Thanks to a highly effective National Immunization Program, most Brazilian parents can feel confident that their children will receive the 
life-saving vaccines they need – when they need them.
The routine vaccination coverage in the country averages over 95% for most vaccines in the childhood immunization schedule every year – surpassing the WHO recommendation of at least 90% coverage.
Most vaccines are produced by local manufacturers and provided free of charge at over 36,000 public health units across the country. Every year, the country supplies more than 300 million doses of vaccines. Recently, it boosted immunization efforts against the yellow fever outbreak with over 27 million extra doses of vaccine.
But some people are still hard to reach. One of the biggest challenges in Brazil is providing essential medical supplies and healthcare to remote communities in the heart of the Amazon jungle, where there are few roads and medical teams must travel hours by boat to reach them.
The National Center for Storage and Distribution of Immunobiologicals (CENADI), in Rio de Janeiro, distributes vaccines throughout the country. In addition to analyzing inventory control, the agency is responsible for monitoring all 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 like dengue.
CENADI has about 150 employees, including technicians who work in the storage, handling, and packaging of immunizations. Since many vaccines need to be kept at low temperatures, staff ensure they are maintained in cold chambers with temperatures between 2–8°C and -20°C, and then packed in coolers with dry ice for distribution.
Once packed, the vaccine coolers are transported by plane from Rio de Janeiro and then driven to a port in Manaus to be loaded onto a ship, and sent on a 30-hour journey by river or a 2-hour flight to São Gabriel da Cachoeira, in the State of Amazonas. At this point, the vaccines have traveled about 
2000 kilometers.
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 indigenous villages are only accessible by river, and the only means of transportation for residents are small canoes.
Throughout the immunization clinic, the vaccines are kept in coolers and refrigerators, monitored for the correct temperatures at all times, and used before they expire.
Even with all the logistical difficulties, the indigenous population maintains one of the best vaccination coverage rates in Brazil – nearly 95% of the population is up to date with their vaccination schedule.
Source: WH