The Ministry of Health has delayed the delivery of the mandatory diluent for the application of the Pfizer vaccine, state health departments complain. In Bahia and Pernambuco, at least 300,000 doses of the immunizing agent against covid-19 are awaiting the arrival of the input. The government of Mato Grosso do Sul also faces the same problem. Demonstrations by truck drivers blocking highways in support of President Jair Bolsonaro contributed to the shortage.
Pfizer’s vaccine requires a diluent to apply. In the country, the dilution has been made with a 0.9% sodium chloride solution (saline solution), which is usually distributed along with vaccines. The volume is applied inside the vial at a ratio of one vial of diluent (1.8 ml) to one vial of vaccine, which contains six doses, as detailed by the health secretariats. Only after this mixture can the immunizing agent be applied to the population.
The government of Pernambuco claims not to receive the diluent from the ministry for more than 20 days – before the protests on the roads. The deficit of the National Immunization Program (PNI) with the State is 38 thousand vials of the input, an amount that would be enough to release the application of 228,000 doses of the vaccine.
The state secretary of Health, André Longo, says that the difficulty is recurrent and already affects the progress of vaccination. “The government of Pernambuco has made a great effort to guarantee this input, through loans with public and private networks, avoiding delays in protecting the population, but this situation should not occur and may, at some point, compromise the vaccination campaign “he said at a press conference this Thursday, 9.
The Department of Health of Bahia confirmed to the state that 81,900 doses of Pfizer are waiting for the diluent to be released in the state. The folder informs having received from the ministry the opinion that there is no forecast to regularize the delivery. Also according to the government of Bahia, VTCLog, a logistics company hired by Pasta, told the State that the truck for the delivery of thinners is being held up in São Paulo because of the truck drivers’ protests.
The Secretary of Health of Mato Grosso do Sul, Geraldo Resende, wants to advance in the vaccination of adolescents and reduce the interval between doses of Pfizer vaccine from eight weeks to 21 days. The product of this brand is the only one released by the National Health Surveillance Agency (Anvisa) for use in children under 18 years of age.
However, he told the state that the lack of thinners is a bottleneck: the product is already lacking in the State. Uncertainty in receiving new doses is another bottleneck, as the Ministry of Health is constantly reducing delivery forecasts, which undermines campaign planning. Mato Grosso do Sul is the state with the highest vaccination coverage, with 48.1% of the population receiving two doses.
In Rio, a shipment of 98,000 doses of Pfizer was delivered on the night of Wednesday, 8. The diluent arrived in the state only on Thursday morning, 9. The immunization of this age group in the capital of Rio de Janeiro has been interrupted by cause of oscillation in dose delivery.
The Ministry of Health informed that, in the coming days, “824.9 thousand bottles of diluents will be delivered to the State of Bahia and 531.3 thousand bottles to the state of Pernambuco”. “The amount is enough to apply the doses of Pfizer sent to the two States”, pointed out the folder. In a statement, VTCLog said that “who is responsible for managing the vaccines is the Ministry of Health”. “VTC only executes, in accordance with security criteria and current contract.”
Lack of AstraZeneca surprises people from São Paulo at health centers
Half of the Basic Health Units (UBSs) in the city of São Paulo were without AstraZeneca vaccine to apply the second dose on Thursday, 9. In total, 240 of the 468 posts were without these doses, according to information from the municipal health secretary , Edson Appeared. The municipality’s stock was around 37 thousand doses, which was not enough to supply all the units.
The State Department of Health states that the ministry should have sent around a million doses by September 4 to meet the demand for a second dose, but it did not. “Not sending these doses violates an obligation of the Ministry of Health for vaccines necessary for the complementary immunization of people who have already taken the first dose”, says an excerpt of the note.
The Ministry of Health says that it anticipated the sending of 315.5 thousand doses of AstraZeneca to the State on September 1st. According to the agency, the doses were scheduled to be delivered until September 30 and are intended for the second dose. “The folder reinforces that it will not guarantee doses for states and municipalities that adopt different vaccine schemes than those defined by representatives of the Union, states and municipalities in the National Plan for the Operationalization of Vaccination against Covid-19 (PNO)”, says the note sent for the ministry.
States are seeing a risk of AstraZeneca vaccine shortages for the coming weeks. The fear comes from a scenario in which the demand for doses produced in Brazil by Fiocruz will continue to rise, and should intensify even more with the plan to shorten the interval between applications, from 12 to eight weeks. Thirty-two million people begin returning for the 2nd dose of AstraZeneca from September through November.