Machado Fernanda Christina Gomes, Ferron Mariana Maleronka, Barddal Maria Tereza da Matta, Nascimento Laura Alves, Rosalen Juliana, Avelino-Silva Vivian I
School of Medicine, Faculdade Israelita de Ciências da Saúde Albert Einstein, Brazil.
Iepe - Instituto de Pesquisa e Formação Indigena, Brazil.
Lancet Reg Health Am. 2022 Sep;13:100319. doi: 10.1016/j.lana.2022.100319. Epub 2022 Jul 19.
Chronic social and health inequities faced by indigenous peoples in Brazil foretell the detrimental impact of COVID-19.
We use de-identified, publicly available data from the Ministry of Health from March/2020 - December/2021 to describe vaccination coverage, cumulative incidence, and cumulative mortality rates due to COVID-19 among indigenous peoples. We also compare vaccination coverage among indigenous peoples with that reported for older adults, who were simultaneously included as a priority group in the vaccination strategy. Finally, we compared COVID-19 incidence and mortality rates in the indigenous population with that reported for the general Brazilian population.
We found important heterogeneities in vaccination coverage across the 34 indigenous districts, and a lower overall coverage among indigenous peoples compared to older adults. We observed higher COVID-19 cumulative incidence rates among indigenous populations compared to the general Brazilian population. Although mortality rates were seemingly lower, data should be interpreted with caution due to a younger age structure and more frequent underreporting of cases and deaths among indigenous populations. After the beginning of COVID-19 vaccination program, we observed a decrease in both incidence and mortality rates among indigenous peoples in all Brazilian regions.
The COVID-19 pandemic has had a heavy toll on vulnerable populations. Although social and geographic isolation challenges the implementation of any vaccination program for indigenous populations, prior experience suggests that the COVID-19 vaccination strategy lacked effectiveness. The absence of a coordinated strategy to reinforce the importance of the vaccine and other prevention methods, to guarantee the access to trustworthy information, and to respond with the necessary resources in extreme situations, resulted in lower COVID-19 vaccination coverage, higher incidence rates, and preventable deaths due to COVID-19 among indigenous peoples in Brazil.
This work was not supported by specific funding.
巴西原住民面临的长期社会和健康不平等预示着新冠疫情的有害影响。
我们使用来自卫生部2020年3月至2021年12月的匿名公开数据，来描述原住民中因新冠疫情导致的疫苗接种覆盖率、累积发病率和累积死亡率。我们还将原住民的疫苗接种覆盖率与作为疫苗接种策略优先群体的老年人的报告覆盖率进行比较。最后，我们将原住民群体中的新冠发病率和死亡率与巴西总人口的报告数据进行比较。
我们发现34个原住民地区的疫苗接种覆盖率存在显著差异，且原住民的总体覆盖率低于老年人。我们观察到，与巴西总人口相比，原住民群体中的新冠累积发病率更高。尽管死亡率似乎较低，但由于原住民年龄结构较年轻，且病例和死亡报告漏报情况更频繁，因此对数据的解读应谨慎。在新冠疫苗接种计划开始后，我们观察到巴西所有地区原住民的发病率和死亡率均有所下降。
新冠疫情给弱势群体带来了沉重代价。尽管社会和地理隔离给原住民群体的任何疫苗接种计划的实施带来了挑战，但先前的经验表明，新冠疫苗接种策略缺乏有效性。缺乏协调一致的策略来强化疫苗及其他预防方法的重要性、确保获取可靠信息以及在极端情况下提供必要资源做出应对，导致巴西原住民的新冠疫苗接种覆盖率较低、发病率较高以及因新冠疫情导致可预防的死亡。
本研究未获特定资金支持。
