All Brazilians are required to be vaccinated against Covid-19 under the penalty of being banned from certain public activities and spaces, the country’s top court has decided.

Ten justices of the 11-member court backed the mandatory inoculation with only one vote against in a virtual session held Thursday. The ruling is a blow to President Jair Bolsonaro, who has said he won’t get a vaccine and nobody should be forced to.

The court underscored that its decision doesn’t mean Brazilians will be taken by force to receive shots that will be offered by the government through the public health network. It will be up to governors and mayors to decide on which restrictive measures to impose on holdouts.

Vaccines against potentially life-threatening diseases such as measles and meningitis have long been mandatory for children in Brazil and the justices dismissed a separate case seeking to free parents from that obligation due to religious beliefs.

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Bolsonaro has promised to make all Covid-19 shots approved by the health regulator available to the public, but at the same time has raised prospects of an ineffective mass inoculation campaign by discouraging Brazilians from participating in it.

“Nobody can force anybody to take the vaccine,” he said at an event in the northeastern state of Bahia after the court’s decision. “We’re dealing with lives, where is our freedom?”

Bolsonaro later added that the court’s decision may end up being “innocuous” because the government will hardly have vaccines for all of the country's 210 million people by the end of 2021.

The number of Brazilians who are open to being inoculated against Covid-19 has declined to 73% in December from 89% in the beginning of August, according to a Datafolha survey. Those who are against taking the shots have risen to 22% from 9% in the same comparison. The pollster interviewed 2016 people over the phone between Dec. 8-10.

Although Health Minister Eduardo Pazuello has said he expects to have 25 million doses of three different vaccines ready by January, a date for a nationwide inoculation campaign hasn’t been set yet.

— With assistance by Luana Souza