KAMPALA, Uganda (AP) — Hati Maronjei once swore he would never get a COVID-19 shot – after a pastor warned that vaccines aren’t safe.

Now, four months after the first batch of vaccines arrived in Zimbabwe, the 44-year-old street hawker of electronic items is desperate for the shot he can’t get. Whenever he visits a clinic in the capital, Harare, he is told to try again the next day.

“I am getting frustrated and afraid,” he said. “I am always in crowded places, talking, selling to different people. I can’t lock myself in the house.”

A sense of dread is growing in some of the very poorest countries in the world as virus cases surge and more contagious variants take hold amid a crippling shortage of vaccines.

The crisis has alarmed public health officials, along with the millions of unvaccinated, especially those who toil in the informal off-the-books economy, live hand-to-mouth, and pay cash in health emergencies. With intensive care units filling up in cities overwhelmed by the pandemic, severe disease can be a death sentence.

Africa is especially vulnerable. Its 1.3 billion people account for 18 per cent of the world’s population, but the continent has received only two per cent of all vaccine doses administered globally. And some African countries have yet to dispense a single shot.

Health experts and world leaders have repeatedly warned that even if rich nations immunise all their people, the pandemic will not be defeated if the virus is allowed to spread in countries starved of vaccines.

“We’ve said all through this pandemic that we are not safe unless we are all safe,” said John Nkengasong, a Cameroonian virologist who heads the Africa Centres for Disease Control and Prevention. “We are only as strong as the weakest link.”

Zimbabwe, which has imposed new lockdown measures because of a sharp rise in deaths and cases in the country of over 15 million people, has used just over a million of 1.7 million doses, blaming shortages in urban areas on logistical challenges.

Long lines form at centres, such as Parirenyatwa Hospital, unlike months ago, when authorities were begging people to get vaccinated. Many are alarmed as winter sets in and the variant first identified in South Africa spreads in Harare, where young people crowd into betting houses, some with masks dangling from their chins, and others without.

“Most people are not wearing masks. There is no social distancing. The only answer is a vaccine, but I can’t get it,” Maronjei said.

At the start of the pandemic, many deeply impoverished countries with weak health-care systems appeared to have avoided the worst. That is changing.

“The sobering trajectory of surging cases should rouse everyone to urgent action,” said Dr Matshidiso Moeti, Africa director of the World Health Organization. “Public health measures must be scaled up fast to find, test, isolate, and care for patients, and to quickly trace and isolate their contacts.”

New cases on the continent rose by nearly 30 per cent in the past week, she said Thursday.

Africa has recorded more than five million confirmed COVID-19 cases, including 135,000 deaths. That is a small fraction of the world’s caseload, but many fear the crisis could get much worse.

Nearly 90 per cent of African countries are set to miss the global target of vaccinating 10 per cent of their people by September, according to the World Health Organization.

One major problem is that COVAX, the UN-backed project to supply vaccine to poor corners of the world, is itself facing a serious shortage of vaccine.

Amid a global outcry over the gap between the haves and the have-nots, the US, Britain and the other Group of Seven wealthy nations agreed last week to share at least one billion doses with struggling countries over the next year, with deliveries starting in August.

In the meantime, many of the world’s poor wait and worry.