Around the world, about 50 countries have already applied more than 38 million doses. Pfizer / BioNTech Immunizer is the most used
Anvisa (National Health Surveillance Agency) authorized on Sunday (17) the emergency use of two vaccines against covid-19 in Brazil. Coronavac, developed by the Chinese laboratory Sinovac in partnership with the Butantan Institute, of the government of São Paulo, and the immunizer developed by the University of Oxford with the Anglo-Swedish pharmaceutical company AstraZeneca, bet by the federal government through a partnership with Fiocruz (Fundação Oswaldo Cruz).
Approval was unanimous among the agency's five directors. The technical areas of the agency gave favorable opinions to the levels of safety and efficacy of the immunizers, and attested to the good manufacturing and distribution practices.
On Saturday (16), the agency rejected the request for emergency use made by Russian Sputnik V, for not meeting basic requirements such as conducting tests in Brazil.
The release comes 46 days after the first Western government authorized the start of vaccination in its territory. On December 2, 2020, the United Kingdom released emergency use of the vaccine developed by Pfizer. Since then, dozens of countries have started their mass immunization campaigns.
Who came out ahead
As of the morning of January 15, 2020, just over 38.4 million doses of vaccines against covid-19 had been administered around the world, according to data compiled by the website Our World in Data. The immunizers against covid-19 in use today require two doses to ensure protection.
In absolute numbers, the United States is the one that most vaccinated, with 11.1 million doses, equivalent to 3.03% of its population. Americans are followed by China (10 million doses) and the United Kingdom (3.3 million doses).
In relative numbers, Israel stands out - the country is seen as a good example for the rest of the world. In just under a month, 24.9 doses had been applied to every 100 Israelis and about a quarter of the 9 million inhabitants were already immunized. The United Arab Emirates and Bahrain, also in the Middle East, are the other two countries with the highest proportion of the vaccinated population.
In general, vaccination started by groups that have more contact with the new coronavirus or are more vulnerable to the disease, such as health professionals and the elderly.
Which vaccines are used
In all, 237 immunizations against covid-19 are being developed and / or manufactured around the world, according to data released by WHO (World Health Organization) on Tuesday (12).
Nine have passed safety and efficacy tests and have been approved by health agencies, but only five are actually being used in the population.
Of the countries that have already started their vaccination campaigns, most use the vaccine developed by the American pharmaceutical company Pfizer in partnership with the German BioNTech, which showed 95% overall effectiveness and was the first to complete its testing phase. In some, such as the USA, Canada and Germany, the immunizer developed by the American laboratory Moderna is also applied.
The remaining countries are being divided between Russian Sputnik V (91.4% effective, but test results have not yet been made available to the international scientific community), British Oxford with AstraZeneca (70.4% average effective) and Coronavac (50.4% overall effectiveness).
Which countries have not yet started vaccinating
Most countries in the world had not started vaccination until Saturday (16). There are places the process did not start due to a delay in the approval of immunizers and the purchase of doses and supplies. This is the case in Brazil, negotiations with pharmaceutical companies were slow and there was a lack of organization in the purchase of inputs.
Brazil has also experienced missed opportunities. Pfizer tried to sell doses of its vaccine to the government, but received no response the Ministry of Health.
There are still countries that will not start vaccination for the time being, in order to observe how the immunization unfolds in the rest of the world. This is the case of New Zealand, which, because it has controlled the pandemic, is in no hurry to start distributing doses to its population. There, the forecast is that immunization will only start sometime in the second quarter of 2021.
The main challenges
Even with purchased doses and a planned vaccination campaign, immunizing a population against covid-19 is no simple task. There are two main challenges in the process: logistical and behavioral.
Logistics involve ensuring the purchase, delivery or manufacture of doses, having enough syringes and needles for the application of the immunizers without affecting other immunization campaigns, correctly storing the substances and preparing places that will serve as vaccination points.
The limited amount of doses available is the main logistical challenge at the start of immunization. For this reason, the United Kingdom has decided to postpone second dose of the vaccine, with the aim of ensuring that the largest number of people receive the first. Denmark, Germany and Brazil are studying the possibility of doing the same.
Storage of doses is also an obstacle. This is because some of the vaccines - the case of the Pfizer / BioNTech immunizer - need to be stored at very low temperatures, and some countries do not have a large enough network of deep freezers, which is the case in Brazil. In the country, there are only 680 scientific freezers that are capable of reaching the necessary temperatures.
Behavioral challenges are related to convincing the population to get vaccinated. In Brazil, President Jair Bolsonaro insists on betting on ineffective drugs and discouraging vaccination. The consensus in science is that immunization is only effective if the majority of the population is vaccinated.
“The vaccine is not an individual tool: I get vaccinated, I protect myself. It is a collective responsibility, ”Isabella Ballalai, vice president of SBIm (Brazilian Society of Immunizations), told Nexo in October 2020.
There is no 100% effective vaccine: there is a chance that a person will get vaccinated and not be protected against the virus. If a vaccine is 95% effective, it means that 5% of the population does not obtain immunity against the disease.
Still, even the unprotected are safe, as they cannot find anyone who passes the disease on to them. The circulation of the virus is interrupted and, therefore, a wide coverage generates collective immunity. That is why it is important for a large part of the target audience to be immunized.
Research released by the Datafolha Institute in December 2020 showed that, in the last quarter of the year, the percentage of Brazilians who are willing to vaccinate against covid-19 fell 89% to 73%, at the same time that it rose 9% to 22% those who declared that they will not receive the immunizer.
To increase the population's confidence in the vaccine and obtain more immunizations, leaders and state agencies need to bet on advertising campaigns to raise awareness among citizens.
In Indonesia, only 37% of the population said they were interested in getting vaccinated, the government has bet on immunizing major digital influencers in an attempt to convince Indonesians - especially the youngest - to receive the vaccine.