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Portugal’s military key to making it the world’s most vaccinated country

Portugal is the most vaccinated country in the world with about 85% of the population fully vaccinated against COVID-19 in just nine months, and with much of the credit is going to Rear Admiral Henrique Gouveia e Melo.

The Associated Press reports that with his team from the three branches of the armed forces, the naval officer took charge of the vaccine rollout in February — perhaps the moment of greatest tension in Portugal over the pandemic. Now, the county could be just days away from hitting its target. As of last Wednesday, 84% of the total population was fully vaccinated, the highest globally, according to Our World in Data.

Along with the rising number of shots, the COVID-19 infection rate and hospitalisations from the virus have dropped to their lowest levels in nearly 18 months.

The government announced last Thursday (23 September) that it would scrap most of its remaining COVID-19 restrictions starting from 1 October, though the wearing of face masks will still be mandatory on public transit, in hospitals and care homes, and in shopping malls.

Such a move would be a welcome development for many countries still in the grip of the highly infectious delta variant and lagging in their own vaccination rollouts.

Previously unheralded outside the military, Gouveia e Melo is now a household name in Portugal, having made a point of going on television regularly to answer public concerns about the vaccination programme.

Easily recogniseable even behind a mask with his blue eyes, close-cropped salt-and-pepper hair and 1.93m height, he’s often greeted in the street by people wanting to thank him.

But the 60-year-old officer is quick to insist he is just “the tip of the iceberg” in the operation and that many others share the credit.

Military involvement in rolling out the COVID-19 vaccine is not uncommon elsewhere, but Portugal has given it the leading role. It turned out to be an inspired choice: although Gouveia e Melo’s team works hand-in-hand with health authorities, police and town councils, the military’s expertise has proven invaluable.

“People in the military are used to working under stress in uncertain environments,” he said at his office in a NATO building near Lisbon. “They’re organised, have a good logistics set-up … and are usually very focused on the mission.”

Gouveia e Melo set the tone of the rollout with his no-nonsense approach and emphasis on discipline. His straight-talking style endeared him to many who worried they might not get vaccinated in time.

In an interview with The Associated Press, he admitted that replacing a political appointee who quit after only three months was “intimidating”.

At the time, Portugal was in the worst phase of the pandemic, when it was among the hardest-hit countries with public hospitals near collapse. Promised vaccine deliveries weren’t arriving. And jockeying for shots was threatening to undermine public trust in the rollout.

“I felt like I had the eyes of 10 million people on me,” he said, referring to Portugal’s population. His 42-year military career helps explain how he handled the pressure.

He was a submarine commander, and at one point in charge of two of the vessels at the same time — returning to base with one, eating a meal on shore and then taking another out to sea. He also captained a frigate, led Euromarfor, the European Union’s Maritime Force, and has logged the most hours at sea of any serving Portuguese naval officer.

He is unapologetic about couching the vaccine rollout as a battle and has worn combat fatigues ever since taking over the effort. He said he wanted to send a message that it was a call to arms.

“This uniform…was symbolic for people to comprehend the need to roll up our sleeves and fight this virus,” he says.

Gouveia e Melo did away with Portugal’s initial efforts to piggyback on established vaccination strategies, such as those used annually for flu shots in usually small, public health centres. The demands of scale and speed to address COVID-19 required a very different approach.

Portugal began using large sports facilities around the country to set up what Gouveia e Melo called a “production line”: a reception and processing area; a waiting room; cubicles where injections are given; and a recovery area. He used soldiers as guinea pigs at the Lisbon military hospital to figure out the fastest flow of people through a building. A major push came with what he described as a “tsunami” of vaccine deliveries in mid-June, which allowed a shift into a higher gear.

Tiago Correia, an associate professor in international public health at Lisbon’s New University Institute of Hygiene and Tropical Medicine, reckons that the public view of Gouveia e Melo as the principal factor in the successful rollout is an “exaggeration” of his role. A key factor, Correia says, is the traditional consenting attitude in Portugal toward national vaccination programmes. Its vaccination rate for measles, mumps and rubella, for example, is 95% — one of the EU’s highest – and there is no significant anti-vaccination movement.

Even so, Gouveia e Melo’s military background meant he was able to “cut through all the politics” and ensure public trust in the rollout, Correia told AP.

Other countries, which he declined to identify because their requests have not been made public, have asked Portugal about its effort. But with significant vaccination hesitancy in some wealthier countries and many poorer countries without sufficient doses, he’s under no illusion that virus variants could come back to torment Portugal.

“We’ve won a battle,” he says. “I don’t know if we’ve won the war against the virus. This is a world war.”


Associated Press article – Naval officer wins praise for Portugal’s vaccine rollout (Open access)


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