Confronting an emergency: the vaccination campaign against meningitis in Brazil (1974-75)

Résumé En

In 1974, Brazil was struck by a major epidemic of cerebrospinal meningitis mainly carried by the meningococcus A strain of the bacteria. Formerly, meningococcus A had been almost exclusively confined to Africa. Confronted with the rapid spread of this epidemic and its high mortality, the Brazilian government made the decision to vaccinate 80% of the country’s population as quickly as possible in order to stop the epidemic. At that time, the Institut Mérieux was the only organization in the world to have developed an effective vaccine against the disease, after 10 years of research on the African continent. The Institut Mérieux accepted the Brazilian government's request to produce and deliver 60 million doses of vaccine in less than a year.I will present the history of the Brazil anti-meningitis programme, and more specifically the logistical problems associated with this unprecedented vaccination campaign. Around 90 million Brazilians were vaccinated in under a year. I will explain why the Brazilian government chose this vaccination strategy and how the Institut Mérieux succeeded in producing such a large quantity of vaccines in such a short time. To illuminate this episode, I will discuss some of the social, political and economic factors that made such a campaign possible. The analysis of this particular episode provides some more general lessons concerning emergency intervention in the case of any major public health problem.