TABLE 6. Reported weaknesses and strengths of programs to introduce vaccination against COVID-19, by country, December 2021 to September 2022^a.

	High impact
	Medium impact
	Low impact

Weaknesses and strengths	Country
Weaknesses	Argentina	Belize	Brazil	Costa Rica	Panama	Peru
Antivaccine groups’ actions	1.20	3.17	4.00	3.40	3.20	3.29
Access to vaccination services	1.00	1.33	1.89	0.33	0.80	2.86
Political decisions	1.00	0.83	3.30	0.60	0.75	2.86
Vaccine storage	1.00	1.33	1.22	0.67	0.60	3.00
Vaccine cold chain	1.00	1.33	1.50	0.33	0.40	2.86
Information system	1.17	2.17	3.10	1.40	1.40	2.57
Vaccine transportation	0.75	0.83	1.10	0.17	0.40	2.71
Limited scientific evidence	3.00	0.67	2.10	0.67	1.40	3.14
Lack of insulated containers	0.25	0.17	0.75	0.00	0.50	1.50
Lack of syringes	0.75	0.00	1.60	0.33	0.40	0.67
Lack of personnel	0.80	2.67	2.30	0.83	1.20	3.86
Lack of planning for COVID-19 vaccine introduction	0.50	0.50	2.00	0.33	0.40	1.57
Lack of crisis management planning for COVID-19 vaccination	1.00	0.50	2.33	0.50	1.40	2.43
Lack of a vaccine adverse event reporting system	0.17	1.67	1.40	0.20	0.80	1.14
Lack of vaccines	3.17	0.50	2.90	0.83	0.20	2.86
Insufficient funding	0.75	1.33	1.56	0.33	0.33	3.14
Occurrence of adverse events following immunization	1.17	1.50	2.10	0.33	1.50	1.43
Population refusal	1.00	2.83	2.70	1.00	1.40	2.71
Delay in delivery of vaccines procured through COVAX Facility	3.33	1.33	3.17	2.60	2.00	2.67
Delay in delivery of vaccines procured from laboratories	3.67	0.00	2.67	1.60	0.33	2.40
Problems with processes of and coordination with COVAX Facility	2.33	1.33	2.50	3.25	2.00	2.67
Poor dissemination of information to or communication with the population	1.17	2.17	2.90	0.60	1.40	2.86

	Low impact
	Medium impact
	High impact

Strengths
Acceptance of COVID-19 vaccine by the population	4.67	3.00	3.90	4.00	4.00	4.00
Performance of the country’s Ministry of Health	4.33	4.50	2.20	4.83	4.80	4.14
Streamlined vaccine procurement processes	3.67	4.00	2.56	4.33	4.67	3.17
Streamlined process for purchasing inputs	4.25	4.00	3.56	4.00	4.67	3.40
Streamlined process for purchasing services	3.67	4.00	3.88	3.80	4.00	3.67
Adequate leadership and political support	4.50	4.50	3.20	4.67	4.40	3.71
Support from international organizations	3.80	4.50	2.90	4.00	3.75	3.86
Outreach campaigns	3.67	4.00	3.20	4.33	4.20	3.43
Health workers’ commitment	4.83	4.50	4.60	5.00	4.80	4.29
Evidence-based technical decisions	4.33	4.00	4.40	4.83	4.80	4.29
Availability of timely data for decision-making	4.50	4.17	3.70	4.67	4.20	3.57
Involvement and participation of other ministries	3.80	4.00	4.11	4.67	3.80	3.00
Mobilization of economic resources	3.67	4.00	4.10	4.17	4.67	4.17
Participation of academia	2.80	2.60	3.00	3.67	4.00	2.43
Involvement of national immunization technical advisory group	4.50	4.00	4.20	5.00	3.80	4.43
Participation of armed forces, police or firefighters	3.50	2.80	4.10	3.67	4.80	3.83
Public participation	3.83	3.17	3.60	3.83	4.20	3.00
Private sector participation	3.00	3.17	3.30	3.67	4.00	3.43
Participation of scientific societies	3.33	2.20	4.10	3.60	3.75	3.00
Participation of civil society (associations, unions, federations, nongovernmental organizations)	2.80	3.33	3.10	3.20	2.50	2.57
Plan for introducing the COVID-19 vaccine	4.33	4.17	4.00	4.50	5.00	4.29
COVID-19 vaccination crisis management plan	3.80	3.50	4.14	4.17	3.50	3.80

COVAX: COVID-19 Vaccines Global Access.

^aThe values in the table reflect scores on a Likert scale. Weaknesses scored 4–5 are categorized as high impact, 2–3 as medium impact and 0–2 as low impact. Strengths scored 4–5 are categorized as low impact, 2–3 as medium impact and 0–2 as high impact.

Source: Table prepared by the authors based on the results of their study.