BRASILIA (Reuters) -The Pan American Health Organization (PAHO) said on Wednesday that COVID-19 cases are dropping overall in North America but remain high in the American Midwest, Alaska, and Canada’s Northwest Territories, where infection rates are 10 times the national average.

Infections are also dropping across South America, though cases are up in the greater Caracas area of Venezuela, and in parts of Chile’s southernmost regions.

In the Caribbean, Barbados is reporting the highest number of COVID cases and deaths since the pandemic started, with a five-fold increase in COVID infections over the last month, PAHO said.

The regional branch of the World Health Organization called for concerted action in the Americas to help every country reach the WHO’s vaccination coverage target of 40% of their population by the end of this year.

So far, only nine countries in the region have vaccinated 50% of their people, while six – Jamaica, St. Lucia, St. Vincent & the Grenadines, Haiti, Guatemala and Nicaragua – have yet to reach 20% vaccination coverage, according to PAHO.

Without concerted action to increase the vaccination rate and public health measures, it is possible that COVID-19 could become endemic in the region, PAHO Director Carissa Etienne warned in a weekly briefing.

Third dose booster vaccination is recommended, especially for people who have received the Sinovac Biotech and Sinopharm vaccines developed in China that studies have shown to provide less protection for young adults, PAHO assistant director Jarbas Barbosa said.

Booster vaccination should begin with those over the age of 80, followed by those over 60 years with prior medical conditions, and then young adults, he said. Using other vaccines is possible when the original doses are not available, he said.

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