Haiti, which has one of the lowest COVID-19 vaccination rates in the Western Hemisphere, will be returning thousands of unused doses donated by the U.S. to keep them from expiring.

The COVAX Facility, which provides free and subsidized vaccines to the poorest nations, confirmed in an emailed statement Wednesday that the doses returned by Haiti will be redeployed elsewhere to “minimize any potential wastage.”

“Hundreds of thousands” of doses expiring in November will be sent to COVAX with the understanding that Haiti will receive a new batch in the future, Le Nouvelliste newspaper reported, citing health ministry officials. The exact number of vaccines being sent back was not confirmed by the government or the COVAX Facility.

The U.S. donated 500,000 doses of the Moderna Inc vaccine to Haiti in July through COVAX — an abbreviation for COVID-19 Vaccines Global Access. According to Haiti’s health ministry, fewer than 66,800 doses have been administered and only 20,354 people in the Caribbean nation of 11.4 million are fully vaccinated.

The country has reported 22,731 cases and 649 deaths due to COVID-19 since the pandemic began. Calls to the ministry seeking comment were not immediately returned.

The news is another blow to Haiti, which was the last country in the Americas to begin offering vaccines and one of only six in the hemisphere that have vaccinated less than 20% of their population. The others are Jamaica, Guatemala, Nicaragua, St. Lucia, and St. Vincent and the Grenadines.

The poorest nation in the hemisphere, Haiti is reeling in the wake of the assassination of President Jovenel Moise in July and a 7.2 magnitude earthquake in August.

Gang violence, natural disasters, fuel shortages and vaccine hesitancy are all making it difficult to roll out vaccines in Haiti, said Ciro Ugarte, the director of health emergencies at the Pan American Health Organization.

“The socio-political situation continues to be tense in Haiti and that is having a negative impact,” he said Wednesday in a video news conference.

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