Of the more than three million (3,181,253) users registered on the RN + Vacina platform, only 19% received the second booster dose of the Covid-19 vaccine. For the first booster dose, the platform counts 54% of the vaccinated population. The rates point to a scenario of declining vaccine uptake as new doses are made available.

The first booster dose, also called the third dose, has been available in the metropolitan region of Natal for people aged 18 and over since December 2021. The second booster dose has been available to the same population since July 2022. Even so, the downward trend in uptake of booster doses remains. The infectious disease preceptor at ISD, Carolina Damásio, emphasizes that the benefits of full vaccination go beyond maintaining the individual's well-being and health, and that its absence brings broader problems related to the community.

“From an individual perspective, not taking the booster doses can mean an increased risk of complications, the need for hospitalization, and even death. In hospitals, most patients admitted had not been vaccinated or had not completed the vaccination cycle. For the community, the fewer people who are immunized, the greater the chance of the virus circulating, with a greater risk for vulnerable populations, such as the elderly and patients with low defenses. New variants may also emerge,” explains the preceptor.

In some cities in Brazil, vaccination has reached the stage where the third booster dose, or fifth dose, is available for people with high levels of immunosuppression. However, data from RN + Vacina shows that more than 230,000 people from Rio Grande do Norte are still behind on their second dose, that is, their basic vaccination schedule is incomplete.

Infectious disease specialist Carolina Damásio believes that delays or lack of adherence to vaccination, whether in the second dose or in booster doses, can be attributed to several factors. One of them is the high frequency of the need to take additional doses. In the near future, this supplementation should continue to exist for some groups.

“The booster dose should remain for risk groups, as is the case with the flu. However, a second generation of vaccines is being developed, with the aim of combating new variants, which could result in longer-lasting immunity,” adds Carolina.

Furthermore, the infectious disease specialist points out factors related to the pandemic itself, such as pandemic fatigue, a term used by the World Health Organization to describe the tiredness and mental exhaustion collectively faced over the last two years, in addition to public misinformation, facilitated by intensified virtual communication during the pandemic.

“There are several reasons, such as insecurity regarding side effects, misunderstandings about the severity of the disease and the need for vaccination, spread by social media, and a lack of confidence in the vaccine, as occurs, for example, with childhood vaccination,” he explains.

Vaccination coverage in RN

It is not only in the vaccination against Covid-19 that low vaccination coverage rates are observed in the state. According to data previously analyzed by ISD, since 2018 Rio Grande do Norte has not reached the vaccination coverage target for any of the routine vaccines recommended for children up to one year of age.

In the metropolitan region of Natal, children aged 3 to 5 can now be vaccinated with the first dose of the Covid-19 vaccine, according to the Ministry of Health's recommendation. For children aged 5 to 11, the vaccination schedule began in January of this year. The public aged 12 to 17 can now receive the first booster dose, or third dose, since May.

The locations and times of vaccination points in Natal can be found on the platform https://vacina.natal.rn.gov.br/.