Back in December, before the COVID-19 variants changed the course of the pandemic, Canadian Prime Minister Justin Trudeau bragged that he had procured enough potential vaccines to protect a population four times the size of Canada. But four months later, not even 2 percent of Canada’s population of just under 38 million is fully vaccinated, and large swaths of the country are going back into lockdown thanks to a brutal third wave.

Canada has logged nearly one million cases and 23,000 deaths since the beginning of the pandemic. Trudeau had hoped to get the population vaccinated by June but now says all Canadians who want a vaccine will get one by the end of September. Canada is one of the only large economies in the world that did not attempt to manufacture its own coronavirus vaccine.

Meanwhile, the variants are taking hold.

On Wednesday, the Centers for Disease Control and Prevention launched a stark warning that even fully vaccinated Americans should avoid travel to Canada. And if they do go for essential purposes, they should be tested three to five days upon return. “This isn’t the news any of us wanted, but hospitalizations are surging, ICU beds are filling up, variants are spreading and even people who had convinced themselves they didn’t need to be concerned are getting sick,” Trudeau said at a news conference Tuesday. “Even if the sun is shining and the weather is getting warmer, COVID-19 isn’t done with us yet,” he said, calling the third wave of the pandemic “very serious.”

More troubling still is that most of the new cases being seen in the hospital’s intensive care units are increasingly younger patients, according to Canada’s top health expert. “While COVID-19 continues to impact people of all ages in Canada, infection rates are highest among those aged 20 to 39 years of age,” Theresa Tam, Canada’s chief public health officer, said in a statement Wednesday. “As well, we are seeing an increased number of adults, under the age of 60 years being treated for COVID-19 in hospital, including in intensive care units.”

So how can a country that had ordered more vaccines per capita than anywhere else in the world now be in such trouble? Canada doesn’t produce any vaccines in its territories—either creating their own or manufacturing others—and the imported doses simply haven’t been delivered. Canada’s government-owned vaccine manufacturer was privatized in the 1980s and eventually bought by the French company Sanofi, whose own vaccine efforts have faltered.

Trudeau announced last week that finally Pfizer will start delivering one million doses a week after the U.S. freed up exports now that it is clear there is enough supply for Americans first. AstraZeneca has also promised to deliver 20 million of its increasingly controversial vaccine, which should also help kick-start the painfully slow rollout. Moderna and Johnson and Johnson are also approved for use in Canada, but they have yet to be delivered in any sizeable quantity.

Trudeau has been under fire by angry Canadians after admitting early on that the country would not be first in line for any vaccines because they weren’t producing any locally. Then when the EU put the clamp on vaccine exports, Canada once again paid the price in missed deliveries. The Biden administration has not yet committed to any exports to Canada or Mexico, both suffering from shortages.