Opinion – Atila Iamarino: Brazilian anti-vaccine denialism is unique

Some regions began to register lower-than-expected adherence to childhood vaccination against Covid, which is at odds with the usual success of Brazilian vaccination. And the reasons can be very different from the European or North American anti-vaccine movement.

In Brazil, we created social immunity against the anti-vaccination movement. In the campaign to combat poliomyelitis, it became clear that we would need the collaboration of families to have good coverage of childhood vaccination. And the Ministry of Health’s communication strategy was transformed from an imposing call to an act of care and love for children. This strategy, coupled with the strong presence of health workers who act as trusted informants for families, saved us from polio and other preventable diseases.

The same cannot be said of the US, where the lack of a public health system generates a huge population of hesitant people, who are not used to receiving free health care such as free vaccinations or seeking health care from professionals – until the ambulance is paid there, forget about “visiting the post” to find out what a health problem is. In addition, both in North America and Europe, there is a strong anti-vaccine movement coordinated for decades by a multi-million industry, exploiting videos on social networks such as YouTube and Facebook very well for disinformation.

In the former Soviet Union, the government’s insistence on imposing mandatory vaccination generated distrust and an anti-vaccine movement as a protest, which still keeps vaccination low and Covid deaths high in Eastern Europe. The opposite of our conquest with Zé Gotinha.

This bottom-up “popular” anti-vaccination movement, with an uninformed or suspicious population that rejects government calls for them to be vaccinated, has little traction in Brazil. We even have translated anti-vaccination content that seems to have been more consumed by wealthier and better-informed Brazilians, which may at least partially explain the drop in childhood vaccinations in recent years. But the Covid anti-vaccine movement is organized in the opposite way. It is a top-down movement, where the government rejects the vaccine and the population’s requests to vaccinate ourselves.

Here, it is our health minister who uses the five denialist tactics that would need to be countered by anyone who wants to inform people in an unprecedented and destructive anti-vaccine campaign. The minister :(i) feeds the conspiracy that vaccines are not safe by ignoring Anvisa’s approval; (ii) uses false experts, by setting the stage for incompetent anti-vaccinations in the hearing on immunization for children; (iii) creates impossible expectations by demanding a consent form from parents, as childhood vaccines are not 100% safe —no drug or treatment can be 100% safe; (iv) selects isolated problems when visiting a child with a rare congenital disease, implying that his heart problem was a reaction to the Covid vaccination; and (v) uses logical fallacies (mind) when stating “there are about 4,000 deaths where there is proof of a causal relationship with the application of the vaccine”, since the Ministry of Health’s own study only saw a causal relationship in 11 deaths among the dozens of millions of vaccinated Brazilians.

Brazilian anti-vaccine denialism is quite unique. It is fostered as a front for a government that didn’t want to vaccinate its people and promoted treatments that don’t work, knowing they don’t work, and now has to sabotage as it saved thousands of lives. If parents’ doubts were really about the effectiveness or safety of the vaccine, parents who do not want to vaccinate their children would not be taking ivermectin or chloroquine against Covid – drugs that are proven to be ineffective and will generate adverse effects without bringing benefit.

We have an infection of misinformation growing. Letting this official speech continue will be very dear to us. The great time to intervene in denialism before it takes hold. When people still get the distorted facts and start to form their opinion. After this phase, converting someone who already has an opinion is much more difficult. For those in doubt, the facts need to come from a trusted source who is willing to make contact. So the reports of health professionals and politicians discouraging parents from wanting to vaccinate their children are especially troubling.

We have already paid for the delay in vaccination against Covid with full pediatric ICUs. But the erosion of public trust in childhood vaccination doesn’t usually stop at the vaccine that sparked the debate. Childhood vaccination as a whole suffers when parents lose confidence in vaccines. And in 2019 we already had the worst childhood vaccinations since the 1980s. Soon we could have children with measles or polio occupying beds.