Understanding COVID-19 Vaccine Hesitancy Among Brazilian Immigrants: Prevalence, Determinants, and Global Health Implications

Background: Vaccine hesitancy extends beyond simple refusal to receive immunizations, encompassing psychological, cultural, and sociodemographic factors that influence individuals' perceptions and decision-making regarding vaccines. Objectives: This study aimed to determine the prevalence and factors influencing COVID-19 vaccine hesitancy among Brazilian immigrants. Methods: A survey targeting Brazilian immigrants in Portugal was conducted from May to August 2020, involving 598 participants. The study explored the relationship between vaccine hesitancy and non-compliance with social distancing measures using a Poisson regression model with robust variance to calculate prevalence ratios (PRs). Results: The study identified a vaccine hesitancy rate of 15.1% among Brazilian immigrants. Older individuals (aged 50 and above) exhibited a significantly higher hesitancy, with an adjusted prevalence ratio (aPR) of 10.0 (95% CI: 1.8 - 13.6). Those adhering to a religion were 2.3 times more likely to hesitate (95% CI: 1.4 - 3.4), and a reluctance to follow social distancing measures was associated with a 10.4 times higher hesitancy rate (95% CI: 4.2 - 15.4). Highlighting these correlations is vital for developing strategies to enhance vaccine acceptance and tackle public health challenges. Conclusions: There is a notable rate of COVID-19 vaccine hesitancy among Brazilian immigrants in Portugal, significantly influenced by age, religious practice, and non-adherence to social distancing measures. Implementing targeted educational and awareness programs is recommended to reduce hesitancy and improve vaccine coverage within this community and in similar settings.