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  • Coronavirus pandemic

image copyrightGetty Imagesimage captionMany cities and states are struggling to carry out their vaccination campaigns with insufficient doses

Vinicius Alexis da Cruz felt a wave of relief when his turn came to take the Covid-19 vaccine.

As the virus ravaged Brazil, the 32-year-old had spent more than a year risking his life, working as an Uber driver. Diabetes and high blood pressure made Mr Cruz especially vulnerable. But he kept driving passengers across São Paulo to make ends meet.

"I was really scared of getting sick," said the father of one, who lost his job as a sports commentator before the pandemic hit. "But I was taking the risk because I had to keep working."

Mr Cruz got his first dose of CoronaVac in late May. But when the time came to get his second jab, he was turned away. "Nobody had a vaccine for me," he said. "I went to five clinics near my house. I couldn't find it anywhere. The same thing happened the next day, and the day after that."

He scoured the city for four days before he got his hands on a second shot. "Finally, I'm fully vaccinated. But it became really clear to me just how short we are on vaccines."

Like Mr Cruz, millions are struggling to get their second shot of the Covid-19 vaccine, dealing a blow to Brazil's already troubled vaccination campaign. Some 3.1 million Brazilians had not had their second jab as of 4 July despite being eligible for it, according to researchers tracking vaccinations.

image captionVinicius Alexis da Cruz received his first jab in May, but was turned away when he tried to get his second dose

Some have intentionally skipped their second dose, falling for misinformation campaigns that have sowed doubts about the vaccine or claimed a single shot offers enough protection. But the main hurdle has been a supply crunch of doses driven by a rushed vaccine rollout, said Dr Ligia Bahia, a public health specialist at the Federal University of Rio de Janeiro.

"There is this drive to speed up vaccination with the first dose," said Dr Bahia, one of the researchers tracking immunisations. "And the second dose has ended up on the backburner."

Coronavirus has claimed more than 530,000 lives in Brazil, a toll second only to the United States. Yet only about 40% of Brazilians have received at least one dose of the vaccine and just 15% are fully immunised.


Global vaccine rollout

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The World
Africa
Asia
Europe
Middle East
Latin America & Caribbean
North America
Oceania

Location

Doses per 100 people

Total doses

World

44.1

3,439,775,179

China

95.8

1,387,280,157

India

27.3

377,352,501

US

99.9

334,151,648

Brazil

53.8

114,456,183

Germany

97.8

81,939,305

UK

120.7

80,646,232

Japan

47.6

60,257,292

France

87.5

59,124,911

Turkey

69.0

58,155,459

Italy

95.3

57,616,037

Indonesia

18.7

51,278,367

Mexico

39.3

50,698,518

Russia

32.6

47,572,228

Spain

99.7

46,612,489

Canada

112.6

42,509,643

Poland

83.3

31,535,478

Argentina

54.5

24,616,918

Chile

125.8

24,053,548

Colombia

41.5

21,124,781

South Korea

39.7

20,330,660

Pakistan

9.0

19,883,900

Saudi Arabia

56.9

19,825,792

Morocco

53.0

19,579,875

Netherlands

100.3

17,191,580

United Arab Emirates

161.1

15,934,124

Philippines

12.0

13,122,277

Thailand

18.0

12,569,213

Belgium

102.1

11,837,865

Malaysia

35.1

11,366,710

Israel

126.2

10,923,521

Hungary

105.1

10,155,466

Bangladesh

6.1

10,107,557

Portugal

94.7

9,660,794

Greece

88.6

9,233,521

Australia

35.7

9,097,969

Romania

47.3

9,092,141

Sweden

90.0

9,086,607

Czech Republic

83.7

8,966,562

Peru

27.1

8,930,921

Dominican Republic

81.4

8,833,615

Cambodia

52.0

8,700,167

Austria

95.6

8,607,754

Switzerland

91.7

7,932,912

Cuba

64.2

7,275,137

Kazakhstan

35.9

6,742,275

Singapore

105.3

6,163,124

Denmark

102.6

5,942,561

Iran

6.8

5,717,914

Ecuador

31.8

5,619,115

Sri Lanka

24.8

5,319,423

Serbia

78.2

5,318,975

Finland

87.1

4,827,970

Ireland

95.3

4,707,181

Norway

85.2

4,617,380

Egypt

4.5

4,560,082

Jordan

42.3

4,312,212

Uruguay

123.0

4,274,165

South Africa

7.1

4,236,718

Azerbaijan

40.5

4,107,950

Vietnam

4.2

4,040,783

Slovakia

71.8

3,919,426

Mongolia

119.0

3,899,770

Nigeria

1.9

3,832,459

Nepal

12.5

3,653,173

Taiwan

15.0

3,565,840

Uzbekistan

10.6

3,541,442

Myanmar

6.4

3,500,000

Ukraine

8.0

3,489,332

Qatar

117.9

3,396,963

El Salvador

49.5

3,212,880

Croatia

68.6

2,814,234

Bolivia

22.7

2,647,544

Costa Rica

49.5

2,521,795

Venezuela

8.8

2,508,201

Algeria

5.7

2,500,000

Lithuania

88.6

2,411,631

Kuwait

55.6

2,375,455

Bahrain

128.9

2,193,232

Tunisia

18.1

2,138,025

Ethiopia

1.8

2,058,122

Bulgaria

26.7

1,852,583

Panama

40.2

1,736,269

Slovenia

76.4

1,587,535

Laos

21.3

1,552,182

Lebanon

22.6

1,541,843

Kenya

2.9

1,539,087

Angola

4.6

1,513,460

Zimbabwe

10.0

1,491,397

Oman

29.0

1,480,949

New Zealand

26.4

1,270,719

Ghana

4.1

1,261,677

Latvia

65.6

1,238,086

Iraq

2.7

1,087,866

Belarus

11.3

1,068,413

Uganda

2.3

1,058,094

Guatemala

5.7

1,028,399

Estonia

77.2

1,023,643

Albania

35.5

1,022,802

Honduras

9.9

980,363

Afghanistan

2.4

934,463

Palestinian Territories

18.1

921,595

Cyprus

99.9

887,110

Ivory Coast

3.2

850,857

Moldova

19.7

793,281

Paraguay

10.9

781,010

Senegal

4.5

751,129

Guinea

5.6

734,918

Mauritius

55.6

706,948

Malta

159.9

705,852

Sudan

1.5

677,957

North Macedonia

31.8

662,372

Rwanda

5.0

646,909

Luxembourg

96.5

604,188

Maldives

99.7

539,092

Mozambique

1.6

508,184

Bhutan

63.0

486,126

Bosnia and Herzegovina

14.3

470,218

Iceland

132.4

451,936

Malawi

2.2

428,407

Niger

1.7

423,335

Libya

5.7

393,688

Fiji

42.3

379,199

Trinidad and Tobago

26.2

366,114

Guyana

45.0

354,014

Togo

4.2

347,246

Tajikistan

3.4

322,907

Montenegro

48.1

302,321

Georgia

7.3

289,399

Jamaica

9.7

288,320

Equatorial Guinea

19.7

277,042

Yemen

0.9

268,753

Botswana

11.4

267,763

Timor-Leste

18.5

244,497

Kosovo

12.6

243,428

Somalia

1.5

235,882

Armenia

7.7

227,172

Sierra Leone

2.8

225,380

Suriname

35.7

209,491

Madagascar

0.7

197,001

Mali

0.9

190,301

Zambia

1.0

181,219

Mauritania

3.8

174,628

Kyrgyzstan

2.7

173,700

Barbados

58.7

168,711

Nicaragua

2.5

167,500

Namibia

6.3

159,585

Seychelles

142.0

139,625

Belize

35.1

139,525

Jersey

125.2

126,554

Congo

2.1

116,110

Isle of Man

134.3

114,190

Cameroon

0.4

110,324

Brunei

24.8

108,457

Syria

0.6

108,276

Cape Verde

17.9

99,686

Bahamas

24.4

95,992

Cayman Islands

143.5

94,277

Liberia

1.8

92,041

Comoros

10.5

90,880

Guernsey

128.2

85,940

Bermuda

131.4

81,845

Central African Republic

1.6

78,685

Gibraltar

231.9

78,125

Andorra

88.4

68,329

DR Congo

0.073

65,567

Antigua and Barbuda

66.5

65,077

Gabon

2.9

64,161

Samoa

31.3

62,161

Faroe Islands

116.3

56,825

Lesotho

2.6

56,322

Saint Lucia

29.2

53,699

Eswatini

4.4

51,451

Papua New Guinea

0.6

51,170

South Sudan

0.4

48,461

Greenland

84.5

47,971

Benin

0.4

46,108

Turks and Caicos Islands

117.1

45,342

San Marino

131.6

44,659

Gambia

1.8

42,975

Turkmenistan

0.7

41,993

Saint Kitts and Nevis

78.9

41,956

Dominica

55.6

40,004

Monaco

99.0

38,849

Liechtenstein

91.9

35,050

Grenada

30.5

34,331

Sao Tome and Principe

15.5

33,996

Tonga

27.1

28,667

Djibouti

2.7

26,796

Burkina Faso

0.1

25,833

St Vincent and the Grenadines

23.0

25,509

Guinea-Bissau

1.2

23,318

British Virgin Islands

73.6

22,247

Solomon Islands

3.2

21,742

Chad

0.1

20,478

Cook Islands

107.8

18,942

Anguilla

109.7

16,460

Vanuatu

3.4

10,480

Nauru

86.0

9,313

Saint Helena

130.0

7,892

Tuvalu

40.5

4,772

Falkland Islands

126.5

4,407

Montserrat

53.0

2,651

Niue

75.2

1,216

Pitcairn

100.0

47

British Indian Ocean Territory

0

0

Burundi

0

0

Eritrea

0

0

Haiti

0

0

Kiribati

0

0

North Korea

0

0

South Georgia and the South Sandwich Islands

0

0

Tanzania

0

0

Tokelau

0

0

Vatican

0

0

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Unlike some other countries, Brazil chose not to hold back supplies for second doses. Its vaccination campaign has mostly relied on CoronaVac shots, made locally using inputs from China's Sinovac. But shipments of Chinese materials have lagged, just as millions are due for their second jab.

And other vaccines have been slow to trickle into Brazil, after President Jair Bolsonaro snubbed early vaccine offers from Pfizer, opting to promote ineffective treatments instead, such as hydroxychloroquine.

He is one of the few leaders in the world who has not yet been vaccinated. And now his government is also under investigation for plans to buy millions of Covaxin shots at wildly inflated prices.

image captionSimone Spadari Da Costa Moura says a political tug of war is hurting Brazil's vaccination efforts

In early July, Simone Spadari Da Costa Moura arrived at a clinic in São Paulo, ready for her second jab. But she, like many others, was turned away as CoronaVac doses ran out.

She blames policymakers, who she says are locked in a political tug of war that is hurting Brazil's vaccination efforts.

"They want to show they're speeding things up – but they are not thinking about the second dose," said Ms Moura, a former schoolteacher. "It's a political war. And we're in the middle of it. For us, we just want to be vaccinated and not get Covid."

While a longer interval between doses appears to boost the efficacy of vaccines like Pfizer and AstraZeneca, research into the impact of delaying a second CoronaVac shot is still lacking. Some experts fear a longer wait could even hinder the effects of the Chinese vaccine, which already may be less effective at preventing serious cases of Covid-19.

It was these unknowns that worried Aline Nogueira Mariano, when she was told there was no second dose for her. At high-risk due to pre-existing illness, Ms Mariano, 32, took the first dose in late May but struggled to find a second CoronaVac shot.

"I spent days calling every clinic, searching for the vaccine," said Ms Mariano, who owns an online jewellery store. "It was really distressing, I was so worried. My fear was that I would miss the window to take the second dose and get fully immunised."

image captionAline Nogueira Mariano managed to get a second shot only after a week-long search

But perhaps the biggest risk is that, with full vaccination delayed, the virus will continue posing a threat to Brazilians, said Dr Gerson Salvador, an infectious disease specialist at the University Hospital of São Paulo.

"There needs to be an easy way for people to get vaccinated," Dr Salvador said. "Without it, some will inevitably give up on getting the second dose. And, unless a large majority of people are fully vaccinated, we will continue to be a long way off from controlling the pandemic."

This is especially worrying as new strains gain traction in Brazil, where authorities have long ago scrapped even loose sanitary measures and many unvaccinated Brazilians are foregoing basic precautions like social distancing and mask wearing. Some variants have proven more dangerous to healthy young adults, posing a threat to Brazilians still waiting for their jab.

After a week-long search, Ms Moura finally got her second dose early this week, as a clinic near her home received a fresh batch of vaccines. She says it brought her relief – and fresh hope for the future.

"You feel that you are more protected, that you're safer," she said. "It's this feeling… that things are getting better."

  • CHINESE VACCINES: What we know about them
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