In Brazil's Amazon, fear of COVID-19 vaccine poses challenges

RIO DE JANEIRO – Navigating complex waterways to remote communities in the Brazilian Amazon is just the first challenge for Waldir Bittencourt, a nurse who vaccinates indigenous peoples and river dwellers against COVID-19. Once there, he faced something he did not expect: a fear of the vaccine.

“It is a recent phenomenon among indigenous peoples, due to the polarization of the vaccine,” said 32-year-old Bittencourt, who has campaigned against tuberculosis, diphtheria and tetanus during his eight-year career.

Health professionals like Bittencourt are stationed in distant areas in northern Brazil, often traveling for hours in small planes and boats. Most jungle communities only have basic medical facilities incapable of treating those with COVID-19. The vaccination is all the more urgent in order to contain the rising number of cases.

According to a record from Johns Hopkins University, Brazil has recorded nearly 235,000 deaths, second only to the US. In a poll by pollster Datafolha last month, 17% of respondents said they did not intend to receive any of the vaccines approved in Brazil. This is higher in the northern and western central regions grouped by Datafolha and lower in the richer southern and southeastern regions.

Health care workers, experts and anthropologists say the rejection or fear of the vaccine is due in part to doubts President Jair Bolsonaro has repeatedly expressed about its effectiveness. Bolsonaro, who was infected with COVID-19 himself last year, has said he has no plans to get vaccinated and has insisted that others shouldn’t do it unless they want to.

He initially declined to approve the purchase of the Chinese Sinovac vaccine, saying on Facebook that Brazilians would never be anyone’s “guinea pigs”. He also opposed the Pfizer vaccine, citing a clause protecting the US company from possible liability. He joked that there would be no recourse when women grew beards, men’s voices rose, or people were turned into alligators.

His anti-scientific message has found its way into the remote communities.

“This anti-vaccine movement doesn’t come from them. It is brought by certain missionaries, social media and false news, ”said the anthropologist Aparecida Maria Neiva Vilaça, who works with indigenous communities in the northern state of Rondonia.

These communities have had better access to technology and the Internet in recent years, but information often arrives in “very distorted ways,” Bittencourt said on the phone from Macapa, capital of Amapa state.

In the Purure Community in Tumucumaque Mountains National Park, some residents asked Bittencourt if they could be injected with the vaccine imported from India because they believed it meant it had been made by indigenous peoples. In Brazil, the word “Indian” is still widely used for indigenous people.

In other villages, some feared they would be used as test subjects for wider vaccination campaigns among non-indigenous peoples, while others feared it would let the devil into their bodies.

Although most eventually decided to take the pictures, both Bittencourt and Vilaça said they hadn’t seen such reluctance among indigenous peoples before.

Some evangelical leaders have been another source of misinformation, they said. Evangelicals broadly supported Bolsonaro in the 2018 presidential campaign, and some pastors in remote churches helped get his message across against receiving the COVID-19 vaccine.

Audio messages circulated on the WhatsApp messaging app reported from pastors claiming they could cure the infected. In a message, a man recalls a pastor who informed him that the vaccine was not necessary because God could heal him.

Vilaça, who teaches social anthropology at the Federal University of Rio de Janeiro when she’s not in the north, said the rest of Brazilian society is no different when it comes to misinformation.

“A large part of the population is only informed via WhatsApp and social media and has no access to newspaper information,” she said.

Sister Luciana Dias da Costa also had some difficulties in the Amazon state. Vaccination is especially important in the state where a spate of infections has overwhelmed the already fragile public health system in the capital, Manaus. It has forced a nationwide mobilization to provide oxygen to patients who have difficulty breathing or to move hundreds to better-equipped facilities in other states.

“We all want to vaccinate, but as I said, some accept and others not,” said 46-year-old da Costa in an interview when he was traveling by boat to Sao Joao do Tupe, 25 kilometers west of Manaus. Many elders there told her they feared the effects of the vaccine they heard about on the radio.

Official government data shows a death rate of 224 per 100,000 in the Amazon state – twice the national average. Some health experts believe that a variant of the coronavirus, which is more contagious and less susceptible to some treatments, has caused the dramatic increase in hospital stays and deaths.

Dr. Ethel Maciel, an epidemiologist who advised the government on its COVID-19 vaccination program, said remote communities in the Amazon were a priority due to their lack of health infrastructure and the long distances people have to travel to get proper medical care in Manaus.

“With an acute infectious disease like COVID-19 that worsens very quickly, the person has sometimes already died by the time those people make the trip,” she said.

In the Amazon, 71-year-old Jane Barbosa de Albuquerque said she was initially skeptical about the vaccine.

“We doubt. Which is the best? Which one will i take? Which one came to us here in the Amazon? ” She asked.

Eventually, however, de Albuquerque agreed to have a nurse insert a needle into her left arm. “Health comes first,” she said.

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