How trust is overcoming fear of vaccination in remote areas of Peru

As soon as the vaccination brigade arrived in the remote community, some mothers hurried and closed their doors. From inside, voices could be heard—expressing fear: “I don’t want my child to get sick from that vaccine,” or “those vaccines don’t work.”

— February 2026 —

For licensed nurse Mariela López Román, who has spent a decade working with Indigenous communities in the Amazon rainforest in the department of San Martín, scenes like this are not new, but she tries not to let them discourage her. Experience has taught her that distrust is overcome with patience, face-to-face conversations, simple images, clear information, and above all, time devoted to listening and explaining how vaccines save lives.

In Peru, the Pan American Health Organization (PAHO), with the support of strategic partners like the Government of Canada, provides technical assistance and works alongside the Ministry of Health in national vaccination campaigns. The goal is to close gaps and maintain coverage that protects children, pregnant women, older adults, and communities in vulnerable situations.

In 2025, during Vaccination Week in the Americas, Peru administered more than 1 million doses, exceeding its national target. The vaccines are part of the National Immunization Schedule, one of the most comprehensive in the Region of the Americas, with 18 vaccines that protect against 28 diseases.

Brigades reached children who had never received a vaccine. “The mother didn’t even know vaccines existed,” recalls a nurse who vaccinated a child in Puno who had never received a vaccine. Door-to-door visits made it possible to initiate vaccination schedules, although the greatest challenge was completing subsequent doses amid logistical complications and persistent misinformation.

Geographies that put efforts to the test

In areas where distances are measured in hours of walking or boat travel, access to health care requires logistics, commitment, and sometimes creativity. On the floating islands of Lake Titicaca, in the high-Andean zone, reaching a family might mean hiring a boat, navigating narrow channels, and moving from island to island.

Some days a brigade administers up to 20 vaccines, while on others they manage only five. “In some areas, homes are separated by as much as an hour’s walk,” explains Sonia García from the Regional Health Directorate of Puno. “That’s why every vaccine counts.”

Road conditions add further challenges. In the rainforest, many brigades travel by motorcycle, along roads that deteriorate with the rain. One health worker sums it up with humor: “Sometimes the tire blows out, the brake breaks, the river rises… and we keep going anyway.”

Perseverance in the face of refusal

Despite the difficulties, sustained efforts have helped build bonds of trust. “Most people accept the vaccines with gratitude, because they know we can’t always reach them,” says a nurse. “But we also encounter refusals. Sometimes we bring small gifts or rely on community health agents to buy time and talk things through, helping families understand the importance of vaccination.”

Mariela López Román recalls difficult episodes in San Martín: families who refused vaccines for children, pregnant women, or older adults, and even incidents of violence against brigades. Today, thanks to the sustained work of nursing staff, coordination with local governments, support from community health agents, and health promotion activities, such situations are increasingly rare. Still, skepticism remains: “There is still rejection in some families, but we are much more welcomed than before.”

Misinformation is a central factor. “Some mothers think that post-vaccination fever means the vaccine made the child sick,” Mariela explains. To address this, the team uses all kinds of communication tools like posters and photos to explain what happens to children who do not receive vaccines—for example, against polio. “Little by little they listen, ask questions, understand how serious these diseases are, and that they can be prevented. In the end, they agree.”

That “little by little” captures the challenge of administering vaccines in the most remote areas. It is not only about traveling long distances, but also about dismantling fears, deeply rooted customs, and, in many cases, decisions shaped by gender roles. “For example, if the father says no, then the children are not vaccinated, even if the mother agrees,” Mariela explains.

Other forms of resistance stem from beliefs that discourage medical interventions that do not come from nature. “Some groups even prevent believers from going to a health facility for care,” explains Nadia Carrasco, a nurse on the coast of Lambayeque. “So, we face a major limitation, because going against a family’s faith is very difficult.”

When a “yes” matters as much as the target

Administering vaccines is not just about giving an injection. It involves procurement, logistics, cold chain management, trained human resources, and information systems.

In 2025, Peru achieved an important milestone, piloting an offline application for vaccination registration in targeted areas of Amazonas, Loreto, and Madre de Dios, isolated areas located along the borders with Ecuador, Colombia, and Bolivia. Developed by PAHO and the Ministry of Health—with support from the German Agency for International Cooperation (GIZ)—this tool improves data quality, prevents information loss, and reduces errors associated with paper records, allowing coverage and gaps to be reflected more accurately.

Mariela recalls a mother who stopped attending checkups because a vaccine caused her baby to develop a fever: “We went three times. On the third visit she said she would come only for the checkup, without vaccination. We told her that was fine, that she should come anyway. And once she was there, she agreed again. Now she comes on time and asks me, ‘Will there be another vaccine at one year?’ That made me happy.”

In this context, PAHO also provides technical assistance in community communication, an urgent need in some regions. “PAHO has helped us strengthen communication, because that is a critical bottleneck,” says Sonia García in Puno. Her colleague Graciela Santos adds: “We have found it helpful to focus on training our nurses in interpersonal skills and empathy—how to reach users and address their fears. We are reaching the goal, slowly but surely.”

For many brigades, these moments make all the effort worthwhile. “One of the most beautiful moments is when you arrive at a home, and the family welcomes you with immense gratitude. You see it in their eyes, when they shake your hand and say, ‘Thank you for taking the time to come all the way here,’” says Nadia.

Because vaccination figures are not just numbers. They are the result of a complex system of components that make it possible for vaccines to reach people. But above all, they are the result of conversations—sometimes long ones—that require patience and empathy. They are collective acts that push back against fear and misinformation and, with greater trust, move toward equitable protection across Peru’s diverse geography, leaving no one behind.

Vaccination Week in the Americas (VWA)

United States of America