Published 18 December 2023

The Rio 2023 protocol: towards optimized vaccination policies

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Press Release

December 18, 2023

The Rio 2023 protocol: towards optimized vaccination policies1


The French National Academy of Medicine will make vaccines its Great Medical Cause in 2024. With this perspective, a delegation from the Academy went to Rio de Janeiro on December 8 and 9 to participate in the joint symposium of the Academies of Medicine of Brazil, the United States, Portugal, and France in the presence of the Ministers of Health of Brazil, Portugal, and the Director of the Pan American Health Organization.

Despite the strength of the national vaccination programs of the four countries and the efforts made to convince their respective populations of the necessity and expected benefits of vaccination, particularly during the Covid-19 epidemic, the participants unanimously reported the increasing reluctance to be vaccinated, the declining involvement of doctors in enforcing vaccination recommendations, and the often-ideological misinformation applied to vaccines. These elements jeopardize the elimination, although acquired, of diseases such as poliomyelitis, the fight against emerging epidemics, or the eradication of cancers induced by viruses.

The decline in vaccination practices observed in France and the United States, and more recently in Brazil and to a lesser extent in Portugal, reflects a distrust of the population regarding vaccines. The relevant figures and the reported variations are influenced by (a) the degree of “traditional” reluctance of the population to vaccination, significant in France; (b) the, sometimes, contradictory messages from the political authorities, leading to more or less rigorous local vaccination policies; (c) the unequal mobilization of the medical profession and (d) a diminution of the population health culture, although initiated at school, and of the confidence in science. Differences in vaccination policies exist between the four countries. In France, an old and consistent vaccination policy in childhood has been implemented without equivalence in adolescents, adults, and the elderly population.

At the end of the symposium, it was unanimously emphasized that the historical benefits and the exciting prospects of vaccination impose a policy which makes it possible to overcome vaccine hesitancy through the mobilization of authorities and caregivers, the use of all information relays, and a restoration of confidence in science started, continued, and strengthened at school.

The joint declaration of the four academies1 underlines the importance of vaccines as a primary strategy for preventing many diseases and recommends to:

– ensure that national vaccination programs are financed and provide the optimal coverage of vaccines recommended by the World Health Organization, particularly among children and the elderly or vulnerable people,

– reduce the impact of false information and disinformation circulating in the four countries, as well as vaccine hesitancy to which they lead, and encourage the diffusion of factual data describing the favorable results of vaccines on the health of populations,

– recognize the cultural and ideological context favoring vaccine hesitancy and encourage citizens and communities to build trust in the individual and collective benefits of vaccines,

– encourage technological innovation in vaccine development and practices,

– mobilize the public, the media, healthcare professionals, political decision-makers and educational institutions to promote the long-term benefits of vaccination,

– mobilize as many countries as possible of those not represented in Rio de Janeiro to commit to vaccination.

The four countries present undertake to maintain and strengthen their mobilization and propose the creation of a “Vaccine Alliance” extending to other countries and allowing vaccination practices to be regularly reassessed,  their progress monitored and  the different regional and national approaches to promote the most effective vaccination strategies and practices compared.


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Bull Acad Natl Med 2024;208:274-5. Doi : 10.1016/j.banm.2024.01.003