Roundtable: Rebuilding Vaccine Consensus in Brazil

The Council of the Americas held a roundtable discussion in Brasilia titled “Rebuilding Vaccines Consensus in Brazil” as part of a series of roundtables focused on developing solutions for COVID-19, and improving preparedness and response to future pandemics. The roundtable convened policymakers, renowned medical doctors, and thought leaders with the objective of analyzing the mechanisms needed for rebuilding the consensus on vaccines in Brazil, particularly looking at strategies to generate acceptance and uptake for vaccines, while discussing lessons learned and developing strategies to be adopted by the government going forward. 

Participants: 

• Eric Farnsworth, Vice President, Council of the Americas (moderator) 
• Fernando Zasso Pigatto, President, National Health Council (CNS) 
• Gustavo Mendes Lima Santos, Director of Regulation, Quality Control and Clinical Studies, Instituto Butantan 
• Leonardo Santos Rocha Pitta, Vice President, Brazilian Federal Council of Medicine (CFM) 
• Luiz Vicente Rizzo, Director of the Israeli Institute of Teaching and Research, Albert Einstein Brazilian Israeli Benefit Society 
• Kristin Kelling, Health Attaché at the U.S. Embassy in Brazil, U.S. Department of Health and Human Services (HHS) 
• Marcelo de Oliveira Maia, Director, Brazilian Intensive Care Medicine Association (AMIB) 
• Marcelo Marcos Morales, Professor, Institute of Biophysics Carlos Chagas Filho
• Marcio Fontão dos Rei, Director of Access and Strategic Partnerships, Pfizer Brazil 
• Renato Porto, President, Research Pharmaceutical Industry Association (Interfarma) 
• Seiarameri Viola Oliveira, National Adviser on Immunizations, Pan American Health Organization (PAHO/WHO) - Brazil 
• Werciley Junior, Infectologist, Clínica Atos

In his opening remarks, Eric Farnsworth, vice president of Council of the Americas, who also moderated the discussion, stated that “based on Brazil’s history, the healthcare system has been highly decorated and referenced across the globe but in recent years that has changed. As we have seen in many Western democracies, vaccination rates have gone down, vaccine rejection has gone up, and the public debate has become politicized.”

Roundtable participants evaluated the lessons learned and the progress that has been achieved thus far, shared their experiences navigating the pandemic from their different perspectives, and offered recommendations for the government to take into consideration moving forward. Among the priorities that participants would recommend policymakers to consider incorporating into the Brazilian health system:

• Cooperation: Roundtable participants stressed the importance of recuperating the spirit of cooperation that was fostered during the pandemic. To better respond to the pandemic, Brazil adopted mechanisms such as compiling and sharing data between researchers, institutions, and other key health stakeholders, which facilitated the response to the virus. Participants reflected that this type of cooperation is what allowed scientists to develop safe and effective COVID-19 vaccines in less than a year, and in the case of Brazil, it allowed the country to be the first in Latin America to complete genetic sequencing of the coronavirus. Cooperation was also essential to implement the most broader vaccination campaign in the country and some experiences from this moment—such as easier access to vaccination centers (expanded hours of operation and locations throughout the country)—can be used to tackle the vaccination rates in the country. 
• Innovation: Participants stated that it is key that innovation remains a core value of the Brazilian public health system, and it is crucial that policymakers normalize and facilitate cooperation between actors to foster the development of effective technological advances that can be implemented in times of crisis. The COVID-19 pandemic served as a catalyst for the adoption and implementation of innovative approaches to tackle health challenges and enhance the public health system. Participants suggested that the government should implement innovation-enabling regulations, as well as mechanisms to make the entry of new technologies somewhat more flexible.
• Communication Strategy: There is a need to improve the communication strategies and find a way to disseminate information to citizens in a clear, continuous, and precise manner. Participants shared that at the start of the pandemic, health personnel were afraid of the backlash they could experience when sharing information about the virus, and later about the vaccine doses and side effects, so relevant information was not shared all at once but rather as problems would arise. Consequently, the population did not receive all the necessary information, resulting in a lack of trust in the recommendations that were being shared by the government and the health community. This lack of transparency by government officials and health personnel resulted in misinterpretation and mistrust, and as a result, the spread of fake news. Participants recommended that the government needs to create a strategic plan that promotes effective management of the information and incentivizes clear communication, and most importantly, there needs to be continuous communication so when the next pandemic hits, the population is already inoculated against fake information.
• Leadership: Roundtable participants mentioned that it is crucial that the government keeps in mind that not everyone can be a source of information, therefore, public figures that regularly communicate with the population need to receive training on how to effectively deliver coherent messages. Additionally, moving forward, the government should incentivize the creation of communication channels that are more accessible, like the radio and the television, and work with state, municipal and federal committees to create positive campaigns and promote communication strategies that raise awareness as well as provoke a proactive and positive attitude towards vaccination.