The Ministry of Health foresees a contract with 60 million doses of the Covid vaccine to immunize priority groups in 2024.
According to an announcement made last Tuesday (31), immunization against Covid should be annual and only for individuals in the target audience, as is done today with vaccination against influenza.
For those who are late or have not yet been reinforced with the bivalent, it is possible to update by the end of the year. “What we have of evidence so far, and even the recommendation of the WHO itself [Organização Mundial da Saúde]is that for those who have already received three doses there is still protection against serious illness and long Covid”, he told Sheet the Secretary of Health and Environmental Surveillance, Ethel Maciel.
In this sense, healthy adults, according to her, would have no apparent benefit from annual vaccination against the disease. The decision was recommended by the CTAI (Technical Advisory Committee for Immunization), of the Ministry of Health, as is the case with other immunization agents included in the annual calendar. A cost-effectiveness analysis was also carried out, and, based on this, the decision was made to only include priority groups.
The rest of the population will be immunized according to the availability of doses, he said. “We saw that there is no substantial gain in relation to the vaccine we already have available in immunocompetent adults [que não têm problemas de saúde graves]including because the vaccines used so far do not prevent infection, they have a role in reducing the risk of serious illness and death”, he stated.
However, some scientific studies that point to the so-called “decay of immunity”, that is, the natural drop in antibodies produced four to six months after the last dose, indicate that there may be a need for annual doses even in people outside the group of risk.
“It is important to remember that we are still learning a lot about this disease, which is very new, about the protection of vaccines in people with multiple infections. So with the data we have so far, we follow the WHO recommendation of annual immunization” , says the federal government representative.
Another announcement made by the secretary is to only use updated vaccines in the campaign. These vaccines, called updated monovalents, are formulated using the S protein (or spike, the molecular hook used by the virus to enter cells) of the dominant variant in circulation. In September, the FDA (the agency that regulates medicines and foods in the USA) approved two formulations against the BA.2.86 variant, one from the pharmaceutical company Pfizer and the other from the biotechnology company Moderna.
The two companies, as well as Novavax, are working on new formulations that use the XBB.1.5 subvariant, predominant in the Northern Hemisphere and considered the most transmissible so far.
“As we are no longer in a health emergency, our processes now occur at the regular purchasing pace, and that is why we are readjusting our contract to forecast 60 million doses for next year according to the most updated version, which we still cannot state what it will be”, said Maciel, also highlighting that vaccines must go through the registration process with Anvisa (National Health Surveillance Agency).
The agency received new registration requests from manufacturers, which are still being analyzed.
For adults aged 18 to 59 who have not yet received the bivalent booster dose, it is important to seek a health center by the end of the year. “We understand that an annual dose is what guarantees protection and, in the case of healthy people, a minimum schedule of three doses. So, anyone who has not yet completed this schedule should go as soon as possible”, he concludes.
WHAT THE WHO SAYS
- High priority group for annual vaccination includes the elderly, adults with comorbidities or severe obesity, immunosuppressed people (including children six months or older), pregnant women and healthcare workers.
- Medium priority group are healthy adults without comorbidities, under 50 or 60 years old (age limit depends on the country), and children and adolescents with serious comorbidities; these are not part of the recommendation for additional annual doses, but can be included according to the availability of the vaccine.
- People not included in any priority group and for whom there is no recommendation for annual doses are healthy children and adolescents aged six months to 17 years.
WHAT THE US CENTER FOR DISEASE CONTROL AND PREVENTION SAYS
People aged five or over regardless of previous vaccination They can receive a new booster with the updated vaccine two months after the last vaccine.
Babies and children aged six months to four years previously vaccinated they may receive one or two doses of the updated vaccine (the time and number of doses administered depend on the Covid vaccine they received before).
Infants and children aged six months to four years who have never received monovalent doses they can receive up to three doses of Pfizer’s updated formula or two doses of Moderna’s new version.
WHAT THE MINISTRY OF HEALTH SAYS
- Are included for annual vaccination children from six months to less than five years of age, elderly people, immunocompromised people, pregnant women, postpartum women, health workers, people with comorbidities, indigenous people, riverside dwellers, quilombolas, people living in long-term care institutions and their workers, people with permanent disabilities, deprived of liberty over 18 years of age, adolescents and young people undergoing socio-educational measures, prison system employees and homeless people.
- For everyone else, including healthy adultsthere is no recommendation for annual vaccination.