A Small Brazilian Town Is Beating Covid-19 Through a Unique Experiment

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SERRANA, Brazil—This town of 45,000 people in southeastern Brazil has been at the center of a unique experiment for the past three months: vaccinate nearly every adult against Covid-19 and see what happens.

In recent weeks, after most of the adults here got their second dose, Covid-19 cases and deaths plunged and life has started to return to normal as the pandemic continues to rage across Brazil.

In the heart of Serrana, children squealed with laughter as they chased each other across the main square, while groups of friends—many unmasked —stopped to chat and bask in the afternoon sun.

Flying kites in Serrana, Brazil, where 98{f08ff3a0ad7db12f5b424ba38f473ff67b97b420df338baa81683bbacd458fca} of eligible adults were vaccinated for Covid-19.

“We feel free,” said Homero Cavalheri, 68 years old, a retired architect who said he no longer spends his afternoons cooped up at home. He was strolling with his wife, Irene, and their 1-year-old grandson. “Everything is new to him,” said Mr. Cavalheri, clutching the boy. “He keeps pointing at all the trees and the birds.”

The experiment in Serrana, a town in Brazil’s sugar-cane-producing savanna, provides hope for countries around the world still battling with coronavirus outbreaks that mass vaccination works. It also offers new evidence of the efficacy of Sinovac’s Covid-19 vaccine, which is being rolled out in dozens of developing nations from Egypt to the Philippines.

All of Serrana’s adults were offered CoronaVac between February and April as part of the experiment, known as Project S. It is the first mass trial of its kind in which an entire town is vaccinated for Covid-19 before the rest of the country.

Not everyone in the town was eligible, including minors under 18, adult women who are pregnant or nursing, and others with serious health problems. Of the roughly 27,700 eligible adults, 27,150, or 98{f08ff3a0ad7db12f5b424ba38f473ff67b97b420df338baa81683bbacd458fca}, were vaccinated, according to town officials.

An aggressive Covid-19 variant called P.1 has spread from the Amazon to other parts of Brazil and has now been identified in U.S. cases. WSJ’s Paulo Trevisani reports from Porto Alegre’s overwhelmed hospitals, where doctors say young people are becoming ill. Photo: Tommaso Protti for The Wall Street Journal

The Butantan Institute, the public-research center that is producing CoronaVac in Brazil and running the experiment, declined to comment until the full results of the mass trial are released later this month.

Town officials and residents said they are thrilled with the results so far. Infections are down 75{f08ff3a0ad7db12f5b424ba38f473ff67b97b420df338baa81683bbacd458fca} from a March peak in Serrana, while there have been no deaths from Covid-19 among the people who were fully vaccinated, suggesting CoronaVac is also effective against the aggressive P.1 variant sweeping the region.

“The numbers speak for themselves,” said Serrana’s mayor, Léo Capitelli. “It worked!”

In the waiting room of the town’s intensive-care unit, the effects of CoronaVac are already visible. “Only three weeks ago, this was so full, people had to stand,” said Lucia Elaine Caldano, the unit’s administrator, pointing to rows of empty chairs. In the past three weeks, only one person has been put on a ventilator—a woman who had refused to take the vaccine.

“There was a lot of fuss at the beginning, many people believed we were lab rats,” said Ms. Caldano. “But it’s been a blessing.”

It is a different story across Brazil, where 7{f08ff3a0ad7db12f5b424ba38f473ff67b97b420df338baa81683bbacd458fca} have been fully vaccinated. Almost a hundred are dying an hour from the disease, while thousands more languish in crowded hospitals.

After registering an average of 67 new infections a day in March, Serrana’s average daily case tally this month has been a quarter of that, about 17 a day. Brazil’s infection rate has fallen about 24{f08ff3a0ad7db12f5b424ba38f473ff67b97b420df338baa81683bbacd458fca} since its March peak.

Serrana, a town of 45,000 in southeastern Brazil, has been at the center of an experiment in the fight against Covid-19.

In April, six people died from Covid-19 in Serrana. Of those, five had only taken the first dose of the vaccine. The other victim had symptoms two days after the second dose, suggesting that the disease was contracted between jabs, according to Mayor Capitelli.

One of the biggest surprises was that almost everyone agreed to take the shot, Serrana’s officials said. In a nationwide survey in December carried out by a Brazilian pollster, half of the respondents said they would refuse to take any China-made vaccine. Sinovac is based in China.

Serrana’s study promises to add clarity to a global mishmash of studies of CoronaVac. In Phase 3 trials carried out by Butantan late last year, it was found to be about 50{f08ff3a0ad7db12f5b424ba38f473ff67b97b420df338baa81683bbacd458fca} effective against symptomatic infections and 100{f08ff3a0ad7db12f5b424ba38f473ff67b97b420df338baa81683bbacd458fca} effective at preventing fatal cases.

The trial’s volunteers were all medical professionals, unlike in the Phase 3 trials of other vaccines such as the one developed by

Pfizer Inc.,

meaning the volunteers were exposed to higher viral loads, potentially leading to a slightly lower efficacy rate, researchers said.

A large-scale Chilean study last month that looked at results across the general public found CoronaVac to have an efficacy rate of 67{f08ff3a0ad7db12f5b424ba38f473ff67b97b420df338baa81683bbacd458fca}, similar to the results of an Indonesian study last year. The Chilean study found CoronaVac to be 80{f08ff3a0ad7db12f5b424ba38f473ff67b97b420df338baa81683bbacd458fca} effective against fatal cases of the disease.

José Ricardo Aranda, operator of a guest house in Serrana, said business is beginning to return to normal, with half of his rooms occupied.

Serrana’s experiment provides some of the first real-world evidence that CoronaVac is effective against the aggressive P.1 strain, which was responsible for at least 60{f08ff3a0ad7db12f5b424ba38f473ff67b97b420df338baa81683bbacd458fca} of the town’s infections in March.

Located in São Paulo state, Serrana was chosen because it is a commuter town with a high infection rate. About a quarter of residents leave the town every day for work, mainly to the nearby city of Ribeirão Preto.

Sinovac provided the doses at no cost for the study in Serrana. With the pandemic largely under control in China, the government in Beijing has looked to hard-hit countries such as Brazil to test its vaccines.

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When Butantan first announced Project S, it said it hoped the results would reassure Brazilians that the vaccine works and is safe. Rumors have raged about the safety of CoronaVac after President

Jair Bolsonaro

told supporters last year that the vaccine could disable or even kill, without offering evidence.

After Mr. Bolsonaro criticized the Chinese vaccine, acquired independently from Beijing by São Paulo’s state government, his administration agreed to buy 100 million doses in January. The right-wing former army captain has continued to cast doubt on its efficacy and safety, while promoting unproven cures for the disease.

Most of Serrana’s residents are grateful for a chance to be fully vaccinated. Jesuel Sacoman, 50, a local electrician, said he wouldn’t have yet qualified to be vaccinated. The state of São Paulo began immunizing people between 60 and 62 this week as the government uses its limited supply of shots to work its way down each age group.

Flávia Cedrinho, owner of a Serrana clothes boutique, said sales would be worse if it weren’t for the mass-vaccination effort.

“We’re living in a cocoon here in the middle of Brazil,” said Mr. Sacoman. “It is a big weight off my mind.”

Town officials have asked residents to continue wearing face masks and follow other precautionary measures such as social distancing.

Not everyone was convinced about getting vaccinated. Silvio Franciscone, a 60-year-old supporter of the president who refused the shot, said he believed he didn’t need the vaccine after he said he recovered from Covid-19 last year with antiparasite drugs and vitamins. He said he is part of a minority, even among fellow Covid-19 skeptics.

“One of my friends cured himself with a hair dryer last year, blowing hot air up his nostrils and down his throat, but then he still went and took the vaccine, the idiot,” said Mr. Franciscone, a radio technician in Serrana.

Serrana is now hoping for a faster economic recovery from the pandemic, which sent its jobless rate surging to 25{f08ff3a0ad7db12f5b424ba38f473ff67b97b420df338baa81683bbacd458fca}. The companies in nearby Ribeirão Preto that employ most its residents laid off workers or shut down. While Serrana’s vaccination program has done little to boost employment, hotels and stores in the town have seen more customers since locals received their second CoronaVac dose.

José Ricardo Aranda, 48, who owns a guest house just off the highway between the city of São Paulo and neighboring Minas Gerais state, said Serrana has become a favorite place to stop. “We’ve become a reference point on this highway as everybody knows it’s much safer here,” he said. After scraping through September to the end of last year with no guests, he said business was beginning to return to normal, with half of his 35 rooms occupied.

At a clothes boutique on the main square that is favored by the wives of wealthy landowners, owner Flávia Cedrinho said sales are down about 30{f08ff3a0ad7db12f5b424ba38f473ff67b97b420df338baa81683bbacd458fca} from normal levels, but would likely be even worse if it weren’t for Project S.

Mayor Capitelli said several textile factories and other companies have approached the local government about setting up operations in the town to take advantage of the ready supply of vaccinated employees. An immunized workforce could reduce the risk that they would have to suspend operations because of new outbreaks of the disease, while the town has also offered fiscal incentives to make the most of its newfound fame to diversify its economy, he said.

“Our town will be the golden child of the region,” he said.

Laughter in the heart of Serrana after the town’s mass vaccination against Covid-19.

Write to Samantha Pearson at [email protected] and Luciana Magalhaes at [email protected]

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