Thanks to a highly effective National Immunization Programme, most Brazilian parents can feel confident that their children will get the 
lifesaving vaccines they need – when they need them.
Routine vaccination coverage in the country averages above 95% for most vaccines on the child immunization schedule every year – exceeding WHO’s recommendation of at least 90% coverage.
Most of the vaccines are produced through local manufacturers and provided free of charge in more than 36,000 public health care facilities throughout the country. Every year, the country provides more than 300 million doses of vaccines. It recently boosted immunization efforts against the yellow fever outbreak with more than 27 million extra vaccine doses.
But some people remain hard to reach. One of the biggest challenges in Brazil is providing essential medical supplies and health care to remote communities deep in the Amazon jungle, where roads are few and medical teams have to travel hours by boat to reach them.
The National Center for the Storage and Distribution of Immunobiologicals (CENADI) in Rio de Janeiro, distributes vaccines nationwide. In addition to analyzing the inventory control, the agency is responsible for monitoring all the immunizations purchased abroad by the Ministry of Health. It also distributes diagnostic kits for measles, rubella and HIV; as well as pesticides to combat diseases such as dengue.
CENADI has about 150 employees, which include technicians that work in the storage, handling and packaging of immunizations. Since many vaccines need to be kept at low temperatures, the employees ensure they are kept in cold rooms with temperatures between 2–8°C and -20°C, and then are packaged in coolers with dry ice for distribution.
Once packaged, vaccine coolers are flown from Rio de Janeiro and then driven to a port in Manaus to be loaded on a ship, and sent on a 30-hour journey by river or 2 hours by plane to São Gabriel da Cachoeira, in the State of Amazonas. At this point, the vaccines have travelled roughly 
2000 kilometres.
When the vaccines arrive, they are stored in refrigerators and then redistributed to local villages. There, local nurses embark on boats to indigenous villages. About 95% of the indigenous villages are only accessible by river and residents’ only means of transport are small canoes.
Throughout the immunization clinic, the vaccines are kept in coolers and refrigerators, monitored for the correct temperatures throughout, and used before they expire.
Even with all logistical difficulties, the indigenous population maintains one of the best vaccination coverage rates in Brazil – almost 95% of the population is up-to-date on their vaccination schedule.
Source: WH