São Paulo will apply the Chinese vaccine against covid-19 in January without the political endorsement of Bolsonaro

São Paulo, the richest and most populous state in Brazil, will begin its vaccination program against the coronavirus on January 25, 2021. The tortuous road to implementation is a political minefield for several reasons.

The first is that the state governor, João Doria, an enemy of President Jair Bolsonaro, made the announcement on Monday despite the fact that the vaccine he plans to use, developed by the Chinese laboratory Sinovac, still does not have authorization from the National Agency for Local Health Surveillance (Anvisa).

Having the endorsement of Anvisa, under the influence of the Brazilian president, is a prerequisite for the application of any immunizing agent in Brazil.

If authorization is finally obtained, the vaccine will be applied free of charge initially to health professionals, people over 60 years of age, indigenous people and the quilombolas (families descended from rebellious slaves), who number more than nine million. people (of the 46 million inhabitants that the State has).

Each should receive two doses.

The governor's announcement puts pressure on Anvisa, which has not even received the safety and efficacy data from phase 3 of the Chinese vaccine research, the last stage of the study.

These data must arrive before December 15.

Hours after Doria's announcement, Anvisa published a note stating that it had received no information from phase 3 and details the vaccine registration process: so far they have only fully analyzed the data from phase 1. Phase 1 2, whose reports were sent to the agency on November 20, are still being studied.

This indicates that the schedule may not allow time for the agency's internal procedures.

Bolsonaro also manifested himself on social networks, and has said that only with "certification, the Brazilian Government will offer the vaccine to the entire population for free and not mandatory."

The Bolsonaro Executive has announced that the national vaccination program, without a specific date, will begin in mid-March.

"Brazil is in a hurry (...) people die every day," replied the governor.

The next few days will be definitive for the future of the Chinese vaccine in Brazil.

"If the data that they present to the regulatory body on December 15 is robust and solid, that is, they guarantee good demonstrated effectiveness, it will be possible to maintain that calendar and start the campaign in January," explained Mellanie Fontes-Dutra, coordinator of the Network of Covid-19 Analysis.

If the results are not satisfactory and the regulatory body denies the authorization, Doria's plans may collapse, and there will be nothing left but to go to court.

Fontes-Dutra insists that "there is no immunization without the support of Anvisa."

"It is important that this issue is always analyzed from a technical and scientific point of view," he stressed.

Military against the pandemic

Preliminary data presented by Doria - citing the medical journal

- shows an immune response in 97% of people (which is not the same as protection against the virus).

Under the coronavirus pandemic legislation, an unregistered drug can be used experimentally to immunize the population if it receives approval from regulatory bodies in the United States, the European Union, or Asia.

This being the case, Anvisa could grant an emergency authorization, without final approval.

In any case, so far there is no legal way in Brazil to apply a vaccine without the green light from the agency.

Bolsonaro's recent moves cast doubt on the transparency of Anvisa's decisions.

The president recommended retired Army Lieutenant Colonel Jorge Luiz Kormann for one of the entity's meetings, however, his name needs to be approved by the Senate.

The goal is to have more control over the organ's vaccine policy by putting more “trusted” people in the agency.

According to a report by the

agency

, in June, when the Health Ministry stopped publishing full data on the pandemic, the military man (who works in the portfolio) hid those statistics.

It is not the first time that the transparency of Anvisa's procedures has been questioned.

In early November, the agency even suspended the CoronaVac tests after an unrelated “adverse event”, and without consulting the Butatan Institute about the event, also sparking criticism about a possible politicization of the agency.

At that time, the president celebrated the suspension of rehearsals as a triumph of his administration.

When asked about the participation of private clinics in the vaccination schedule, Doria said that they can participate, but for free and with universal care.

"There is no possibility of using this vaccine privately or at a cost," said João Gabbardo, executive coordinator of the contingency center against covid-19.

Vaccine tourism

Doria also said that "every Brazilian who is in São Paulo can be vaccinated, they will not have to prove their residence."

"São Paulo is part of Brazil, it cannot turn its back on any Brazilian," he said.

This raises fears that there will be a displacement of people from other States to receive the vaccine here, the so-called

.

According to the governor, “eight states and several municipalities [among them Rio de Janeiro and Curitiba] have already requested the CoronaVac from Butantan and expect to receive 4 million doses.

It is not an easy path.

There are specific rules for vaccines to enter the national network of the SUS (Unified Health System).

Doria's bet, if it materializes, will serve as a platform for the Social Democrat for higher flights in 2022, when he will have to present his presidential candidacy.

This is the scene of Doria's political dispute with Jair Bolsonaro over the vaccine.

The president has repeatedly criticized what he has slantedly called "the Chinese vaccine";

Doria, on the other hand, refers to it as "the Brazilian vaccine."

In fact, so far there is no prospect of including CoronaVac in the national vaccination schedule, but rather increasing pressure from state health secretaries to make that happen.

On Monday, December 7, the national government announced that it is negotiating the purchase of vaccines from Pfizer, an option that it had initially ruled out due to the difficulty of the required cooling conditions.

Information about the coronavirus

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