What can Canada learn from the most vaccinated country in the world? We asked the man behind Portugal’s vaccination effort

Last week, Vice Admiral Henrique Gouveia e Melo, coordinator of Portugal’s COVID-19 vaccine working group, said goodbye to most of his staff.

Then he went home and slept for 12 hours.

With more than 95 percent of its eligible population vaccinated, Portugal says it no longer needs a vaccine task force.

As Canada and other wealthy nations experience some stagnation in vaccine adoption, many look to Portugal for lessons. About 12 percent of eligible Canadians have yet to receive a dose of the COVID-19 vaccine, and 18 percent have yet to receive a second.

When Gouveia e Melo, a Portuguese naval officer, assumed control of the vaccine delivery from a politician appointee in February, the program was “in shambles,” he says.

In the last week of January, Portugal reported more than 12,000 new COVID-19 cases and more than 200 deaths a day among its population of just over 10 million. Their healthcare system was on the brink of collapse, ambulances transporting COVID patients had to queuing outside hospitals, waiting for beds, and nearly 2,000 people died from COVID-19 in the span of a week.

“I had the feeling that we had to climb a huge mountain and couldn’t see the peak,” Gouveia e Melo told the Star in an interview this week.

In his 42-year military career, the 60-year-old officer has served as a submarine commander, captain of a frigate, led the European Union Maritime Force and holds the record for most hours logged at sea of ​​any Portuguese naval officer on duty. according to The Associated Press.

Gouveia e Melo attributes much of the success of Portugal’s vaccines to military leadership during launch. Keeping politics out of public health helped build trust in vaccines, he says.

At first, about 40 percent of the Portuguese population had doubts, he said, but by clearly and calmly communicating the benefits of vaccines and using the language of war to unite the population, he believes he was able to change his mind. .

Portugal is now the most vaccinated country in the world, according to Our world in data, with more than 85 percent of its entire population vaccinated against COVID-19. On Friday, it removed nearly all COVID-19 restrictions, reopening bars and nightclubs that had been closed since the pandemic began in March 2020. The country has been reporting around 600 new cases per day, just five per percent of its all-time peak. and hospitalizations have been drastically reduced. Portugal will begin distributing third doses to the elderly next week.

Gouveia e Melo used notions of solidarity and personal responsibility framed in a war effort to convince people to take charge, he said.

“You are a warrior. You have to fight the war. Get vaccinated,” said the blue-eyed, salt and pepper admiral, dressed in his navy blue uniform during a conversation about Zoom.

Other countries, including Canada, have involved their military in vaccines (as of April, Ontario’s vaccine distribution task force was headed by retired Gen. Rick Hillier), but perhaps not on the scale that Portugal did. .

There is “no question” that having non-political leadership as the face of the pandemic effort helps build trust, but it is natural for politicians to be at the forefront because they are the ones who finance and enact policy, said Barry Pakes, public health specialist. from the University of Toronto.

Politicians have largely led the launch of the vaccine in Canada, with liberal cabinet minister Anita Anand in charge of obtaining and distributing injections, and prime ministers setting policy and encouraging people to get punctured.

Vaccination strategy has also been a hot political issue, with Prime Minister Trudeau frequently criticizing Conservative leader Erin O’Toole during the recent election campaign for not requiring that his candidates be fully vaccinated against COVID-19. Meanwhile, the right-wing People’s Party of Canada was able to rally the anti-vax crowd and nearly triple its share of the vote since 2019.

Still, politics and vaccines are much less intertwined in Canada than in other countries, such as the United States, Pakes said. He added that he is not sure whether the militaristic message works that well here.

“That is not something that resonates with many Canadians.”

Vice Admiral Henrique Gouveia e Melo says it was important to keep politics out of vaccine deployment.

Henrique Barros, an epidemiologist at the University of Porto, disagrees with Gouveia e Melo’s framing of the pandemic effort as a “war.” (With infectious diseases, there are no bad guys or good guys, he says, there are no winners or losers.) He acknowledges that the military is well equipped to lead a vaccination campaign because they are trained to respond to emergencies, but attributes the effective deployment of Portugal to local governments.

Gouveia e Melo describes himself as the “tip of the iceberg” in a team of military strategists, mathematicians and doctors who coordinated with officials from the health ministry and local governments, overseeing a network of around 300 vaccination centers run by the thousands. of doctors and nurses. and volunteers.

Underlying historical and social conditions have also driven the vaccine’s success in Portugal, Barros said. People generally accept the safety and efficacy of vaccines in Portugal and there is no history of anti-vaccine movements. Beyond the COVID-19 vaccine, Portugal has one of the highest vaccination coverage rates in Europe.

“Vaccination was seen as something modern, something that would take you from a certain misery to a more hopeful situation,” Barros said. Public health measures during the height of the pandemic, such as curfews and travel restrictions, also made people more eager for the vaccine and viewed it as a “key to a more normal life.”

That said, Portugal is not immune to the misinformation and opposition to vaccines that has affected other countries.

Gouveia e Melo described walking through an anti-vaccination demonstration in front of a vaccination center in Lisbon in July, where she calmly explained that “the killer is the virus” as protesters yelled “genocide” and “murderer” at him.

But most of the reception has been positive. Gouveia e Melo has become a household name in Portugal and, at five foot five, he is sometimes recognized on the street and grateful for his efforts.

Throughout his leadership, the media has frequently put him “in place” to explain things, but he never avoids questioning, he said, “even in the most difficult moments.”

“You have to be very honest in the eyes of the public.”

His advice to Canada and other countries struggling to push vaccine adoption?

“Explain until exhaustion.”

Gouveia e Melo said it asks people to imagine they are at a fork in the road. If they go one way, refusing the vaccine, they have a one in 500 chance of dying, according to Portuguese figures. If they go the other way, and they get the shot, they have a one in 500,000 chance. “If you are smart or logical, which path do you want to take?” I ask.

He is a fan of frankness.

Meanwhile, Pakes isn’t sure it’s that easy.

“I think we already have,” he said.

Now, the challenge is to reach specific communities that may have their own reasons for resisting vaccines, such as historical mistreatment by the government and doctors.

As his tenure as head of Portugal’s vaccine working group is ending, Gouveia e Melo said the war is far from over, as long as rich countries keep stockpiling vaccines while poorer nations don’t have access. Closing that gap is a public health problem and a moral imperative, he said.

“We in the western world talk a lot about ethics, but we also have to practice these ethics.”

Lex Harvey is a Toronto-based newsletter producer for The Star and author of the First Up newsletter. Follow her on Twitter: @lexharvs


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