Over the past two years, the Haitian government has intensified vaccination campaigns and epidemiological surveillance to combat vaccine preventable diseases (VPDs) amid severe humanitarian and security challenges.
— Port-au-Prince, Haiti, April 2025 —
“In Haiti, gangs control an estimated 85% of the Port-au-Prince metropolitan area and other neighboring localities,” said Dr. Oscar Martin Barreneche, the Pan American Health Organization (PAHO) Representative in Haiti. “This makes implementation of all health services, including vaccination, very difficult. However, Canadian funding has successfully supported critical routine vaccination services for both children and pregnant women.”
Since 2022, Haiti’s Ministry of Public Health and Population (MSPP, per its French acronym) has received financial support from Canada’s global CanGIVE initiative to improve access to vaccines for vulnerable populations. These funds have been channeled through PAHO, which has also provided technical assistance for vaccination services.
In a measure of impact, vaccination coverage with the first dose of the pentavalent vaccine against diphtheria, tetanus, pertussis, hepatitis B, and Haemophilus influenzae type b was up 22 percentage points in 2023 and up 4 points in 2024 compared with 2022. Coverage with the third and final dose of the pentavalent vaccine was up 23 percentage points in 2023 and 10 points in 2024 compared with 2022.
“Extending vaccination services and increasing immunization coverage are national priorities for the Haitian government,” said Dr. Martial Beneche, Director of the Expanded Programme on Immunization. “Our aim is to ensure the highest level of protection for the children of our country against potential epidemics.”
As part of the intensification of vaccination, the MSPP launched operations throughout the country to “catch up” eroded vaccination rates, which declined even before and especially during the COVID-19 pandemic. Last year at least 421,000 children were vaccinated with the pentavalent vaccine. To combat recurring diphtheria outbreaks, more than 343,000 children were vaccinated against the disease.
The severity of the security crisis continues to make vaccination operations difficult. The Port-au-Prince metropolitan area and the lower region of Haiti’s Artibonite Department have been particularly affected, with people seeking refuge in improvised camps, including children and pregnant women. In some areas, such as the Carrefour neighborhood in Port-au-Prince, PAHO and the MSPP must work with community vaccinators as access for outsiders is blocked by gangs.
Still, “it’s very important to strengthen routine vaccination, especially in remote areas where many children have not received any doses or have not completed their vaccination,” said Yolande Gabriel, a health provider from the Felisane medical center in Haiti’s Southeast Department. “Sometimes parents have no way to take their child to a health center. So sending teams into the field allows these children to receive their vaccines directly in their own locality.”
To improve the skills of vaccination providers, some 105 health care professionals, including 84 women, received PAHO-supported training to become trainers in the norms and protocols of vaccination. The trainers were then involved in “cascade” trainings of 395 frontline health providers working in facilities in the field.
The security crisis has also impacted some critical epidemiological surveillance activities. For example, wastewater collection sites in Cite Soleil in Port-au-Prince can no longer be accessed by MSPP supervision teams because of gang activity.
But with Canadian support, PAHO provided transportation for epidemiological investigation of suspected cases of VPDs in 341 health facilities and communities in eight of Haiti’s 10 departments. PAHO also provided transportation for training 77 VPD surveillance professionals from the Center Department and 47 from Artibonite.
“We are looking for cases of diphtheria, like the one recently treated by the Departmental Investigation and Response Team (EDIR),” said Dr. Jose Raphael, Epidemiology Assistant in the Northeast Health Department. “As part of epidemiological surveillance, we are also monitoring measles, rubella, and congenital rubella syndrome in children under one year of age, as well as acute flaccid paralysis in children under 15.”
Using CanGIVE funding, PAHO provided logistical support for the delivery of COVID-19 and routine vaccines from Port-au-Prince to all 10 Haitian departments. Jointly with the MSPP, PAHO used local transporters who were able to cross the gangs’ strongholds to reach the northern part of the country. For the southern regions, PAHO found a local partner that used boats to transport vaccines and vaccine supplies from Port-au-Prince.
“The security situation continues to make it difficult to carry out basic tasks,” said Dr. Barreneche. “But with dedication, perseverance, and support from our partners, we have been able to help Haiti protect the health and well-being of its citizens.”
