Countries in Central America are struggling to set a concrete schedule for vaccinations against the novel coronavirus, with few exceptions among the region's seven nations.
President Carlos Alvarado of Costa Rica celebrated the arrival of the fourth batch of the Pfizer-BioNTech coronavirus vaccines on Jan. 12 and declared: "We reached a total of 87,750 vaccinations received in 20 days."
Ticos are again at the forefront of Central American countries, being the only nation in the isthmus to have a clear vaccination plan.
Panama, with 269,000 infected, which represents the highest rate in the region, trails Costa Rica.
Panamanian authorities reported that they will receive a shipment of 40,000 vaccines from Pfizer-BioNTech by Jan. 25.
In Nicaragua, Honduras, El Salvador and Guatemala, uncertainty surrounds those countries as they cling to COVAX, the mechanism launched by the World Health Organization (WHO), the European Commission and France, in response to the pandemic.
It works with governments, scientists, private and philanthropic organizations, as well as millionaires to provide vaccines to poor countries.
Although COVAX is a fact for the countries, there are still no definite dates to receive vaccines and start applications.
Experts warn that as time passes, the virus will reappear in the region due to complacency by citizens, especially during Christmas and New Year celebrations.
The hope is that the COVAX mechanism will be effective in the first half of 2021 but an analysis released by The Economist newspaper in December indicates that there will not be enough vaccines to cover the world's population until 2023 or 2024.
In December, high-income countries had 4.1 billion confirmed doses, upper-middle-income countries had 1.1 billion doses and lower-middle-income countries had 2 billion doses.
Apart from Costa Rica and Panama, steps by other governments to obtain more vaccines on their own is not encouraging since Central America is one of the regions with the poorest countries in the hemisphere.
Also, the isthmus was devastated by hurricanes Eta and Iota, which left millions of dollars in economic losses in 2020.
- Guatemala anticipates a fund
Guatemala advanced 15% of a fund to purchase 6.74 million doses for 3.37 million people, equivalent to 20% of the population, according to its Ministry of Public Health and Social Assistance.
Authorities also acknowledged in November that due to the deep-freezing system required by the Pfizer-BioNTech vaccine, they will not be able to access it.
This is one of the main problems of Central American health systems. The Pfizer-BioNTech vaccine needs to be stored at minus 70C (minus 94F) and the installed capacity in regional countries is equipment that maintains drugs between minus 18C and minus 20C.
Guatemalan President Alejandro Giammattei assured the nation this week that he will present an initiative to Congress to make a direct purchase of 2.5 million vaccines. So far, Guatemala said it is ready to buy 3.3 million doses, although the date for arrival is unknown.
At the same time, deaths from the pandemic continue to rise. Last Friday, 44 fatalities were registered, bringing that number to 4,972 since the first case of the virus was detected in March.
The same uncertainty looms in Honduras, but with a little more relief. According to the director of the Expanded Immunization Program of the Ministry of Health, Berenice Molina, Hondurans will have access to 9.4 million doses to immunize 81% of the population.
"Honduras has guaranteed access to the vaccine for 20% of the population through the COVAX Facility, and another 20% through a purchase with other funds, which represents more than eight million doses of the vaccine," said Molina.
The Honduran Institute of Social Security (IHSS) will acquire "more than 1.4 million vaccines." However, the government continues to present a preliminary plan to receive COVAX vaccines.
On other hand, the government of Nayib Bukele in El Salvador, despite repeated promises, does not have a date to start vaccinations.
Minister of Health Francisco Alabi predicts 4.5 million people will be vaccinated with the purchase of 9 million vaccines from pharmaceutical companies. The first 2 million correspond to an agreement with AstraZeneca and the University of Oxford.
However, the discussion of vaccination in El Salvador is centered on the controversial installation of 162 vaccination booths, due to its high cost of $32,000 for each unit.
- Nicaragua, the most uncertain view
In Nicaragua, a policy of secrecy is imposed on everything related to the pandemic, and vaccines are no exception. Although the country will have access to the COVAX mechanism, the arrival of vaccines will be in March, according to the Pan American Health Organization (PAHO). But COVAX will cover 20% of the population: Some 1.3 million.
The government of Daniel Ortega has kept silent about whether it is seeking more vaccines on its own.
The only thing that was hinted at is that the government plans to acquire the Russian Sputnik V vaccine and Vice President Rosario Murillo revealed Thursday, through official television channels, that it will buy 7.4 million vaccine doses "with the aim of applying in a first phase to 55% of the population," estimated at 6.5 million people.
"With the funding that has been received for the purchase of these vaccines through the different mechanisms, we would be able to protect 3,731,900 people, that is, in the first moment, 55% of the population," said Murillo.
The vice president said the application of 7.4 million doses is equivalent to two vaccines per person at a cost of $115.7 million, including the costs of the cold chain refrigeration and ensuring the preservation of the vaccines.
The government, accused of negligence in the face of the pandemic, is considering four vaccine options: Sputnik V, Oxford AstraZeneca from the UK; Moderna, from the US and Covaxina from India.
The Ministry of Health ruled out the US-German Pfizer-BioNTech jab because it is not compatible with cold chain installed in Nicaragua.
*Maria Paula Trivino contributed to this story.