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SARS-CoV-2 vaccination uptake, vaccination willingness and associated factors among indigenous women in Guerrero, Mexico (2020–2021): a cross-sectional study
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DOI：10.1186/s12884-026-09803-w.png)
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Abstract
En 中文
Indigenous people experienced high morbidity and mortality from COVID-19 pandemic. Pregnant women are more susceptible to COVID-19 infection due to changes in physiological and immunological function. We documented vaccination coverage, willingness to get vaccinated against SARS-CoV-2 and associated factors in Indigenous women reporting pregnancy or childbirth in the last three years. Cross-sectional study in December 2021 and January 2022 in predominantly Indigenous (Me’phaa and Nancue Ñomndaa) municipalities. A house-to-house survey interviewed women reporting pregnancy or childbirth in the last three years asking about vaccination uptake and willingness to get vaccinated against SARS-CoV-2. We analysed factors associated with vaccination through cluster-adjusted bivariate and multivariate analysis using the Mantel-Haenszel procedure. We report associations as cluster-adjusted odds ratios (ORa). Of 1125 participants, 512 were from Acatepec and 613 from Xochistlahuaca. Some 42% (475/1125) received the SARS-CoV-2 vaccine, 48% (245/512) in Me’phaa (Mixteco) and 38% (230/613), p < 0.01, in Nancue Ñomndaa (Amuzgo) communities. The main reason for non-acceptance was fear of the vaccine (44%, 286/650). Factors associated with the vaccine up-take were education (ORa = 2.12, 95%CI 1.39–3.24), social security coverage (ORa = 2.43, 95%CI 1.44–4.09), cases of COVID-19 at home (ORa = 2.81, 95%CI 1.80–4.39) and husband accompanying to prenatal care (ORa = 1.92, 95%CI 1.38–2.68). Some 43% (283/650) of unvaccinated women reported vaccination willingness, a finding more prominent in Me’phaa (56%, 150/267) than in Nancue Ñomndaa communities (35%, 133/383) (p < 0.01). Factors associated with willingness on multivariate analysis were social security coverage (ORa = 2.60, 95%CI 1.30–5.19), and prenatal care with a Western doctor (ORa = 1.83, 95%CI 1.37–2.44). Women reporting use of home remedies (ORa = 0.86, 95%acl CI 0.74-1.00) and participating in traditional community rituals (ORa = 0.46, 95%acl CI 0.30–0.72) were less likely to report vaccination willingness. Less than one half of women in these predominantly indigenous municipalities had a dose of vaccine against SARS-CoV-2 and nearly one half of unvaccinated women were willing to be vaccinated. With fear of the vaccine the main reason for vaccination, the public health implication is vaccination programs need different ways to prioritize indigenous women. They need to open respectful information sharing and dialogue in indigenous languages and provide meaningful logistical support for those who live in remote communities. We conducted the research through local-language interviews, adopting an intercultural approach and a human rights perspective.
Keywords:
COVID-19 vaccine
Associated factors
Vaccination uptake
Vaccination willingness
Indigenous women
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