Lessons from the bolivian covid-19 vaccine mandate
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Universidade Federal da Bahia Brazil
Boston Children’s Hospital United States
Publication date: 2023-04-26
Popul. Med. 2023;5(Supplement):A540
The study analyzed the Bolivian governments implementation of the COVID-19 vaccination card, which purports to increase vaccination rates and strengthen coverage with the entire vaccination schedule in the country. We aimed to describe the measures adopted, their effectiveness and impacts on adherence to the vaccine.

We conducted an exploratory study, based on the analysis of Supreme Decrees 4640 and 4641 of 2021, and secondary data from the Bolivian Ministry of Health and Our World in Data. The 7-day moving average of COVID-19 vaccination was calculated. We also estimated the difference of the cumulative vaccination rate between December 22, 2021, and January 19, 2022, referring to the dates of enactment and suspension of the decrees.

The requirement of a vaccination card to enter public and governmental spaces increased vaccination coverage by 9.6% for the first dose and 4.4% for the second dose. Resistance to the measure resulted in its postponement and, later, suspension after only 28 days of effectiveness, which was followed by a decrease in the 7-day moving average of COVID-19 vaccination. The short time span between the measures announcement and implementation left insufficient time to plan vaccine distribution and manage supply shortages. New vaccination centers were not created, and existing centers were overcrowded and often had to share their spaces with testing centers. Long queues fueled public discontent with the policy, which then was exploited by the anti-vaccine movement, responsible for spreading misinformation and contesting the measures.

The COVID-19 vaccination card had a positive impact on the vaccination rate, principally among the unvaccinated, however, it was not a long-term effect, because it was soon revoked. Management challenges and misinformation about the vaccines had a negative impact on adherence to the proposal and the lack of planning placed a heavy burden on the health system.

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