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The politics of Covid-19 vaccination in middle-income countries

Lessons from Brazil

Bibliographic Data

ID4977211
AuthorsElize Massard Da Fonseca (0000-0003-3847-3105, Fundação Getulio Vargas, corresponding author), Kenneth C Shadlen (0000-0003-4010-4835, London School of Economics and Political Science), Francisco I Bastos (0000-0001-5970-8896, Fundação Oswaldo Cruz)
Year2021
Volume281
Pages114093
Publication date2021-07-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueSocial Science & Medicine (JOURNAL)
Journal identifiersISSN: 0277-9536 • E-ISSN: 1873-5347
PublisherElsevier BV (PUBLISHER)
DOI10.1016/j.socscimed.2021.114093
PMID34144480
OpenAlexW3166698541
LanguageEN
Citations received24
References cited19

As the world struggles to meet the challenges of vaccination against COVID-19, more attention needs to be paid to issues faced by countries at different income levels. Middle-income countries (MICs) typically lack the resources and regulatory capacities to pursue strategies that wealthier countries do, but they also face different sets of challenges and opportunities than low-income countries (LICs). We focus on three dimensions of vaccination: procurement and production; regulation of marketing registration; and distribution and uptake. For each dimension we show the distinct challenges and opportunities faced by MICs. We illustrate these challenges and opportunities with the case of Brazil, showing how each dimension has been affected by intense political conflicts. Brazil's procurement and production strategy, which builds on a long trajectory of local production and technology transfer, has been riddled by conflicts between the national government and state governments. The regulatory approval process, based around one of Latin America's most highly-regarded regulatory authorities, has also been subject to acute inter- and intra-governmental conflicts. And with regard to distribution and uptake, in the face of high uncertainty, even with a solid health infrastructure, Brazil encounters difficulties in promoting vaccine delivery. The research also reveals the importance of coordination among these dimensions, in Brazil and beyond. Pandemic preparedness and response must include sharing knowledge of how to produce vaccines and recognition of the crucial linkages between procurement, regulation, delivery, and uptake that are necessary for ensuring access to these products

Business · Coronavirus disease 2019 (COVID-19 · Developing country · Development economics · Distribution (mathematics · Economic growth · Economics · Government (linguistics · Pandemic · Political science · Politics · Preparedness · Procurement · Public economics · Vaccination · COVID-19 Pandemic Impacts · Global Maternal and Child Health · Medicine · Vaccine Coverage and Hesitancy · Marketing · Virology

  • A comparative analysis of supply chain factors impacting Covid-19 vaccine security in high-income countries (HICs) and low-income and middle-income countries (LMICs)

    Open Access•Manveen Puri, Jeremy Veillard et al.•BMJ Global Health•2024

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    Open Access•Zachary D V Abel, Zachary DV Abel et al.•Health Policy•2025

  • How Covid-19 illness perceptions and individual shocks are associated with trust during the Covid-19 pandemic in Australia, France, Germany, and South Africa

    Open Access•Marie‐Hélène Broihanne, Marie-Hélène Broihanne et al.•Health Policy•2025

  • Preparing for future pandemics

    Open Access•Emmanuel Odame, Emmanuel A Odame et al.•PLOS Global Public Health•2025

  • Análise estratégica da atuação do governo federal brasileiro na pandemia de Covid-19

    Open Access•Carmen Fontes Teixeira, Jamilli Silva Santos•Ciência & Saúde Coletiva•2023

  • Strategic analysis of the Brazilian federal government’s performance in the Covid-19 pandemic

    Open Access•Carmen Fontes Teixeira, Jamilli Silva Santos•Ciência & Saúde Coletiva•2023

  • Mortality Risk Factors for Coronavirus Infection in Hospitalized Adults in Brazil

    Open Access•Rafael Alves Guimarães, Raquel Silva Pinheiro et al.•International Journal of…•2022

  • Understanding Factors to Covid-19 Vaccine Adoption in Gujarat, India

    Open Access•Viral Tolia, RK Renin Singh et al.•International Journal of…•2022

  • Disparities in Healthcare Utilization Among Vulnerable Populations During the Covid-19 Pandemic in Brazil

    Open Access•Letícia Perticarrara Ferezin, Rander Junior Rosa et al.•International Journal of…•2025

  • Political Populism, Institutional Distrust and Vaccination Uptake

    Open Access•Almudena Recio-Román, Manuel Recio-Menéndez et al.•International Journal of…•2022

  • Responding to the covid-19 in West Bank Palestine refugee camps

    Open Access•Lama Shakhshir, Weeam Hammoudeh•BMC Public Health•2025

  • Cross-country evidence on the role of national governance in boosting Covid-19 vaccination

    Open Access•Takeshi Aida, Masahiro Shoji•BMC Public Health•2022

  • Covid-19 vaccination and governance in the case of low, middle and high-income countries

    Open Access•Dan Lupu, Ramona Țigănașu•BMC Public Health•2023

  • Eupd performance in Latin America

    Roberto Domínguez, Andrea Ribeiro Hoffmann et al.•Journal of Contemporary European…•2022

  • Os desafios da continuidade da vacinação contra a Covid-19 em um cenário de hesitação vacinal

    Open Access•Vilma Bragas Oliveira, Adriana Bezerra et al.•Cadernos de Saude Publica•2026

  • Dependency, Capacity, and Agency

    Open Access•Matt Flynn, Elize Massard Da Fonseca•Studies in Comparative…•2023

  • BRICS na gestão da pandemia de Covid-19

    Open Access•Thalyta Cássia De Freitas Martins, Raphael Mendonça Guimarães et al.•Cadernos de Saude Publica•2025

  • A panel dataset of Covid-19 vaccination policies in 185 countries

    Open Access•Emily Cameron-Blake, Helen Tatlow et al.•Nature Human Behaviour•2023

  • Unbalanced global vaccine product trade pattern

    Open Access•W Cao, Debin Du et al.•Social Science & Medicine•2023

  • Borrowing regulatory capacity in middle-income countries during public health crises

    Open Access•Elize Massard Da Fonseca, Herschel S Nachlis et al.•Social Science & Medicine•2025

  • Self-esteem influences the willingness to engage in Covid-19 prevention behavior and persuasion efficacy

    Open Access•Anika Stuppy, Robert W Smith•Social Science & Medicine•2023

  • Cognitive underpinnings of Covid-19 vaccine hesitancy

    Open Access•Sinem Acar-Burkay, Daniela-Carmen Cristian•Social Science & Medicine•2022

  • Vacinar ou arriscar? A mensagem da Organização Mundial de Saúde para promover a vacinação contra a covid-19

    Open Access•Silva, Sónia Silva et al.•Saúde e Sociedade•2024

  • Contested Illness and Alternative Expertise Networks in Global Health

    Open Access•Renan Gonçalves Leonel Da Silva, Amanda Curi et al.•Sociology of Health & Illness•2025

  • The Brazilian health system

    Open Access•Jairnilson Silva Paim, Jairnilson Paim et al.•The Lancet•2011

  • Spatiotemporal pattern of Covid-19 spread in Brazil

    Open Access•Márcia C Castro, Sun Kim et al.•Science•2021

  • Challenges in ensuring global access to Covid-19 vaccines

    Open Access•Olivier J Wouters, Kenneth C Shadlen et al.•The Lancet•2021

  • The Politics of Precaution

    David Vogel•Politics of Precaution•2012

  • Promoting and regulating generic medicines

    Open Access•Elize Massard Da Fonseca, Kenneth C Shadlen•Revista Panamericana de Salud…•2017

  • Taking a Covid-19 Vaccine or Not? Do Trust in Government and Trust in Experts Help Us to Understand Vaccination Intention

    Open Access•Jan Wynen, Sophie Op de Beeck et al.•Administration & Society•2022

  • What is the importance of vaccine hesitancy in the drop of vaccination coverage in Brazil

    Open Access•Ana Paula Sayuri Sato•Revista de Saúde Pública•2018

  • Institutional change and political decision-making in the creation of the Brazilian National Health Surveillance Agency

    Open Access•Márcia Franke Piovesan, Maria Eliana Labra•Cadernos de Saude Publica•2007

  • Vaccine confidence and hesitancy in Brazil

    Open Access•Amy Louise Brown, Marcelo Sperandio et al.•Cadernos de Saude Publica•2018

  • Medical populism

    Open Access•G Lasco, Nicole Curato•Social Science & Medicine•2019

  • Public Production of Anti-Retroviral Medicines in Brazil, 1990-2007

    Open Access•Matt Flynn, Matthew Flynn•Development and Change•2008

  • Health Policy as Industrial Policy

    Open Access•Kenneth C Shadlen, Elize Massard Da Fonseca•Latin American Politics and Society•2013

Unique citing works24
Citations per year6
Citation span2022 - 2026 (5)
Citation velocitycurrent
Highly citedNo
Citation typesNeutral: 24
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