Brazil included Indigenous people in its first vaccination group against COVID-19 because of their greater vulnerability to infection (see However, only those living on legally demarcated territories were vaccinated. The Supreme Federal Court later extended immunization to the 500,000 or so Indigenous people living elsewhere (see In practice, many in that group were excluded because they did not have access to the country’s unified health system.

This vaccination scheme is another example of the dearth of meaningful public-health policies aimed at the Indigenous population (see also R. Santunes et al. Nature 584, 524; 2020; E. Benites et al. Nature 591, 369; 2021). It exposes a lack of coordination between the government entities that drafted it. And it stokes discrimination and segregation.

The Brazilian constitution mandates the special protection of Indigenous peoples by the state. There is therefore an urgent need for a more robust vaccination plan that is tailored to the health and social determinants of these people.