Only 48.7% of the indigenous population over 5 years of age living in municipalities with special indigenous health districts (Dsei) had received the primary vaccination schedule against covid-19 by March 1 of last year, reveals a study conducted by several institutions and published in preprint in the scientific journal The Lancet. Conclusions of work released in this format are considered preliminary because they have not yet been reviewed by scientists not involved in the research. The total number of indigenous people immunized with two doses or a single dose of vaccines against covid-19 was almost 30 percentage points lower than that of the non-indigenous population, which reached 74.8%. The study was conducted by researchers from the Data Integration Center for Health Knowledge (Cidacs/Fiocruz Bahia), together with the London School of Hygiene and Tropical Medicine, the Federal University of Rio de Janeiro (UFRJ), the São Paulo University ( USP), the Universitat Pompeu Fabra (Barcelona), the Federal University of Bahia (UFBA) and the State University of Rio de Janeiro (Uerj). To calculate the percentage of vaccination coverage, the indigenous population in the Dsei was estimated at around 600,000 people, of which 389,000 received only one dose (65%) and 291,000 were considered to have complete basic immunization. The basic or primary vaccination scheme does not include any of the booster doses, considered essential to maintain long-lasting immunity against covid-19. The article considers that the calculated vaccination coverage, however, may be overestimated, also because the government itself calculates an indigenous population about 10% higher in these districts (657 thousand people). In addition, the researchers point out that there are indigenous people who live outside the Dsei, which prevents generalization of the results to the entire indigenous population of Brazil. “Low vaccination coverage in many indigenous communities made up of just a few hundred people may also threaten their cultural continuity, since covid-19 affects older people more, and they are primarily responsible for cultural transmission between generations”, warns the study. One of those responsible for the survey, Julia Pescarini, from Cidacs/Fiocruz, also recalls that the indigenous population is younger than the Brazilian population in general, with a lower percentage of elderly people. “Adults have more mobility and are more likely to walk to a more distant city and get vaccinated. Now, a person over 60 has much more difficulty getting to cities and getting vaccinated. This also explains why vaccination is less ” said Julia. The researcher also draws attention to the vaccination coverage of children aged 5 to 9 years. As of March 1, 2022, only 2.6% of the Dsei indigenous population in this age group had received their first dose, while the average in Brazil was 40.7%. The researchers also evaluated the effectiveness of vaccines in the indigenous population. To this end, a group of indigenous people over 5 years vaccinated between January 18, 2021 and March 1, 2022 was followed and the rate of protection against symptomatic cases, mortality and hospitalization was calculated. One concern of the researchers was the possibility of nutritional deficiencies impairing the immune response of indigenous people to vaccination, but the data showed a similar performance of vaccines to that observed in the non-indigenous population. Julia maintains that monitoring has to be continuous. “This was an alert in March, but it is ideal that monitoring be done on a constant basis to see in which populations it is necessary to strengthen the vaccination system”, said the researcher. is that there is inequality by race, socioeconomic position, and with the indigenous population, it is no different. The indigenous population, the black population, the population of the slums have more difficulties, even in urban centers, to access vaccination”, said the researcher.
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