Enablers and barriers of COVID-19 vaccination efforts in Nepal.

Nepal, a landlocked country with a population of 29.1 million faced great socioeconomic, financial, and social hardships during the Coronavirus disease 2019 (COVID-19) pandemic. Nepal had increasing cases of COVID-19 despite multiple lockdowns and travel restrictions. Nepal reported 1,000,775 cases and 12,019 deaths till early November 2022. Timely government decisions, strategic political diplomacy, flexible vaccine policy, and multiple loan deals helped Nepal secure the COVID-19 vaccine from India in a commendable time frame. With the existing structure of the primary health care settings and experience of having implemented childhood vaccination campaigns, Nepal rolled out the COVID-19 vaccines across the nation on 27 January 2021. However, the delta wave was a devastating blow to South Asia with a high number of hospitalizations and deaths and a complete disruption of the COVID-19 vaccine supply from India. The government ran a relentless effort in COVID-19 vaccination and provided full vaccination to 33% of the total population by the end of 2021 and 81.1% by May 2022. The booster doses were administered beginning in 2022, but the campaign efforts have been lethargic with a coverage of only 29.2% and a lack of keen support from the public. The emergence of new variants of the virus continues to pose a challenge in controlling the disease and reopening the country to pre-pandemic levels of socioeconomic activities.