By Luize Sampaio
The vaccine is the only way to combat the new coronavirus pandemic, but the lack of unified work between government levels has resulted in a slowness in the vaccination process. Today we are experiencing a second wave of the disease with a daily increase in the lack of beds in the ICU throughout Rio de Janeiro. In the metropolitan region, which concentrates 70% of the state's population, priority groups suffer from the lack of vaccines and long queues that start in the early hours of the morning. At the moment, the metropolis of Rio de Janeiro vaccinated only 5.3% of its population. Until the last Saturday of the month (27/03), some municipalities in the region had still not managed to vaccinate even 1% of their residents, as is the case of São Gonçalo, Seropédica and Cachoeiras de Macacu.
The situation in São Gonçalo draws attention. The second most populous municipality in the state, which is why it is also the one that receives the most doses after the city of Rio, had vaccinated only 9,261 of its more than 999,000 residents as of the date the map was consulted (03/27). Data from the Health Surveillance Secretariat of the Ministry of Health (SVS/MS) show that the city has already received more than 170 thousand doses, but the application is the worst in the entire metropolis. For the health nutritionist, Amanda Oliveira, who participated in the preparation of the local agenda of São Gonçalo, the city hall is making mistakes in communication.
“The start of the vaccination process was greatly hampered by the way the city hall announced the priority groups. A lot of people went to those long queues thinking they were entitled, but didn't fit the criteria. This lack of communication also caused the municipality to run out of doses for a period of time. Another point is that to date the municipality's vaccination plan has not been published; on the city hall's website, the announced data also does not match reality. In addition to all these obstacles, we still have to deal with a health secretary, who is a doctor, stating in a public hearing that he does not intend to be vaccinated”, said Amanda.
The political dose of the vaccine
In recent weeks, clashes between mayors, state and federal governments have intensified. A response from the acting governor, Cláudio Castro, was the announcement of a unified calendar for all municipalities. He explained that the new change took place at the request of the mayors themselves as a way of organizing the application of vaccines and reducing the traffic of people seeking doses in neighboring municipalities. Vaccination against Covid is one of the only immunization campaigns in the country that began without planning unified dates for all states and municipalities.
For the doctor and professor at the Institute of Public Health at UFRJ, Lígia Bahia, the current vaccination situation in Brazil is not an isolated case. She points out that many countries have suffered from a shortage of vaccines, which would explain these low vaccination numbers here in Rio. But, according to her, an aggravating factor that becomes a differentiator here is poor management. If in Brazil there is currently no target for vaccination, in Rio this type of policy is reinforced by the state government.
“We have one of the worst governments in the country, which automatically aligns with the president's ideas of reinforcing everything that is anti-science. Our State Department of Health is very weak and has proven incapable of coordinating the moment we are experiencing. Instead of supporting the work that some municipalities are doing, the state government wants to play who owns the ball at a time when there are people who don't even have bread to eat. This hyper-politicization of the vaccine is regrettable,” said the expert.
Last Sunday (28/03), the governor caused an illegal gathering to celebrate his birthday.
Contradictions in vaccine distribution data
According to the Ministry of Health, the doses are distributed proportionally and equally to the population of the states. In this account, Rio de Janeiro is the third Brazilian state that receives the most vaccines. The data shows that 3 million vaccines have already been sent to Rio, which recently completed the milestone of 1 million doses applied. For the vice-director of the Faculty of Nursing at UERJ, Ricardo Mattos, Rio should have vaccinated at least triple that number. Mattos works daily on the front line of vaccination and said that this process of distributing doses, which passes through the hands of the federal, state and municipal governments, is not a simple procedure. “This delivery is not as agile as we imagine, even with the support of helicopters in this distribution. We have already had an episode of vaccine shortages in the middle of the day here at UERJ”, reported the deputy director.
He also states that there is no point in the city of Rio thinking about an immunization schedule that is separate from Baixada Fluminense, because in a metropolis everything mixes. For him, the pandemic warned about the importance of unifying the Health System.
“It is not possible to think about combating an airborne disease without a joint and unique program. One of the consequences of this lack of programming is the absence of a vaccine delivery schedule, which generates absurd anxiety among frontline health professionals. Since February 1st, there hasn't been a day that goes by that we don't stay until close to dawn in anticipation of the next day, we don't know if we will have enough doses. Without information, the population is lost and rightly seeks the vaccine in other cities. Only here at UERJ have we vaccinated people from practically all 92 municipalities in the state”, informed Mattos.
While the Ministry of Health shows that more than 12 thousand doses of vaccine were distributed in Seropédica, data from the Government of RJ shows that only 180 vaccines were administered in the city. This scenario is repeated in other locations. In theory, Duque de Caxias has already received 116 thousand doses, but has only 24 thousand applied, counting both the first and second doses.
Data on color is also a problem, as 40% in the records of those vaccinated in the metropolitan region do not contain this information. For Ricardo Mattos, color registration in Brazil has always been underreported. “It seems that this data cannot be interpreted as a variable of great importance, but we know that the black population has been less vaccinated. Just look at the drive thru lines, the majority of people there are white. The black population lacks a database, public policies and access to health equipment”, explained Mattos.
When questioned about the lack of race information, the Superintendency of Epidemiological and Environmental Surveillance of the State of Rio de Janeiro reported that it followed the guidelines of the National Operational Plan. This report from the Ministry of Health lists 10 basic information for the registration form for the person who will be vaccinated, but race/color is not among the minimum information prioritized by the federal government.
Another problem is the constant scenes of crowds that are repeated throughout the Metropolitan region. In Belford Roxo, the application of the vaccine was suspended for two weeks after reports of disturbances in queues at the city's stations. Only on Monday night (29/02), the city hall announced the return of vaccination after pressure from the population on social media. But, for a city resident who prefers not to identify herself, Mayor Waguinho still needs to take a serious look at the pandemic.
“The problems start with the lack of supervision, there has been a lot of crowding, the mayor is completely ignoring the Covid crisis. Recently, even with the suspension of vaccines, the city hall itself has announced the return of in-person group activities, such as sports in the city's Olympic village. Here, we have no control over vaccination and there is a lack of transparency in the data. We don't know how many people were vaccinated daily or who this audience is. I know many health workers who were unable to get vaccinated, for example,” said the resident.
