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As yellow fever spreads Brazil struggles to vaccinate millions

As yellow fever makes its way toward Brazil's big cities, the country struggles to vaccinate millions,
Issued: 2018-03-05

They began arriving as early as midnight, air mattresses and beach chairs tucked under their arms, lined up down the sidewalk and around the corner in downtown São Paulo, Brazil.

"Make sure you have your vaccination card and your number in hand," a public health clinic worker shouted to those lucky enough to have one of the 300 numbers that would allow them to receive a full dose of the yellow fever vaccine, good for a lifetime.

"If you're not here when your number is called, you'll lose your place in line!"

Brazil is fighting to stay ahead of one of its worst epidemics of yellow fever, a sometimes-fatal virus transmitted by Haemagogus and Sabethes mosquitoes and named for the yellowing of the skin and eyes of those infected.

Though the surge has largely been in rural areas, there is increasing concern that if people don't get the vaccine, the virus could spread into the country's biggest cities.

Those lined up on the January morning in São Paulo were also racing the clock. The Brazilian government, faced with the task of vaccinating millions as quickly as possible, said it would begin reducing vaccine doses in São Paulo and Rio de Janeiro by the end of January to help stretch supplies.

Though health officials insisted even a partial dose would protect people for up to eight years, many remained unconvinced.

"Why would I only want only part of a vaccination?" asked Isabel Antônia Martins, who waited in line that day. "We don't know if it will have the same affect as a full dose. I'm not taking any chances, especially with the way yellow fever has been spreading."

Unlike the country's recent epidemic of Zika, another mosquito-borne virus that caused severe birth defects as a result of microcephaly in hundreds of babies, the yellow fever that is spreading across the country is not being transmitted by Aedes aegypti, the urban-dwelling mosquito blamed for the Zika epidemic.

Still, the yellow fever that has surged in rural parts of the country has now made its way into Minas Gerais, São Paulo and Rio de Janeiro, three states with some of the country's largest metropolitan centers — areas where people traditionally don't have to worry about getting the vaccine.

"It's a case of opportunity," said Maurício Nogueira, president of the Brazilian Society of Virology. "To urbanize, it would need a population that is susceptible [to the virus] and mosquitoes that are susceptible to the city. So the quicker we control these rural outbreaks, the lower the chances that it will urbanize.

It's something we can't waver on," he added. "We need to vaccinate the largest number of people as quickly as possible."


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