KINGSTON (NYTIMES) - In Guatemala, shortages of syringes have slowed Covid-19 vaccination efforts. In Haiti, logistical and security challenges after a devastating earthquake on Aug 14 have contributed to making it the country with the lowest vaccination coverage in the world.

And across the Caribbean, countries are grappling with unequal distribution of doses and vaccine hesitancy, World Health Organisation (WHO) officials warned on Wednesday (Oct 13) in an online news conference.

An "important challenge that the Caribbean is facing - English-speaking countries and French-speaking countries and territories - is vaccine hesitancy", said Dr Sylvain Aldighieri, Covid-19 incident manager at the Pan American Health Organisation, which is part of the WHO.

"Even if some territories of the Caribbean are leading the regional effort in terms of vaccination coverage, we can say the vaccine uptick is sub-optimal in most of the Caribbean countries," he added.

The WHO has set a goal of having every country in the world vaccinate at least 40 per cent of its population by the end of the year.

Four of the six countries in the Americas that have yet to reach the 20 per cent threshold are in the Caribbean: Haiti, Jamaica, St Vincent and the Grenadines, and St Lucia. The other two - Nicaragua and Guatemala - are in Central America.

"Across all these countries, vaccine availability due to unequal distribution of doses has been a central challenge," said Dr Carissa Etienne, director of the Pan-American agency.

But several of the countries are also "facing their own unique barriers", she added, like the shortage of syringes in Guatemala.

At the same time, Jamaica has had to cope with supply delays.

Haiti, where the August earthquake killed at least 2,200 people, has fully inoculated less than 1 per cent of its population.

"The sociopolitical situation in Haiti is still tense, and that has negatively impacted" vaccination efforts, said Dr Ciro Ugarte, the Pan-American agency's director of health emergencies.

Countries in Latin America and the Caribbean receive vaccines through bilateral agreements with manufacturers as well as through the United Nations-backed Covax programme and donations from countries with excess doses.

The Pan-American agency has also sealed deals for countries to buy millions of vaccine doses from China's Sinopharm and Sinovac, as well as from AstraZeneca.

Although the numbers of Covid-19 cases in much of Latin America and the Caribbean are declining, several islands in the Caribbean are seeing increases.

Barbados, for example, is reporting the highest number of infections and deaths since the pandemic started, said Dr Etienne.

Dominican Republic, Haiti, the Cayman Islands, Antigua and Barbuda, and Anguilla are also reporting increases in cases.

Dr Aldighieri said: "In the eastern Caribbean, health services have been - or are still - overwhelmed by the influx of patients requiring hospitalisation."

He also noted that the situation was a sharp contrast to that last year, when most of the Caribbean island countries were largely able to avoid widespread transmission of the coronavirus.

Despite vaccine hesitancy, 39 per cent of the population across Latin America and the Caribbean have been fully vaccinated against Covid-19, Dr Etienne said.

That is sharply higher than in Africa, where less than 5 per cent of the population have been fully vaccinated, according to the Africa Centres for Disease Control and Prevention.

As more vaccines start to flow to the region, though, it is important for countries "to make the necessary preparations so these doses can be used as quickly as possible", Dr Etienne said.