The Ministry of Health announced that the new vaccination schedule against Covid will start on February 27th.
The first stage of the 2023 PNI (National Immunization Program) campaign will begin with the application of bivalent vaccines to people in risk groups, which include the elderly, pregnant women and immunosuppressed people.
As of March, there will be an intensification of vaccination campaigns against Covid in the entire population aged 12 years and over with booster doses and in children from six months to 11 years of age.
However, many doubts may still arise about who can receive the new doses, how long the interval between them is and whether it is better to wait for the new vaccination stage or receive the boosters already available.
See below questions and answers about vaccination with bivalent vaccines against Covid.
What are bivalent vaccines?
Bivalent vaccines are updated versions of Covid immunizers containing the original Wuhan strain combined with the omicron variant, currently prevalent worldwide.
There are two companies that have bivalent vaccines already approved for use. Moderna and Pfizer have already licensed their vaccines containing omicron subvariants BA.1 and BA.4/BA.5.
In Brazil, Anvisa (National Health Surveillance Agency) approved the emergency use of two bivalent Pfizer formulations (for BA.1 and BA.4/BA.5). The agency authorized the use of immunizers as boosters for people aged 12 and over.
On January 20, Moderna filed a request with Anvisa for approval of its bivalent vaccine, but the demand is still under analysis by the agency.
Who can receive boosters with bivalent vaccines?
Despite Anvisa’s authorization for the use of bivalent boosters in all people over 12 years of age, the Ministry of Health decided to reduce the target audience of immunizations only to priority groups, which include elderly people over 60 years of age, pregnant and puerperal women, immunocompromised people, people with disabilities, patients living in long-stay institutions, indigenous peoples, riverside and quilombola communities and health professionals.
For the other Brazilians, the evaluation of the paste is that there is no proven benefit of gain in effectiveness with immunization with the bivalent booster compared to the original formulation.
It is worth noting that all Covid vaccines continue to be considered safe and protect against hospitalizations and deaths.
How many booster doses will be given?
For bivalent vaccines, a single dose is planned for all people in the priority group who received the last booster (third or fourth dose) at least three months ago.
There is still no forecast in Brazil for the inclusion of bivalent vaccines as a form of primary scheme against Covid-that is, in people who have never received a dose against Covid.
Last Tuesday (31), Anvisa received the definitive registration request for Pfizer’s bivalent vaccines. In the case of a definitive authorization, the vaccine can also be used outside the context of a health emergency against Covid. All other vaccines currently used in the country, except Coronavac, already have a definitive record.
What to do if I am not in the priority group to receive bivalent reinforcement?
The recommendation of experts and the health department is that, at this time, anyone who is not a priority group to receive bivalent vaccines should seek to update the booster with the monovalent doses in use: Pfizer, AstraZeneca, Janssen and Coronavac.
According to the Ministry of Health, vaccination against Covid in the population over 12 years old and not included in one of the risk groups continues to be recommended with the aim of increasing coverage. In the country, until last January 5, about 69 million people had not taken the last booster dose.
If you are not included in one of the priority groups for bivalent vaccines, the application of a booster dose — third dose, in the case of children aged 5 to 11 years, adolescents aged 12 to 17 and adults over 18 years of age, or fourth dose, for those over 40 years old—can currently be given at all vaccination posts in the country.
Are there any contraindications for bivalent boosters?
In scientific studies, there were no side effects of bivalent vaccines different from those observed with monovalent vaccines, with a general incidence of mild effects, such as pain at the application site, fever and muscle aches.
There is also no contraindication to receiving the Covid vaccine in conjunction with other vaccines, such as the flu. Updating vaccination with boosters can be done after four months since the last vaccine applied.
Regarding the third and fourth dose boosters or for those individuals who have not yet been immunized against Covid, the Ministry of Health published on December 27th a technical note restricting viral vector vaccines (AstraZeneca and Janssen) for adults only aged over 40, with other vaccines being administered preferentially for the rest of the population.
According to the resolution, the decision is given for two main reasons: the more favorable epidemiological situation, with a large part of the population already vaccinated with the primary scheme (two doses or a single dose), and the occurrence, although rare, of adverse events serious problems related to the two vaccines, such as thrombosis with thrombocytopenia, a type of clot that can form after immunization and is associated with low blood platelet counts (or cells of the immune system).
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