Equidade e vulnerabilidade em saúde no acesso às vacinas contra a COVID-19

Abstract

O presente artigo discute a importância da equidade no acesso aos serviços de saúde, refletindo sobre a aquisição e a distribuição de vacinas — insumos estratégicos e fundamentais no contexto da COVID-19. Ainda, aborda aspectos que aumentam os riscos de transmissão, reinfecção e surgimento de novas variantes, como fake news, negacionismo e movimento antivacina, os quais perpetuam o ciclo epidêmico. Ressalta-se a importância de todos os setores da sociedade traçarem planos e políticas de saúde para o controle da pandemia em um contexto nacional e global de enfrentamento conjunto, considerando a necessidade de garantir o acesso universal e oportuno a vacinas e insumos e à logística necessária para sua aplicação. A equidade é examinada como o princípio norteador global para a redução da vulnerabilidade no acesso às vacinas contra a COVID-19, sendo destacado o panorama do Brasil — onde, apesar da ampla expertise em vacinação, um cenário de queda em investimentos em ciência e tecnologia, logística precária e corrupção colocam em risco o acesso às vacinas. Por fim, são apresentados possíveis caminhos que podem ser explorados e transformados em ações a serem realizadas por diversos setores da sociedade — por exemplo, a priorização de regiões e grupos sociais vulneráveis para distribuição de vacinas — e que permitam alcançar a equidade no acesso aos serviços de saúde em relação à cobertura vacinal da COVID-19.

Suicidal behavior during the Covid-19 pandemic: Results from cross-sectional surveys of Brazilian adults from 2020 to 2022

“…This was the year when Brazil made progress in vaccination, and a decrease in the number of deaths was observed [34]. Despite being slow and uneven, the large-scale vaccine coverage allowed for the relaxation of restriction measures and a return to social interaction [35] [36], possibly leading to changes in the perception of the pandemic's risk. This finding suggests a potential trend of decreasing fear of Covid-19, as Brazil continues to report a reduction in cases and deaths caused by the coronavirus [37].…”

Equal access to vaccines: lessons learned and future perspectives

“…The NIP is one of the largest and most successful immunization programs in the world. However, its intricacy presents various challenges, including logistics for the acquisition, distribution, and vaccination, the lack of adequately skilled professionals specializing exclusively in these activities, and the difficulty in instituting an integrated information system that allows total vaccine traceability until the time of vaccination (Buss;Burger, 2023;Gadelha, 2022;Castro-Nunes;Ribeiro, 2022).…”

“…Brazil is a country with a large population, of continental dimensions, and regions that are difficult to access, which hinders the creation and maintenance of a cold chain and organized healthcare services for vaccination activities in remote regions. These factors are added to the complex socio-cultural issues in relation to gender that exist in the territory, which reinforce the need for multi-sectoral and multidisciplinary strategies to promote equity in access to vaccines in the country (Buss, Burger, 2023;Gadelha, 2022;Castro-Nunes;Ribeiro, 2022;Gauto, 2022).…”

“…Vaccines with more than one dose scheme have progressively lost coverage and there are significant differences between socio-economic strata-favorable to the highest in some cities and the lowest in others (Barata et al, 2023) Despite its history of vaccine production with important contributions from public laboratories, Brazil still needs to make significant progress in order to achieve a sustainable ecosystem for research, development, and innovation that will allow it to possess the necessary technology for sustainable self-sufficiency in producing national immunobiologicals and basic health supplies. Notwithstanding the progress made in recent years in governance and the development of public policies aimed at creating and strengthening the Health Economic-Industrial Complex (HEIC), the country still has challenges to overcome (Gadelha, 2022;Castro-Nunes;Ribeiro, 2022;Gauto, 2022).…”

“…In Brazil, the Productive Development Policy ( 2008) was created to seek synergy between technological industrial development and the national productive sector, with a focus on increasing the population's access to medicines, vaccines, and equipment (Gadelha, 2022). However, the very dynamics of implementing this public policy ended up accentuating the country's dependence on the international market, which became evident during the COVID-19 emergency (Gadelha, 2022;Castro-Nunes;Ribeiro, 2022;Gauto, 2022).…”