Argentina, Brazil, and Mexico purchased approximately 151 million doses of H1N1 vaccine directly from manufacturers. This was in addition to the approximately 174 million doses acquired by Canada and the United States. As part of their response to the Influenza (H1N1) pandemic, WHO coordinated a global effort

PD0332991 to donate pandemic influenza (H1N1) vaccine to 95 eligible countries. Ten LAC countries (Bolivia, Cuba, El Salvador, Guatemala, Guyana, Haiti, Honduras, Nicaragua, Paraguay, and Suriname) were originally eligible to receive donated vaccine. Chile was later added to the list after a devastating earthquake in February 2010 [27]. To receive donated vaccine, countries had to present a national vaccination plan specifying vaccine target populations to be approved by regional WHO offices and headquarters. Additionally, countries had to demonstrate that the vaccine had been approved by national regulatory authorities and accept the liability for any ESAVI. As of September 2010, approximately 10 million donated doses had been received; 6.8 million (67.3%) contained adjuvant and 3.3 million (32.7%) were un-adjuvanted. Haiti was eligible to receive one million doses, Alpelisib manufacturer but a final decision as to whether to accept this donation was not received from

the country. Bolivia, Chile and Honduras purchased vaccine through the RF and received WHO donated vaccine. Brazil purchased vaccine directly from the manufacturer, as well

as through the RF, and Suriname received WHO donated vaccine and also procured vaccine through the government of the Netherlands. LAC countries had access to H1N1 vaccine; however it was far from equitable, both in the quantity Thiamine-diphosphate kinase of vaccine available as well as in the timeliness of vaccine availability. Vaccine arrived in most countries between January and May 2010, generally past the main peak of pandemic influenza activity [28]. For the 19 countries and territories with complete information available, the interval between vaccine reception and initiation of vaccination activities ranged from 1 to 39 days, median of 11 days. The first two countries in the Western Hemisphere to have access to the pandemic influenza (H1N1) vaccine were Canada and United States in October 2009 (both purchased vaccine directly from manufacturer). Argentina, Brazil and Mexico received vaccine, also through direct purchase, from December 2009 to April 2010. Brazil and Mexico had previous agreements with manufacturers for the transfer of technology related to influenza vaccine production. Argentina had also developed a public–private agreement with a manufacturer. Countries buying vaccines through the RF received shipments from January 2010 to May 2010, with the exception of Trinidad and Tobago, which received 80,000 doses in November 2009. Recipient countries of WHO donation began to receive vaccine in March–June 2010 (Fig. 1).