“The most expected vaccine in history”. This is how many people and media institutions referred to the immunizer capable of stopping the spread of the new coronavirus. Since December 2019, when the first case of covid-19 was diagnosed in the Chinese peninsula of Wuhan, more than 100 million people worldwide have been contaminated and 2.2 million have lost their lives as victims of this disease. As a result, scientists, politicians and leaders from different countries fought a real race for immunization, which brought unprecedented visibility to the vaccine production process.
In this sense, in January 2020, even before the disease crossed national borders and the WHO declared that the world was facing a covid-19 pandemic, Chinese researchers had already released the genomic sequencing of the coronavirus. This enabled scientists from other countries – many of whom the virus had not even arrived – to begin studying the genome of the virus and to begin the search for immunization. In addition, in view of the negative impact of the pandemic, billionaire investments in research were made, thousands of volunteers became available for clinical trials, and more than 150 vaccines were tested worldwide. All these factors, together with the sense of urgency that accelerate the bureaucratic process, made that the first vaccine against the new coronavirus – Pfizer/BioNTech – was approved and started to be produced in less than 11 months, a record time in the production of these immunizers, whose normal development process usually takes between 10 and 15 years.
From that, the application of the vaccine developed by Pfizer/BioNTech started to be performed in the United Kingdom still in the beginning of December 2020, with about 10 million doses directed to health professionals and elderly over 80 years. Besides it, four other vaccines – Modern, Sputnik V, Oxford/AstraZeneca and Coronavac – were approved by national health agencies and are being used in the population. In Brazil, the first person to be vaccinated was Nurse Mônica Calazans, who received a dose of the immunizer produced by Coronavac on January 17, 2021. Two weeks later, on January 31st, according to the project “Our World in Data”, more than 94 million people had already been immunized against covid-19 worldwide. Of these, 2.07 million are in Brazil, which corresponds to about 1% of the country’s population.
The immunization plan proposed by the Ministry of Health of Brazil, presented in December 2020, foresees that the entire risk group of the disease – approximately 50 million people – will be vaccinated in the first half of 2021. The rest of the population should be vaccinated in up to 16 months. Throughout this year, the federal government is expected to acquire 350 million doses of the coronavirus vaccine to make it available to the Brazilian population. However, despite the efforts of scientists and authorities to encourage vaccination and combat the health crisis caused by covid-19, many people still hesitate about the vaccine that fights the new coronavirus.
Brazilians’ reluctance to vaccination: why does it happen and how can it affect OVID-19 vaccination coverage?
The vaccines from China and India – Coronavac and Oxford/AstraZeneca – arrived in Brazil and the vaccination campaign has already started. But despite the new hope that the COVID-19 vaccine has given to the world and to Brazilians, there is still a considerable group of people who refuse to vaccinate. According to the DataFolha survey conducted on 20 and 21 January, 79% of Brazilians interviewed want to be immunized. This number decreased in relation to August, when it was found that 89% of Brazilians had the intention to be vaccinated. Why a part of the population refuses to take the vaccine?
This rejection to the vaccine is happening due in large part to the influence of the anti-vaccine mentality. Although there is no organized anti-vaccine movement in Brazil, vaccine coverage has declined in a worrying way in recent years. It is to be expected that this reluctance towards vaccination will also cover the COVID-19 vaccine.
One of the most worrying problems that harm the vaccination coverage of the coronavirus is the disinformation and dissemination of fake news by anti-vaccine groups. The Internet allows the rapid sharing of various types of information on a global scale, without requiring scientific proof for publication, which allows the posting of false information by anyone and unlimited.
Socorro Gross, WHO representative in Brazil, highlighted that the antivaccine groups with fake news will be a challenge to face the pandemic. This is clear when taking into account the amount of fake news to which internet users are exposed and the willingness of internet users to believe this false information.
A survey evaluated 2,276 Internet publications related to OVID-19 from dozens of countries and concluded that only 9% of these publications were true. Many trusted sites disseminated the truth about the fake news that was circulating on the Internet, but even so, this information is still very widespread at frightening speeds and amounts: it increased the amount of fake news in social networking groups by 383% in 2020.
Also, many Brazilians believe in this disseminated false information, IBOPE did a survey in September 2020 in which 10 incorrect statements about vaccines were exposed, and 67% of Brazilians interviewed believed in at least 1 of them. Thus, it is understandable why the number of Brazilians who intend to be vaccinated remains undesirable.
Moreover, it does not help that the President himself has been making comments that strengthen groups that are against vaccination. The Chief Executive has already made statements saying that “no one is forced to take the vaccine” and made criticism to the side effects of Pfizer’s vaccine, suggesting in a sarcastic way that if someone took this vaccine he could become an alligator. Such comments from the president caused repercussions in Brazilian anti-vaccine groups, which collaborated to harm the campaign in favor of vaccination against the virus that caused the death of more than 220 thousand people in Brazil.
In relation to the speech of Bolsonaro about the obligation of vaccination, the Brazilian Society of Immunization (SBIm) published a note stressing that the public authorities should make the population aware of the importance of vaccination and that it is the duty of each citizen to seek vaccination as protection not only individual as well as collective. After all, vaccination is a public health issue and its lack affects everyone, both the unvaccinated and the vaccinated.
It is valid to emphasize the importance of vaccinating as many Brazilians as possible. As the vaccine is not 100% effective, it is important to reach a good vaccination coverage to reach the necessary collective immunity. This way a vaccinated person has less chance to become infected and to contaminate others and ends up protecting, also, people who could not be vaccinated or in which the vaccine had no effect.
And the performance of the federal government?
Since the beginning of the pandemic in the country, President Jair Bolsonaro minimizes the seriousness of the health and economic crisis, discourages the adoption of masks and social distance, encourages misinformation by spreading lies and facts, questions the efficacy of vaccines proven effective and is insensitive to the pain of millions of Brazilians affected by the disease. The idea of collective health, protected by the 1988 Constitution and essential to the success of the immunization campaign – since the vaccine is first and foremost a measure of collective protection – is eroded daily by the president. The conclusion is that, since the beginning of the pandemic, the federal government has been engaged in a real campaign for the spread of the virus. The irresponsible behavior of Bolsonaro and his ministers, therefore, also represents an enormous obstacle to the success of the vaccination campaign in Brazil.
The Bolsonaro family’s attacks on China, for example, charge their price at a time when the partnership between the two countries is crucial for the production of doses of the Coronavac vaccine, developed by the Butantan Institute together with the Chinese pharmaceutical company Sinovac. On January 26, 2021, the government of São Paulo announced the arrival of ingredients needed for the production of Coronavac after days of uncertainty regarding the arrival of such inputs. This delay, although mainly due to bureaucratic reasons, is also due to the unease between the two countries provoked by the hostile comments of Congressman Eduardo Bolsonaro and Chancellor Ernesto Araújo regarding the Chinese government.
The Brazilian vaccination campaign, still incipient, suffers from the slowness and disarticulation of the Ministry of Health. According to the database Our World Data, the country immunizes, on average, 120 thousand Brazilians per day against the new coronavirus, an insufficient amount that would require years until the entire population, composed of more than 212 million people, is vaccinated. It is important to remember, however, that Brazil has the structure to quickly immunize a large contingent of its inhabitants due to the National Immunization Program (PNI), implemented in the 1970s and responsible for the eradication of diseases such as neonatal tetanus and rubella. However, the disarticulation of the Ministry of Health undermines the efficiency of the Brazilian vaccination campaign by refusing proposals from pharmacists for the purchase of immunizers and even taking days to acquire new doses of Coronavac vaccine, generating a scenario of uncertainty that aggravates the sanitary, social and economic crisis experienced by the country. No wonder, according to the Australian study center Lowy Institute, Brazil is in the last position in the ranking that evaluates the performance of almost 100 countries in the fight against the pandemic.
By Julia Ester de Paula , Lucas Perrone Camilo  and Ester Wagner Siqueira .
For more information:
- Nexo Jornal: The uncoordinated spread of vaccination in Brazil
- Science against negationism
- Coronavirus Disease (Covid-19): Vaccines
 PhD student in Social Communication at UFMG. Researcher at the Media and Public Sphere Research Group (EME/UFMG) and the Center for Studies on Transitional Justice (CJT/UFMG). Volunteer in the extension project “How to Read Infographics” (UFMG).  Graduating in Law at UFMG and extensionist at the Center for Studies on Transitional Justice (CJT/UFMG).  Law student at UFMG and extensionist of the Center for Studies on Transitional Justice (CJT/UFMG).