The governor of São Paulo, João Doria, said this Wednesday (9) that the state will adopt the fourth dose of the vaccine against Covid-19.
In a press conference, Doria said that the fourth dose is being studied by the state government, but did not give a date to start the calendar. “The fact of considering does not mean that the application [da quarta dose] will be immediate or short term because it won’t.”
The uncertain tone regarding the topic was different from the assertive way in which Doria announced the measure earlier in an interview with Eldorado radio. “[A quarta dose] is already confirmed by the scientific committee of the government of São Paulo. We are ready to start the fourth booster dose,” the governor told the radio.
According to the State Secretary of Health, Jean Gorinchteyn, the state has about 2 million people without the complete vaccination schedule that must be immunized before the start of the application of the fourth dose. “Right now we have to focus on those who are not fully immunized,” he said.
According to Doria, these are people who forgot to take the second dose, not people who are against immunization. Therefore, the state adopted a method of sending SMS to reinforce the need to take the second dose.
Regarding the brand of vaccine to be used for the fourth dose, Gorinchteyn said there is still no defined strategy. “We don’t even want to use the term ‘fourth dose’ because it’s a vaccine that has to be given every year.”
Earlier, in an interview with Eldorado radio, the governor said that the booster dose in immunization will be adopted “regardless of whether or not there is a recommendation from the Ministry of Health”.
In the interview, Doria mentioned the “considerable” number of people who have not yet taken the second dose in the state. Therefore, the fourth dose will be applied after the advancement of this row. “Advancing in the second dose, we can in São Paulo start the booster dose, the fourth dose, and also following an order of age group.”
The governor said that the fourth dose is approved by Anvisa (National Health Surveillance Agency). “Anvisa has been a competent and respectable example of attitudes in defense of science and life.”
Last Monday (7), a technical note released by the Ministry of Health stated that there is not enough data for the need to apply the fourth dose of the vaccine in the population.
“Before we move towards new indications in the PNO calendar [Plano Nacional de Operacionalizações]it is necessary to understand the epidemiological scenario in greater detail regarding hospitalizations, deaths and infections by Covid-19 among certain age groups and their relationship with vaccination status (vaccinated vs unvaccinated)”, says the published technical note.
The recommendation of the Ministry of Health so far is that the fourth dose continues to be applied in immunocompromised patients. This group started to receive another dose of the immunizing agent in December last year.
According to infectious disease specialist Bruno Scarpelinni, there is still no evidence that the fourth dose will benefit the general population. “There is evidence of effectiveness of the fourth dose in the groups that took Coronavac at the start of vaccination in 2021, such as the elderly and immunocompromised,” he said.
For the infectologist at Hospital das Clínicas and director of the Paulista Society of Infectious Diseases Evaldo Affonso de Araújo, there are doubts about the general use of the second booster dose. “It’s a rash thing,” he says. “The whole world is experiencing a vaccine supplement crisis, so it makes no sense to reinforce vaccination in certain countries when there are places like the African continent that still have a significant undervaccination”, he continues.
For now, the fourth dose has been given generally in Chile and Israel. “With the fourth dose, we seek to maintain this leadership position and protect the health and lives of our compatriots,” Chilean President Sebastián Piñera said during an announcement of the booster dose in early January.
A study conducted by physician and researcher Gili Regev-Yochay at the Sheba hospital in Israel concluded that the fourth dose of the vaccine is not able to prevent infection by the Ômicron variant. “The reality is that the vaccine is very good at containing the Alpha and Delta variants, but it is not very effective at containing the Omicron,” the doctor said in an interview with The Times of Israel in January.
So far, the state of São Paulo has applied 96 million doses and has 97% of the population with a complete vaccination schedule. An additional 17.8 million doses were administered.
The governor said at a press conference that hospitalizations for Covid-19 dropped for the eighth day in a row this Wednesday, after two months of high. “Today is the first day that we have less than 10,000 patients admitted to hospital units,” said the state secretary of health.
The secretary stated that the number of 1,521 hospitalizations per day dropped to about 1,200 hospitalizations per day.
The announcement of the fourth dose by Doria opened a new chapter in the political dispute with the federal government over vaccination against Covid-19. Opponents in the dispute for the Presidency of the Republic in the next elections, the governor of São Paulo and President Jair Bolsonaro (PL) act on opposite sides in relation to the matter.
After Doria’s announcement, the Minister of Health, Marcelo Queiroga, criticized the initiative and highlighted the ministry’s priority in immunizing people who have not yet received the second dose. “The governor of São Paulo and other heads of executives, whether state or municipal, often interfere in the decision-making process regarding immunization”, he said in an interview after meeting with the president of the Chamber, Arthur Lira (PP-AL).
Health technicians and the PNI (National Immunization Program) should reassess on Friday (11) whether they indicate the application of a new dose against Covid-19.
In January, the minister accused the toucan of “making a stand” with the start of childhood vaccination. That day, Doria opened the national campaign to immunize the public from 5 to 11 years old with doses of Pfizer.
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