country, in January, until the last day of November were tabulated.