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Brazil facing vaccine delays despite history of immunization success

. Jan 19, 2021
vaccine delays in sight for brazil Rio administered its first vaccines at the feet of the Christ the Redeemer statute. Photo: Eliane Carvalho/Shutterstock

Though Brazil vaccinated its first citizens against the coronavirus on Sunday, the country has a long way to go before fully implementing a nationwide immunization campaign. This, despite the fact that Brazil has traditionally been a leading example around the world in how to vaccination efficiency.

In several countries, including the U.S., health officials have run into problems regarding how to distribute, store, and administer vaccines at the desired pace. Meanwhile, Brazil already has 38,000 vaccination clinics — which can reach 50,000 during campaigns — and a network of professionals capable of inoculating the population en masse. All that’s missing is the vaccine itself.

</p> <p>There are numerous reasons for <a href="https://brazilian.report/coronavirus-brazil-live-blog/2021/01/14/brazil-delays-vaccine-effort-for-marketing-stunt/">Brazil&#8217;s delays</a>, from the inactivity of the Health Ministry — which dithered over purchasing needles and syringes — to the <a href="https://brazilian.report/podcast/2020/10/21/podcast-electoral-calculations-around-covid-19-vaccine/">politicization of the vaccine race</a>, pitting far-right President Bolsonaro against his right-wing rival, São Paulo Governor João Doria. </p> <p>There is another aggravating factor: a December opinion poll from the DataFolha Institute indicated that 22 percent of respondents do not intend on taking a Covid-19 vaccine. In August, this rate stood at just 9 percent, showing how much the anti-vaccine movement has progressed in Brazil, with the unwavering support of President Bolsonaro, his politician sons, and their most radical supporters.&nbsp;</p> <h2>Victims of their own success</h2> <p>According to former Health Minister Nelson Teich — fired by Mr. Bolsonaro in May after disagreeing with the president over his coronavirus-skeptic stance — the increased distrust of vaccines is precisely a result of the country&#8217;s immunization successes in the past. Thanks to efficient and comprehensive vaccination campaigns, several diseases were practically eradicated in Brazil, creating a false sense of security among the population.&nbsp;</p> <p>“We have had so much success in controlling diseases that, as people no longer see the disease existing, they stop paying attention to the importance of controlling it,&#8221; Mr. Teich tells <strong>The Brazilian Report</strong>.</p> <p>&#8220;The people didn&#8217;t live with the disease, or the mortality it caused. Those who did experience it have forgotten. Time passes and you lose the palpable element. The success of vaccination programs has made people lose sight of the severity and they begin to contest it,&#8221; he adds.</p> <p>Another former Health Minister, Luiz Henrique Mandetta — sacked less than a month before Mr. Teich, for the same reasons — adds that the success of the national immunization program created so much confidence in previous governments that the size of vaccination campaigns between 2010 and 2012. &#8220;They believed the population was already aware of the vaccination routine,&#8221; he tells <strong>The Brazilian Report</strong>.</p> <p>According to Health Ministry data, childhood vaccination coverage in Brazil has not reached any established targets since 2018. Of the 15 jabs on the country&#8217;s juvenile vaccination schedule, half have not hit desired targets since 2015, including polio boosters.</p> <p>As Mr. Mandetta recalls, Brazil saw an outbreak of polio in the 1980s, with more than 26,000 cases. According to him, the military government attempted to &#8220;hide the numbers,&#8221; before resorting to vaccination as a way of containing the disease.</p> <p>On Friday, President Bolsonaro told his supporters he was certain that over half of the population would not take a coronavirus vaccine, according to his own surveys. At 65 years old, Mr. Bolsonaro himself has claimed he will not be inoculated, though magazine Época revealed last week that the government moved to seal the president&#8217;s vaccination records for a period of 100 years.</p> <p>Meanwhile, 67-year-old Vice President Hamilton Mourão declared he will take a vaccine, &#8220;when it is [his] turn.&#8221;</p> <p>&#8220;According to the plan, I am in group two. I won&#8217;t cut in line,&#8221; he said this week, after 12 days on leave due to a coronavirus infection. &#8220;The vaccine is for the whole country, it is not an individual matter,&#8221; he added.</p> <h2>Brazil&#8217;s anti-vaccine movement</h2> <p>Vaccination hesitation has existed ever since the first inoculations were created in the 18th century. However, the anti-vax movement only became a cohesive cause in the U.S. and Europe in the 1980s, largely as a result of the 1982 documentary &#8220;DPT: Vaccine Roulette,&#8221; which incorrectly associated the diphtheria, tetanus, and acellular pertussis vaccine to severe disabilities in children.</p> <p>In 1998, British doctor Andrew Wakefield published a study in American medical journal The Lancet, claiming a link between the MMR vaccine and autism in children. It was later revealed that the children in the study were chosen by a law firm that intended to sue the pharmaceutical industry and Mr. Wakefield was struck off the medical register. The paper itself was retracted in 2010.</p> <p>However, the information had already made its way around the world, and the damage had been done.&nbsp;</p> <p>José David Urbaez, scientific director of the Infectious Disease Society in Brazil&#8217;s Federal District, explains that the anti-vax movement had never been particularly strong in the country until now. &#8220;It was always something of folklore,&#8221; he tells <strong>The Brazilian Report</strong>. &#8220;But when folklore reaches the federal government, it gains power. The strength of a federal government is much greater than you can imagine, because it is an everyday thing. In such a fragile moment as this, it makes it harder for people to be rational.&#8221;</p> <h2>Brazil&#8217;s success in vaccination</h2> <p>Despite President Bolsonaro&#8217;s resistance toward vaccines, it was precisely <a href="http://observatoriohistoria.coc.fiocruz.br/local/File/na-corda-bamba-cap_6.pdf">during the military dictatorship</a> — for which the president is nostalgic — that Brazil&#8217;s national immunization program began, as a way of centralizing isolated campaigns, in 1973.</p> <p>The first vaccine to be administered nationwide in Brazil was against smallpox, followed by the polio jab in the 1980s. Today, the national program involves vaccines against the measles, neonatal tetanus, and other diseases such as diphtheria, pertussis, accidental tetanus, hepatitis B, meningitis, yellow fever, and severe forms of tuberculosis, rubella, and the mumps.</p> <p>The efficiency of the national immunization program increased with the implementation of <a href="https://brazilian.report/business/2020/04/27/brazil-unify-public-private-healthcare-systems/">Brazil&#8217;s public health system</a> (SUS). The Health Ministry coordinates which vaccines will be included in the yearly schedule, as well as purchases inputs and decides the quantities to be distributed to each state. State authorities decide on their own campaigns, sending vaccines to municipalities, and monitoring vaccine coverage. Local governments are in charge of carrying out the vaccination itself.</p> <p>To increase coverage, family health teams actively search for unvaccinated individuals in needy communities. Also, as a way of upholding the importance of inoculation, government programs such as Bolsa Família require beneficiaries to vaccinate their children before they may receive cash transfers. The Armed Forces also take an active role in vaccination campaigns, transporting supplies to the country&#8217;s most remote areas.

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Débora Álvares

Débora Álvares has worked as a political reporter for newspapers Folha de S.Paulo, O Estado de S.Paulo, Globo News, HuffPost, among others. She specializes in reporting on Brasilia, working behind-the-scenes coverage at the Executive, Legislative, and Judiciary branches of government.

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