The COVID-19 Vaccination Strategy in Brazil—A Case Study

Abstract

Brazil is among the countries which have faced two devastating infection waves of COVID-19 in the past year. Despite the fact the country has one of the world’s leading immunization programs, Brazil only slowly established a national COVID-19 vaccination strategy and campaign. This case study is based on an integrative review of primary and secondary literature sources. Different search strategies on Medline and Google Scholar were performed for the case presentation, for the management and outcome of the COVID-19 outbreak and for the state of the COVID-19 vaccination program. Official documents from the Brazilian Ministry of Health, the website of the World Health Organization and pharmaceutical companies were also reviewed. Searches were limited to English, French, German, Portuguese and Spanish. This article describes the Brazilian COVID-19 vaccination campaign and the drivers and barriers to its implementation; and evaluates further investigations needed to have a conclusive overview over the constantly evolving situation. Healthcare inequalities, which were widened during the pandemic, a lack of coordination at the federal level, the absence of federal government support for scientific research and the lack of endorsement and commitment to the mitigation of the COVID-19 pandemic set the country’s COVID-19 vaccination campaign off to a challenging start. However, Brazil had a well-developed primary care system and national vaccination program prior to the pandemic, which are both important facilitators. At the time of writing, six vaccines are currently available in the country, and the program is advancing. The scientific community needs to continue to investigate the country’s vaccination strategy and its implementation to make sure that maximum effort is undertaken for the health of the Brazilian population.

Effect of vaccination against Covid-19 one year after its introduction in Brazil

“…Our study showed that vaccination coverage for booster doses was incipient and had slow advancement in Brazil. Although the supply and availability of vaccines has progressively increased, vaccine hesitancy and the feeling of security by the population brought about by the rapid decrease in cases may be related to low adherence to booster doses [ 11 , 28 ].…”

“…Later, in May 2021, the population aged 18 to 59 began to be vaccinated according to the guidelines of the Brazilian NOP [ 19 ]. Subsequently, in June 2021 the vaccination of adolescents (12 to 17 years old) was started and in December 2021, children aged 5 to 11 years were also included for vaccination against Covid-19 in the country [ 11 ].…”

“…In Brazil, in 2020, the seroprevalence of antibodies against SARS-CoV-2 was considered low, ranging from 3 to 15%, totaling approximately 212 million people infected before the start of vaccination against Covid-19, which in this country, began on January 17, 2021 [ 10 , 11 ].…”

Successive Pandemic Waves with Different Virulent Strains and the Effects of Vaccination for SARS-CoV-2

“…However, only 10% of people from low-income countries were vaccinated with one dose at that date. Even in largely vaccinated countries with severe inequalities, such as Brazil, there were areas with low vaccine coverage [ 51 ]. Additionally, vaccine hesitance and rejection spread in the developed world due to misinformation.…”

Clinical Characteristics and Outcomes of Covid-19 Patients With Underlying Dementia: Results From a Large Multicenter Propensity-matched Brazilian Cohort Study

“…It is a multicentre cohort, involving several hospitals, from different cities in Brazil. It, also, includes the pandemic waves with different virulent strains of the virus, and the periods pre and post-vaccination for SARS-CoV-2 in Brazil [29].…”