Brazil's vaccination crisis: only 2 of 16 childhood vaccines meet coverage targets

Brazil is about to send thousands of soccer fans to the World Cup in the United States, Canada, and Mexico—three countries that together account for more than two-thirds of all measles cases in the Americas. It's an uncomfortable collision of timing. The U.S. recorded 2,144 measles cases in 2025, with transmission still spreading. Canada, which lost its disease-free status last year, has already confirmed 907 cases in 2026. Mexico carries its own burden. Meanwhile, inside Brazil, childhood vaccination coverage has collapsed to levels not seen in years.

Data from Brazil's Health Ministry paint a stark picture. Of the 16 vaccines in the national childhood immunization schedule, only two achieved the 95 percent coverage threshold considered safe by public health standards in 2025: BCG, at 96.8 percent, and neonatal hepatitis B, at 95.1 percent. Everything else—measles, polio, pneumococcal, meningococcal—fell below the line. The ministry launched a campaign in April specifically warning World Cup travelers to check and update their vaccination records before boarding.

The warning extends far beyond those heading to stadiums. Brazil has already detected two confirmed measles cases in 2026. One arrived from international travel in São Paulo; the other emerged in Rio de Janeiro in a person with no vaccination record. The country still holds its disease-free certification from the Pan American Health Organization, granted in 2024, but that status feels increasingly fragile. Across the Americas in 2025, measles cases jumped to 14,891 with 29 deaths—a 32-fold increase from 2024. About 78 percent of those cases occurred in unvaccinated people or those with unknown vaccination histories.

Whooping cough tells a similar story of resurgence. Brazil recorded 1,634 confirmed cases in the first 19 weeks of 2025, including five deaths. That's the second-highest number of notifications since 2019. The trajectory is alarming: 216 cases in 2023, then 7,440 in 2024—the worst year in a decade. The disease follows a cyclical pattern, but the drop in vaccination coverage between 2016 and 2021, combined with the return of normal social contact after the pandemic, created conditions for rapid spread. "We're watching diseases return that had disappeared from everyday clinical practice," said Alberto Chebabo, an infectious disease specialist at Alta Diagnósticos in Rio de Janeiro. "When coverage falls below safe thresholds, the virus finds gaps—and it moves fast, especially among unvaccinated children and adults with incomplete schedules."

The problem extends well beyond childhood. The Health Ministry launched a rescue campaign targeting 15- to 19-year-olds who had never received the HPV vaccine—the first time this age group gained access to it through the public system. The goal was to reach roughly 7 million young people. By December 2025, only 208,700 doses had been administered. The deadline was extended to June 2026. Adult vaccination presents an even larger blind spot. Eder Gatti, director of Brazil's National Immunization Program, acknowledged that the country has failed to meet most vaccination coverage targets since at least 2014. "We regularly see adults who don't remember when they last received their tetanus booster, who never completed their hepatitis B series, or who don't realize they need boosters throughout their lives," said Maria Isabel de Moraes-Pinto, vaccine coordinator at Dasa. "Adult vaccination is treated as optional. It isn't."

Research on vaccine hesitancy identified the main barriers: lack of trust accounts for 41.4 percent of vaccine refusals, doubts about effectiveness and safety for 25.5 percent, and fear of side effects for 23.6 percent. The COVID-19 vaccine achieved only 3.49 percent coverage among children in 2025—a direct result of misinformation campaigns, according to the Health Ministry. The government has tried to adapt. In the first half of 2025, the ministry administered more than 1 million doses in schools across 4,100 municipalities through its School Health Program. Private vaccination services, including home visits, have begun filling gaps by removing practical barriers for elderly people, families with young children, and those with mobility challenges. "When we bring the vaccine to the person, we eliminate the main reason for delay," Moraes-Pinto said. "For elderly people and those with chronic diseases, that convenience can be decisive."

As June arrives and immunization day passes, Brazil faces a narrowing window. The World Cup looms. Measles and whooping cough are circulating. Vaccination coverage remains dangerously low. The question now is whether the country can rebuild trust and access fast enough to prevent what public health officials fear most: the reintroduction of diseases that had been controlled, spreading through a population increasingly unprepared to resist them.