Health experts slam Bolsonaro's vaccine comments.

Brazil has begun COVID-19 vaccinations, but health experts are having to boost confidence following the president's remarks. Joe Parkin Daniels reports.

In the Brazilian city of Manaus, hospitals have been failing for a second time under the strain of a surging new coronavirus variant. With oxygen supplies running low, doctors have been unable to ventilate patients. News reports revealed that health professionals were using their own vehicles to move patients around, as locals resorted to the black market to secure oxygen tanks. Brazil's Air Force began sorties with supplies from São Paulo state, and at one point planned to evacuate 61 premature babies in incubators before emergency oxygen was procured. Yet despite the clear threat of COVID-19 to Brazilians, health experts are becoming increasingly worried about getting people to take a vaccine that President Jair Bolsonaro regularly lambasts.

“It is frustrating and disappointing to have a president undermine science, but much more than that, people are dying because of it”, said Pedro Curi Hallal, an epidemiologist at the Federal University of Pelotas, who was insulted via tweet by Bolsonaro earlier this year, in part due to his criticism of the government's mismanagement of the crisis. Hallal also works on EPICOVID, a nationwide survey on COVID-19 that lost government funding in July, last year, after its findings angered officials.

Bolsonaro has repeatedly questioned the efficacy of COVID-19 vaccines and has said that he will refuse to be vaccinated when offered. “If you turn into a crocodile, it's your problem”, the bellicose leader told local media in December, 2020, about the side-effects of the vaccine developed by Pfizer and BioNTech, which was at the time already being administered in the USA and the UK. “Some people say I'm giving a bad example, but to the imbeciles and idiots that say this, I tell them I've already caught the virus, I have the antibodies, so why get vaccinated?”

“His comments won't change, so we as scientists need to talk to the media and to local governors and mayors to develop good policy and communications strategies and reverse the damage caused by the president”, said Hallal. “Football players, actors, and other public figures should go public and urge people to get vaccinated.”

In December, last year, 22% of Brazilians said they would refuse to take any COVID-19 vaccine, up from 9% in August, according to local polling company Datafolha.

Civil society organisations are joining the effort to combat misinformation around the various vaccines. Barong, a non-governmental organisation that usually focuses on HIV/AIDS treatment and awareness, will in February launch a campaign urging people in vulnerable communities to take the vaccine when it is their turn. “The idea is to hit the streets and explain all these myths surrounding the vaccine”, said Marta McBritton, who runs Barong. Her team is preparing exhibits to display on the streets, as well as making videos with young social media influencers. “We have to combat the messaging from the president that basically puts the responsibility onto individuals, rather than the government.”

Brazil's supreme court in December dealt a blow to Bolsonaro when it ruled that all Brazilians are required to be vaccinated against COVID-19, or face bans from certain public activities and spaces. The court underscored that its decision will not mean people will be forcibly injected, instead leaving governors and mayors to decide how to punish those who refuse to be vaccinated. However, Bolsonaro's sway over his base remains considerable, and watchdogs have previously warned that WhatsApp groups and other social media networks are contributing to the spread of misinformation and fake news among his supporters.

Atila Iamarino, a prominent science communicator, said misinformation is able to spread quickly in Brazil owing to internet inequality, with cheaper data plans allowing unlimited use of certain social media sites. “Many Brazilians get WhatsApp and it's their only point of contact with the internet, so it's where they get their information”, said Iamarino, who has received death threats due to his YouTube videos debunking conspiracy theories and misinformation about the pandemic. “Now we have official sources spreading misinformation, which is new.”

In São Paulo and Rio de Janeiro, the country's most populous and wealthy cities, the first doses of the China-made CoronaVac vaccine were administered to much fanfare on Jan 17. But the vaccine drive is lagging—only on Jan 23 did Brazil begin distributing the 2 million doses of the AstraZeneca vaccine sent from India—and there are calls for president Bolsonaro's resignation over his bungling of the pandemic response. With over 8·8 million confirmed cases of COVID-19, and over 215 000 resulting deaths, Brazil is behind only the USA and India in infection rates.