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Vacina covid-19: O que significa uso emergencial? O que é placebo? As respostas para as 10 perguntas mais procuradas sobre vacinação nas últimas 24 horas

A aprovação da CoronaVac (Sinovac/Instituto Butantan) e da CoviShield (FioCruz/Universidade de Oxford/AstraZeneca) representou um enorme avanço para conter a pandemia de covid-19, que já vitimou quase 210 mil brasileiros.

Essas duas vacinas são as primeiras a serem liberadas pela Anvisa (Agência Nacional de Vigilância Sanitária). No domingo (17/01), técnicos e diretores da agência sanitária brasileira se reuniram para tomar a decisão e aceitar de forma emergencial a aplicação das doses.

Em meio a tanta expectativa e planejamento, a população brasileira está cheia de dúvidas e perguntas a respeito dos produtos e, claro, de como vai acontecer a campanha nacional de imunização contra a covid-19.

Prova disso é um levantamento feito pelo Google, ao qual a BBC News Brasil teve acesso com exclusividade.

Algumas perguntas relacionadas à vacinação contra a covid-19 tiveram um crescimento de 2.500% nas buscas durante as últimas 24 horas.

Confira abaixo as questões mais comuns e as respostas para elas.

1. O que significa uso emergencial da vacina?

O uso emergencial é uma aprovação que as agências regulatórias, como a Anvisa no Brasil e a FDA nos Estados Unidos, dão a determinados produtos em caráter provisório e por um tempo determinado.

Essa liberação se baseia nas análises preliminares dos testes clínicos. Esses estudos acompanham milhares de voluntários e geralmente demoram alguns anos para serem finalizados.

O problema é que, durante uma pandemia que afeta milhões de pessoas em todos os continentes, é impossível esperar tanto tempo para encontrar uma solução.

Para acelerar um pouco esse processo, os cientistas determinam um número mínimo de eventos. Em outras palavras, isso significa uma quantidade de participantes do estudo que pegam covid-19.

A partir daí, é possível fazer comparações e cálculos para determinar uma taxa de eficácia do imunizante e saber se ele é seguro e não provoca efeitos colaterais graves.

A CoronaVac e a CoviShield passaram por todo esse processo nos últimos meses e mostraram capacidade para conter a infecção pelo coronavírus. Por isso, foram aprovadas para uso emergencial no Brasil.

É importante mencionar que isso não significa que os estudos acabaram: eles continuarão pelos próximos meses para garantir que essas observações iniciais se mantêm ao longo do tempo.

A partir dos dados completos, será possível pedir a autorização definitiva dos produtos num futuro próximo.

2. O que é imunogenicidade?

A imunogenicidade é a capacidade que uma vacina tem de gerar uma resposta imune e fazer com que uma pessoa fique protegida contra determinada doença.

“A partir do momento em que aplicamos as doses, o imunizante vai induzir uma produção de anticorpos que vão nos resguardar contra determinado vírus ou bactéria”, explica o médico Fabiano Ramos, coordenador do Serviço de Infectologia do Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul.

Pelos estudos feitos até o momento, a CoronaVac e a CoviShield tem uma boa imunogenicidade. O que ainda não se sabe é quanto tempo essa proteção dura — será preciso acompanhar os voluntários por mais tempo para obter essa resposta.

Pode ser que essas vacinas precisem de doses de reforço a cada seis, 12 ou 24 meses (como acontece com as vacinas contra a gripe).

Outra possibilidade é que o efeito delas na imunidade seja duradouro (como no caso dos imunizantes que resguardam contra a febre amarela e o sarampo, por exemplo).

3. Quando começa a vacinação?

As primeiras doses já foram aplicadas, logo após a aprovação pela Anvisa. A primeira brasileira a receber a CoronaVac foi a enfermeira Mônica Calazans, de 54 anos, que trabalha no Instituto de Infectologia Emílio Ribas, em São Paulo.

A CoviShield ainda deve demorar um pouco para ficar disponível. Os primeiros frascos do produto serão importados e a previsão é que cheguem ao país nas próximas duas semanas. A FioCruz, que vai produzir essa vacina em território nacional, aguarda a chegada de insumos para iniciar a fabricação.

De acordo com o site Our World in Data, até o momento 112 brasileiros foram vacinados. A expectativa é que esse número aumente bastante nos próximos dias.

Os lotes da CoronaVac já começaram a ser distribuídos e chegaram em algumas localidades, como Distrito Federal, Piauí, Santa Catarina e Goiás.

4. O que é vacina placebo?

Esse termo “vacina placebo”, na verdade, está errado. Uma coisa é vacina e outra completamente diferente é o placebo.

Acontece que, durante os testes clínicos antes da aprovação, os cientistas precisam saber se o imunizante é seguro e eficaz.

Para isso, os voluntários são divididos em dois grupos. O primeiro toma doses do produto ativo, que vai gerar aquela imunogenicidade que explicamos um pouco mais acima.

Já o segundo recebe doses de placebo, uma substância sem nenhum efeito no corpo.

A expectativa é que, na comparação dos resultados, o grupo que foi vacinado esteja mais protegido contra determinada doença infecciosa em relação àqueles que receberam placebo.

5. Quantas vacinas o Brasil comprou?

Por enquanto, estão autorizadas no Brasil a CoronaVac (Instituto Butantan/Sinovac) e a CoviShield (FioCruz/Universidade de Oxford/AstraZeneca).

No momento, 6 milhões de doses da CoronaVac são distribuídas pelos Estados. O Instituto Butantan calcula que tem capacidade de produzir 46 milhões de doses até abril.

Cerca de 2 milhões de doses da CoviShield devem chegar ao país nas próximas duas semanas. A FioCruz promete entregar 100 milhões de doses desta vacina durante o primeiro semestre de 2021.

Algumas concorrentes já possuem acordos com governos estaduais. É o caso da Sputnik V (Instituto Gamaleya de Pesquisa), que tem intenção de compra no Paraná e na Bahia. Mas sua distribuição depende do aval da Anvisa — recentemente, a agência pediu mais dados sobre os estudos deste imunizante para poder tomar a decisão.

Há concorrentes já aprovados em outros países, como aqueles produzidos por Pfizer/BioNTech e Moderna, mas eles não têm previsão de chegada ao Brasil.

6. O que fazer quando se perde a carteira de vacinação?

Para a campanha de imunização contra a covid-19, isso não será um problema. “Os postos de vacinação vão estar preparados para fornecer algum tipo de comprovante, mesmo que o cidadão não tenha a carteirinha antiga”, prevê Ramos, que foi o coordenador das pesquisas com a CoronaVac em Porto Alegre.

Ainda não há orientações específicas, mas espera-se que na hora da vacinação contra a covid-19 as pessoas levem algum tipo de documento de identificação, apresentem o Cartão Nacional de Saúde ou informem o número do CPF.

Em alguns casos, será necessário comprovar de alguma maneira que você faz parte dos grupos prioritários (falaremos mais sobre esses grupos na próxima pergunta).

No entanto, é essencial que todos guardem sua carteirinha de vacinação com muito cuidado. Ali estão informações importantíssimas de saúde.

Muitas vezes, se o indivíduo não sabe se tomou determinado imunizante e perdeu esse documento, ele precisa repetir todo o esquema vacinal contra uma doença ou outra.

É importante também que todos atualizem sua carteirinha de tempos em tempos. Há vacinas que precisam ser tomadas na infância, na adolescência, na fase adulta e após os 60 anos.

7. Como será a vacinação no Brasil?

O Ministério da Saúde lançou um plano nacional de imunização contra a covid-19 no final de dezembro de 2020.

Nesse documento, foram definidos os grupos prioritários e algumas etapas do processo. Em resumo, o esquema e o público-alvo foram definidos da seguinte forma:

  • Primeira fase: trabalhadores da área da saúde, indígenas, indivíduos com mais de 75 anos e pessoas com mais de 60 anos que vivem em asilos e hospitais;
  • Segunda fase: idosos de 60 a 74 anos;
  • Terceira fase: pessoas com comorbidades, como diabetes, hipertensão grave, doença pulmonar obstrutiva crônica, doença renal, doenças cardiovasculares e cerebrovasculares, indivíduos transplantados, com anemia falciforme, câncer, obesidade grau III ou deficiência permanente severa;
  • Quarta fase: trabalhadores da educação, população em situação de rua, membros das forças de segurança e salvamento, trabalhadores do transporte coletivo e transportadores rodoviários de carga, funcionários do sistema prisional e população carcerária.

Esse planejamento pode ser acelerado ou sofrer atrasos, a depender da chegada das doses das vacinas.

Ainda não há um calendário de como esses grupos serão atendidos ou quando cada um deles deve procurar um posto de saúde.

Uma estratégia sugerida por especialistas é reforçar a vacinação nos locais onde a situação da covid-19 está mais grave.

Isso poderia trazer alívio ao sistema de saúde e garantir uma melhora mais rápida no panorama da pandemia.

Trabalhadores transportam caixas de isopor com doses de vacina
Legenda da foto,A distribuição das primeiras 6 milhões de doses da CoronaVac para os estados começou hoje (18/12)

8. Onde vai começar a vacinação contra o coronavírus?

O Ministério da Saúde afirma que as doses das vacinas serão distribuídas por todo o país de forma igualitária, de acordo com a população de cada local.

Os Estados já estão começando a receber os seus lotes e devem aplicar as vacinas nos profissionais da saúde durante os próximos dias – alguns já iniciaram na segunda-feira, como Goiás e Rio Grande do Norte.

9. Quem serão os primeiros a serem vacinados?

Os primeiros vacinados contra a covid-19 serão os profissionais da saúde. Na sequência, a prioridade será de indígenas e idosos. Mas qual a razão dessa prioridade?

“Em primeiro lugar, isso tem a ver com a exposição ao vírus. Médicos, enfermeiros e outros trabalhadores da linha de frente estão sob grande risco e precisamos proteger logo essas pessoas”, justifica Ramos.

Já idosos e indígenas são populações vulneráveis, que correm mais risco de sofrer com o agravamento e morte por covid-19.

10. Como cadastrar para a vacinação para a covid-19 pelo SUS?

No momento, não há orientações para fazer cadastro em nenhum site ou aplicativo. “É provável que as secretarias municipais e estaduais de Saúde de cada lugar se organizem de formas diferentes”, diz Ramos.

O governo de São Paulo, por exemplo, lançou o site Vacina Já, para que os paulistas tenham informações sobre os locais de aplicação das doses e façam um pré-cadastro.

Por enquanto, somente trabalhadores da área de saúde e indígenas devem preencher as informações por lá.

Nesse momento é bom tomar cuidado com fraudes e pegadinhas: o Ministério da Saúde diz que não vai realizar agendamentos e nem envia códigos pelo celular para usuários do Sistema Único de Saúde (SUS).

A melhor coisa a se fazer por ora é aguardar novas orientações que serão dadas pelas autoridades de saúde em breve.

Fonte: BBC Brasil

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