Cuba has begun a mass Covid-19 vaccination drive using two homegrown shots before they have full regulatory approval, after declaring a health emergency as cases surge.

The government said it aimed to vaccinate the entire adult population with its Abdala and Soberana 2 shots. The programme began in Havana on Wednesday for residents aged 60 years or older, with frontline workers in other provinces also receiving the vaccines.

The Pan American Health Organization said this week that Cuba was driving most new Covid-19 infections in the Caribbean. Although case rates in the communist-ruled nation have been low by international standards, it recorded its worst month for infections in April since the pandemic began, with 31,346 cases and 229 deaths among its 11m population. The number has continued to creep up this month.

José Angel Portal Miranda, public health minister, said he expected full approval for both vaccines in June but that Cuban law allowed the step to be bypassed in an emergency. “This makes it possible to initiate intervention in risk groups and territories with Cuban vaccine candidates,” he said after announcing the emergency last Friday.

Abdala’s phase 3 trials — the final stage before regulatory approval is normally sought — ended on May 1 while those for Soberana 2 will be completed this weekend. More than 300,000 Cubans have been vaccinated to date, including trial participants and frontline workers.

Cuban health authorities say both shots have proved safe and highly effective but have not released trial data.

Cuba opted not to join the World Health Organization-backed Covax vaccine procurement facility or accept jabs from allies such as Russia and China. The island nation has been manufacturing vaccines for years and authorities cite long experience and a policy of not depending on others as behind the decision.

A scientist works on the Abdala vaccine at a Havana biotechnology centre

All but bankrupted by US economic sanctions and the Covid-induced crisis, Cuba is suffering its worst economic crisis since the collapse of the Soviet Union three decades ago. The economy declined 11 per cent last year and local economists said it continued to lose ground during the first quarter as the pandemic crippled tourism, which accounts for about 11 per cent of gross domestic product.

Both of Cuba’s vaccines require two doses, and a third booster shot has been added to combat new variants of the virus.

Portal Miranda said 70 per cent of the population would be vaccinated by September and the remainder by the end of the year.

Patients and medics preparing for vaccination on Wednesday expressed confidence in the programme. Physiotherapist Vladimir Lahenes did not believe Abdala, named after a famous poem by national revolutionary hero José Martí, which he was about to receive in the Havana municipality of Playa de Este, would prove unsafe or ineffective.

“Here there’s lots of experience with Cuban vaccines. Everyone knows, everyone is confident,” he said.

Family doctor Yolanda, who asked that her full name not be used, said she had been preparing for weeks. “I have been giving Cuban vaccines forever. I’m already vaccinated and very glad my patients will now be too,” she said.

Eduardo Martínez Díaz, president of BioCubaFarma, the state pharmaceutical monopoly, said last week that Cuba “will probably be the first country to immunise its entire population with its own vaccine”.

However, Cuba’s cash-strapped health service is facing a shortage of vital equipment. Its network of community-based family health offices are spearheading the vaccination drive, but some lack working fridges, according to local doctors.

International supporters have also launched an appeal for funds to supply 30m of the 40m syringes they say Cuba needs to fully vaccinate the population.

Cuba appeared to have handled coronavirus much better than the rest of Latin America last year, closing its borders early and deploying community health professionals to test and track cases. But in November it opened its airports and visitors were initially not required to take Covid tests before arriving.

The highly infectious variant first identified in South Africa is now dominant in the country and the main reason for the surge in cases, the authorities said.

Trials of the Cuban vaccines are under way in Iran and Venezuela. Havana hopes to negotiate agreements to manufacture them in third countries, to help fund plans to produce 100m doses this year at home.