Rio de Janeiro, currently Brazil’s epicenter for the variant
and home to one of its largest elderly populations, began administering the
boosters Wednesday. Northeastern cities Salvador and Sao Luis started on
Monday, and the most populous city of Sao Paulo will begin Sept. 6. The rest of
the nation will follow the next week.
France, Israel, China and Chile are among those countries
giving boosters to some of their older citizens, but more people in those
countries are fully vaccinated than the 30% who have gotten two shots in
Brazil. A U.S. plan to start delivery of booster shots by Sept. 20 for most
Americans is facing complications that could delay third doses for those who
received the Moderna vaccine, administration officials said Friday.
About nine out of 10 Brazilians have been vaccinated already
or plan to be, according to pollster Datafolha. Most have gotten their first
shot but not their second.
Brazil’s cases and deaths have been falling for two months,
with 621 deaths reported in the seven days through Sept. 2 — far below April’s
peak of more than 3,000 reported deaths over a seven-day period. Older
Brazilians have expressed concern about the efficacy of the Chinese Sinovac
vaccine against the delta variant, prompting authorities to offer the booster
shots.
Diana dos Santos, 71, received two shots of the Sinovac
vaccine even after President Jair Bolsonaro spent months publicly criticizing
it. Dos Santos, who lives Rio’s low-income Maré neighborhood, is diabetic and
was hospitalized for a heart condition. She refuses to leave home until she
gets her booster.
“I can’t go out like before and I’m still afraid of all of
this,” dos Santos said. “I will feel safer (with a booster).”
Because of the variant, some experts say the government
should slow the rollout of boosters and focus on distributing second doses.
Delta is the most contagious variant identified, and many studies have
suggested that one dose doesn’t protect against it. Two shots provide strong
protection, with nearly all hospitalizations and deaths among the unvaccinated.
Ethel Maciel, an epidemiologist and professor at the Federal
University of Espirito Santo, said pushing boosters at this early stage recalls
the lack of concern given the gamma variant that overwhelmed Amazonian city
Manaus earlier this year, only to feed a new wave nationwide. Brazil has seen
more than 580,000 deaths from COVID-19, making it home to world’s
eighth-highest toll on a per-capita basis.
“It seems we’re in the same movie, repeating the same
errors,” Maciel said. “It’s only a matter of time until what’s happening in Rio
leads to a greater number of more serious cases in the rest of the country.”
The delta variant already is dominant in Rio de Janeiro
state, detected in 86% of the samples collected from COVID-19 patients,
according to the Ministry of Science, Technology and Innovation. Intensive care
units have reached full capacity in eight municipalities, although only a small
rise in deaths have been recorded so far.
Authorities in Sao Paulo state expect a similar scenario
within weeks. It registered its first confirmed death from the delta variant on
Tuesday, a 74-year-old woman who had received two Sinovac shots.
Globally, doubts have plagued Chinese vaccines, especially
as the delta variant has gained hold in many countries. Chinese officials have
maintained the vaccine protects against delta, particularly preventing
hospitalizations and severe cases.
Still, Brazil’s Health Minister Marcelo Queiroga said Aug.
25 that people aged 70 or older or who have a weak immune system will be
eligible for a third dose, starting Sept. 15 -- preferably with the Pfizer
vaccine. He said that people over 18 will have received their first doses by
then, althgough he didn’t address their vulnerability to the delta variant
without a second shot.
He also criticized governors and mayors who sought to
deliver booster shots earlier, saying it could lead to vaccine shortages.
Carla Domingues, former coordinator of Brazil’s national
immunization program, agrees with the need to provide the elderly boosters, but
not for people aged 70 and up right away. Shots should first go to nursing
homes and people who are bed-ridden, she said, then people 80 and above, with
the age slowly decreasing as supply allows.
“Certainly there will be problems with shortage, because
there won’t be enough vaccine,” Domingues said.
Japan and South Korea both wrestled with slow vaccine rollouts,
and under half their populations are fully vaccinated; their governments are
only planning booster shots in the fourth quarter of this year. Malaysia also
is considering boosters, but Health Minister Khairy Jamaluddin said the
priority is those who haven’t received a first dose.
Thailand began giving booster shots even as most people wait
to be vaccinated — but only for health and front-line workers who received two
Sinovac shots. The decision came after a nurse died of COVID-19 in July.
Russia, Hungary and Serbia also are giving boosters,
although there has been a lack of demand in those countries for the initial
shots amid abundant supplies.
In addition to doubts over boosters, the issue is sensitive
due to implications for global vaccine distribution. World Health Organization
Director-General Tedros Adhanom Ghebreyesus has called for a moratorium on
boosters “to allow those countries that are furthest behind to catch up.”
Epidemiologist Denise Garrett, vice president of the Sabin
Vaccine Institute, which advocates for expanding global vaccine access, said in
an interview there is no doubt about the need for two jabs, but she sees no
scientific or moral justification for a third.
“Authorities giving a third dose are prioritizing protection
against light disease instead of shielding people in poor countries from
death,” said Garrett, who is Brazilian. “That is shameful, immoral, and this
vaccine inequity must end.”
That doesn’t sway 97-year-old Maria Menezes, who wants to
spend time outside her home where she has lived for the last seven decades in
Rio’s western region. Her two daughters say Menezes wants to a booster shot.
“She asked us to take her for the third vaccine,” said
daughter Cristina França, 38. “It will be important to beef up her immunity to
reduce her risks. Her life won’t change much after the third dose, because she
is more frail now, but she would live with more calm.”