COVID-19 vaccines have been available for over a year now and yet some regions of the world continue to have low vaccination rates. The question remains: Why have people still not been vaccinated?

A restricted supply of COVID-19 vaccines has been one of the biggest hurdles the world has faced, however, experts believe that vaccine hesitancy, unpredictable deliveries and weak health care systems have added to the problem, according to reports from the Associated Press.

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The African continent is one of the most heavily impacted regions. Phionah Atuhebwe, who works with World Health Organization, said that 13 African countries continue to have a full-vaccination rate of less than 5% as of February.

Conflict-ridden regions like Haiti, Yemen and Syria also have very low vaccination rates against COVID-19.

Other setbacks to vaccinations have also emerged.

“The main problem among countries with low vaccination rates is poor infrastructure to distribute shots,” says Dina Borzekowski, director of the Global Health Initiative at the University of Maryland, according to reports from Associated Press.

“What is absent are best practices to get vaccines to populations who typically live without safely managed sanitation systems or reliable electricity”, Borzekowski added.

The economic capabilities of countries also played a major role in the vaccination process. While wealthy nations developed and tested their vaccines at an early stage of the pandemic, hoarding of COVID-19 vaccines doses became a problem.

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Meanwhile, developing countries were facing a lack of supplies. COVAX — an initiative to distribute vaccines equally around the world — faltered in delivering shots, according to reports from Associated Press.

Donated vaccines are also sometimes delivered close to their expiration dates, giving health officials little time to distribute them, says Sinhye Ha of Doctors Without Borders.