In Portugal, There Is Virtually No One Left to Vaccinate

Portugal’s health care system was on the verge of collapse. Hospitals in the capital, Lisbon, were overflowing and the authorities were asking people to treat themselves at home. In the last week of January, nearly 2,000 people died as the virus spread.

The country’s vaccine program was in a shambles, so the government turned to Vice Adm. Henrique Gouveia e Melo, a former submarine squadron commander, to right the ship.

Eight months later, Portugal is among the world’s leaders in vaccinations, with roughly 86 percent of its population of 10.3 million fully vaccinated. About 98 percent of all of those eligible for vaccines — meaning anyone over 12 — have been fully vaccinated, Admiral Gouveia e Melo said.

“We believe we have reached the point of group protection and nearly herd immunity,” he said. “Things look very good.”

On Friday, Portugal ended nearly all of its coronavirus restrictions. There has been a sharp drop in new cases, to about 650 a day, and vanishingly few deaths.

“The first thing is to make this thing a war,” Admiral Gouveia e Melo said in an interview, recalling how he approached the job. “I use not only the language of war, but military language.”

“He formulated a communications policy about what was happening that gave credibility and trust,” she said.

As the task force devised the most efficient system to safely stream the most people through inoculation centers, they used troops to build confidence in the system. People could see the vaccines were safe as soldier after soldier got shots.

At the same time, the task force made a point of showing doctors and nurses getting their shots, as well, to drive home the message of vaccine safety.

While other countries have featured doctors, nurses, police officers and soldiers in their vaccine campaigns, Admiral Gouveia e Melo said the consistency of the messaging was critical.

Still, as the campaign moved onto younger age groups over the summer — with less than half of the public vaccinated — there were signs that resistance was building.

In a submarine, the admiral said, you are in a slow ship trying to catch faster ships.

“You have to position yourself and be smart about how to do it,” he said, “and seize the opportunity when it arrives.”

In July, Admiral Gouveia e Melo seized such an opportunity.

Protesters were blocking the entrance to a vaccination center in Lisbon, so he donned his combat uniform and went there with no security detail.

“I went through these crazy people,” he said. “They started to call me ‘murderer, murderer.’”

As the television cameras rolled, the admiral calmly stood his ground.

“I said the murderer is the virus,” Admiral Gouveia e Melo recalled. The true killer, he said, would be people who live like it is the 13th century without any notion of reality.

“I attempted to communicate in a very true and honest way about all doubts and problems,” he said.

But not everybody welcomed his approach.

“We don’t really have a culture of questioning authorities,” said Laura Sanches, a clinical psychologist who has criticized Portugal’s mass vaccination rollout as too militaristic and called for it to exclude younger people.

“And the way he always presented himself in camouflage army suits — as if he was fighting a war — together with the language used by the media and the politicians, has contributed to a feeling of fear that also makes us more prone to obey and not question,” she said.

Still, the public messaging campaign — including an aggressive television and media blitz — made steady progress.

“In the beginning, we had some 40 percent who were unsure,” Admiral Gouveia e Melo said. Now, according to polls, he said, only 2.2 percent do not want the vaccine.

As he stepped down from the task force this week, the admiral said he felt the country was on a good course. But, ever the submariner, he cautioned that vigilance would remain essential to ensuring that this war was won.

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