LIMA, Peru — The hope brought by the arrival of the first vaccines in South America is hardening into anger as inoculation campaigns have spiraled into scandal, cronyism and corruption, rocking national governments and sapping trust in the political establishment.

Two ministers in Peru and one in Argentina have resigned for receiving or giving preferential access to scarce vaccines. A minister in Ecuador is being investigated for doing the same.

Prosecutors in those countries and in Brazil are examining thousands more accusations of irregularities in inoculation drives, most of them involving local politicians and their families cutting in line.

As accusations of wrongdoing ensnare more dignitaries, tension is building in a region where popular outrage with graft and inequality has spilled in recent years into raucous protests against the political status quo. The frustration could find an outlet in the streets again — or at the polls, shaping voter decisions in upcoming races such as Peru’s elections in April.

“They all knew that patients have been dying,” Robert Campos, 67, a doctor in Peru’s capital, Lima, said of the country’s politicians. “And they vaccinated all their little friends.”

The anger at powerful line-cutters has been amplified by the scarcity of the vaccines. South America, like other developing regions, has struggled to procure enough doses as rich nations bought up most of the available supply.

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Campos said he did not make the vaccination list when limited doses arrived for hospital staff last week.

South America was shattered by the virus, accounting for nearly one-fifth of all pandemic deaths worldwide — 450,000, according to the official tally — despite representing about 5% of the world’s population. Mortality data suggests the pandemic’s real toll on the region is at least double the official numbers.

The virus also collapsed national health care systems, pushed millions into poverty and plunged the region into its worst economic crisis in modern history.

Despite the heavy toll, the pandemic shored up public support for most of the region’s governments as several offered financial support to their populations and called for unity.

The vaccine scandals could bring this goodwill to an end, heralding a new wave of instability, analysts warn.

“People find it much more difficult to tolerate corruption when health is at stake,” said Mariel Fornoni, a pollster in Buenos Aires, Argentina.

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The scandals mirror similar affairs in Lebanon, Spain and the Philippines — and the United States, where there have also been instances of elite access to early shots and unequal distribution across racial and ethnic groups.

In Latin America, the brazen nature of some of the cases has fueled outrage.

In Peru, a deputy health minister was inoculated with extra doses from a clinical trial, along with his wife, sister, two children, a nephew and a niece. Ecuador’s health minister sent doses from the country’s first vaccine batch, which the government said was reserved for the public sector, to a luxury private nursing home where his mother lives.

A prominent Argentine journalist disclosed last week in a radio interview that he got a shot at the health ministry after calling his friend, who was then the health minister, exposing what the locals have called a “VIP Immunization Clinic” for government allies. In Brazil, prosecutors have requested the arrest of the mayor of Manaus, a northern city devastated by two waves of coronavirus, on suspicion of giving allies preferential vaccine access.

And in Suriname, the 38-year-old health minister allocated to himself the country’s first vaccine shot to “set an example.”

As the exposés poured in, citizens across South America took to social media to denounce the abuses and identify the suspected line-cutters. Doctors and nurses in Peru protested outside hospitals last week to demand vaccines as the country’s vaccine graft scandal grew.

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Health ministers have resigned in Peru and in Argentina, where the former official was charged with abuse of power; Ecuador’s health minister is facing an impeachment trial and a criminal investigation.

The vaccine scandals have resonated especially hard in Peru, where the pandemic has killed more than 45,000 people, according to the official tally, although excess mortality data suggest the real toll could be more than double that number.

Earlier this month, the doctor conducting Peru’s first vaccine trial acknowledged inoculating nearly 250 politicians, notables and their relatives as well as university administrators, interns and others, with undeclared extra doses. Some had received three doses, according to the trial’s director, Dr. Germán Málaga, in an attempt to maximize their immunity.

The scandal rocked a nation already reeling from a string of corruption investigations that have eviscerated trust in democratic institutions and ensnared all six of the country’s most recent former presidents.

Only one of the former presidents, Martín Vizcarra, left office with high approval ratings, thanks to his tough stance on corruption. Now Vizcarra has become entangled in the vaccine trial scandal after it emerged that he secretly got a shot while in office before Peru had even approved or purchased any vaccines. He then tried covering it up.

“We thought he was a good person,” said Ana Merino, a newspaper vendor in Lima whose husband died from COVID last year. “Who can we turn to? Who’s left?”

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The list of those who benefited illicitly from the vaccine trial in Peru include the health minister, vaccine regulators, the trial’s academic hosts and even the Vatican’s envoy in the country. The envoy, Nicola Girasoli, told local media he got the vaccine for being an “ethics consultant” to the university conducting the trial.

After resigning, Peru’s health minister, Pilar Mazzetti, said getting the injection was “the worst mistake of my life.” Another politician who took advantage of the trial, the country’s foreign minister, Elizabeth Astete, also quit after arguing she “didn’t have the luxury” of getting sick on the job.

The vaccine scandal could shake up Peru’s general elections in April, benefiting candidates promising a radical break with the current political system, said Alfredo Torres, head of the polling company Ipsos in Lima.

Among them are Keiko Fujimori, the daughter of a jailed former president, who has said she will turn Peru into a “demodura,” a mix of Spanish words for democracy and dictatorship, and Rafael López Aliaga, who has proposed giving death sentences to corrupt politicians.

Because most countries in the region have so far received only a tiny fraction of the vaccines they need, various groups have been jostling for priority.

In Peru and Venezuela, the governments have said security forces would be given priority along with the health workers, prompting protests from the medical community.

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In Brazil, which has vaccinated only 3% of its population, one-third of the country’s 210 million people are now included in the priority list, far outstripping the number of available doses. The group includes veterinarians, who argued that they work in health care; truck drivers, who threatened to strike if they did not get the vaccine; and psychologists, firefighters and builders.

The confusion was made worse by the Brazilian government’s decision to partially delegate the vaccination order to local officials, leading to a kaleidoscope of conflicting rules. Some prosecutors investigating vaccine graft said the bureaucratic chaos may have been deliberately amplified in order to hide cronyism and corruption.

“Doctors call me all the time saying they are scared to die” because they cannot get vaccines, said Edmar Fernandes, president of the medical union in the Brazilian state of Ceará. “This type of corruption kills.”