Haiti’s COVID-19 vaccination campaign, which finally got underway with an initial COVAX allocation of vaccines in mid-2021, faced the full gauntlet of challenges that had been anticipated in a country with limited health infrastructure, high vaccine hesitancy, ongoing political crisis, and the cold chain and logistical requirements of modern vaccines. The rollout was slow, constrained by supply, and complicated by the simultaneous demands of the presidential assassination and the August earthquake.
Vaccine hesitancy was a significant challenge. Surveys of Haitian populations found high levels of reluctance to accept COVID vaccination, rooted in distrust of government institutions, concerns about vaccine safety that had been amplified by social media misinformation, and the specific history of harm that the healthcare system — and specifically the UN — had inflicted on Haitians through the cholera epidemic. Converting hesitancy to acceptance required sustained community outreach through trusted local messengers.
The cold chain requirements of the Pfizer-BioNTech and Moderna vaccines — which required ultra-cold storage — were particularly challenging in a country with unreliable electricity. Haiti’s vaccination program relied primarily on the Johnson and Johnson vaccine, which required only standard refrigeration temperatures, as the more logistically manageable option for the Haitian context.
By the end of 2021, Haiti had vaccinated only a small fraction of its population, making it one of the least vaccinated countries in the Western Hemisphere. The combination of supply limitations, distribution challenges, and hesitancy had prevented the vaccination campaign from achieving meaningful coverage, leaving the population vulnerable to ongoing COVID transmission and future variant waves.