The state of Alagoas has started to apply the second dose of vaccine against covid-19 in people who had AEFI (Adverse Post-Vaccination Event) and need hospital monitoring to receive the immunobiological complement. Data from Sesau-AL (Secretary of State for Health) indicate that 1,041 people reported an adverse event after the application of vaccines.
A doctor heard by the UOL, who preferred not to be identified, confirmed that there are cases of second doses pending since the month of January this year.
Until then, the vaccination cycle had not been completed due to the lack of an equipped structure, as a precaution, to assist these patients in case of need. There are records of those who waited up to eight months to finally have a date to get a full immunization. There are no data on which of the vaccines caused an adverse reaction in patients in the state.
The estimated time of the vaccine package insert was not respected because, only in July, the space for the application of the vaccine with medical monitoring by the hospital staff, with defibrillator devices, orotracheal intubation and medication began to be set up. Only in September, the medical team received training.
The place is located at Crie-AL (Special Immunobiological Reference Center), which is operating within the Women’s Hospital of Maceió, a reference for the care of patients with covid-19. O UOL it has already shown that pregnant and postpartum women were exposing themselves to the hospital environment to take the vaccine against the disease.
Equipped, Crie’s room will be able to provide first aid in case of adverse reactions. But, exclusively for patients with covid-19, the care would have to be done in another health unit, not at the Women’s Hospital, where the vaccines will be applied.
a long wait
The delay in taking the second dose of the covid-19 vaccine has caused anguish and distress in people who could not complete the vaccination schedule on time, following the vaccine leaflets. The fear is that of not knowing if the second dose will be effective or not.
Yesterday, the first people who started taking the second dose were told that there will not be a booster application. According to Crie-AL, the case of those who had an adverse reaction does not fit the Ministry of Health’s recommendation for a third dose, recommended for elderly people over 70 years of age.
A 42-year-old resident of Maceió reports that she had trouble reporting AEFI to Crie-AL soon after taking the vaccine because the organ was changing, from the Doctor Helvio Auto teaching hospital, in the Trapiche da Barra neighborhood, to the Women’s hospital. Crie-AL went without assistance for two months due to the change of building, and only in the second week of July, 16 days before the second dose that was scheduled on her vaccination card, was the attempt to contact the team successful.
I had an allergic and extrapyramidal reaction, which I had to be admitted to a hospital, about 15 minutes after taking the vaccine”, says the woman, who said she had included the documentation recommended by the Crie-AL team, with a medical record and analysis. infectologist, but was informed that she would have to wait for the room to be ready. I got in touch by email and by phone almost every day, as I was distressed at not receiving my second dose at the correct time.”
She also states that after asking why she has to be forced to take the same immunobiological, since in São Paulo, Rio de Janeiro and even Salvador, exchange of vaccines was already taking place — and there was a technical note from the Ministry of Health on the 23rd of July about the possibility of an exchange — the woman says that she heard the following answer: “Création-AL said that I wouldn’t take any more vaccines, that I didn’t know what to do.”
Only yesterday, by telephone, the team at Crie-AL informed that the protocol had changed and that another vaccine would be applied. She has been waiting for her second dose since July 30th. Yesterday, she was informed of her schedule, scheduled for October 23, one month after the start of activities in the space and 85 days after the correct date on which she should receive the immunizing agent.
Another 35-year-old from Alagoas said she was vaccinated in March, as a health professional, and confused the adverse reaction with stress.
“When I got home, I almost can’t take a shower and I had to go to the hospital urgently. I reported the case to Crie Maceió and I’m still waiting for my second dose. I’m a health professional, I’m exposed every day, and I’m scared that I took it only the first dose,” he told the UOL.
She criticizes that she will have to go to the space where Crie-AL was installed precisely because it is located inside a hospital that only treats covid-19. “I feel embarrassed about it, but if it’s the only way, I’ll be forced to take the vaccine right there.”
One of the interviews stated that it will formalize today’s complaint about the case in the MPAL so that the facts are verified and, if there is evidence, those involved are held responsible.
‘No patient can wait that long’
The infectious disease physician Alexandre Naime Barbosa, a professor at Unesp (State University of São Paulo), says that the delay in applying the second dose of vaccine against covid-19 directly affects the immune response, and “no patient can wait that long”, as there is no way of knowing if it will be effective.
“It is strange that Alagoas did not carry out the vaccine interchangeability right away, because even in the package insert of these immunobiologicals there is a time between the first and second dose, regardless of having had an adverse event after vaccination or not. Never, under any circumstances, could it be wait so long”, criticizes the doctor, a member of the Brazilian Society of Infectology.
The infectologist also criticized that the place to apply the vaccine against covid-19 for people with AEFI is in a hospital that is a reference in the care of covid-19. “This is an undeniable error. I know Alagoas and I know the problems of the public network, but after this time of vaccination, the state should have reviewed all this care for patients who had AEFI, from the location to the time of application of D2”, highlights.
O UOL he sought out the Alagoas Public Ministry and the prosecutor said he was not aware of the matter, but said he would investigate the allegations.
A week ago, the UOL tries answers from Sesau on the problems mentioned, but only yesterday, when the service finally started operating, did the secretariat take a stand on the matter. In a statement, the agency explains that “two months ago, Crie was transferred to the Women’s Hospital, which does not serve clinical urgency, and it was necessary to set up the entire structure of emergency care and training of emergency personnel.”
Regarding the monitoring room for people who have had AEFI, the text states that “this structure has already been set up, technicians have been trained and scheduling is already taking place, as well as the vaccination of these patients with precaution, within the entire emergency protocol and emergency”. The agency does not take a position, however, on the fact that, in the event of an emergency, the patient will have to be taken to another hospital, since the Women’s Hospital is currently exclusive to covid-19 patients.
Regarding the interchangeability of immunobiologicals, Sesau admitted having learned about the matter with Technical Note number 6, released by the Ministry of Health on July 23, 2021, but did not explain why the procedure was only adopted two months later.
According to data from Sesau, 3,062,095 doses of vaccine against covid-19 were applied in Alagoas until yesterday. A total of 2,002,254 people are in the first cycle. Another 1,059,841 patients completed immunization with two applications or a single dose. In the state, 237,842 people were infected by the virus, with 6,185 deaths.