COVID-19 Vaccination Hesitancy in Mexico City among Healthy Adults and Adults with Chronic Diseases: A Survey of Complacency, Confidence, and Convenience Challenges in the Transition to Endemic Control

Abstract

Background. Monitoring of SARS-COV-2 vaccine hesitancy is important for epidemic control. We measured vaccine hesitancy among healthy adults and adults with chronic diseases after they had been offered the first dose of the vaccine in Mexico City. Methods. An observational cross-sectional study was undertaken among 185 healthy adults and 175 adults living with chronic diseases. Differences in means of variables for confidence, complacency, and convenience were analyzed. Aggregate indicators were constructed and their association with socioeconomic and demographic conditions and vaccination acceptance analyzed using multivariate analysis of variance and multivariate logistic analysis. Results. Up to 16.8% of healthy adults and 10.3% of sick adults reported not having received the SARS-COV-2 vaccine. Healthy adults were more complacent about COVID-19 risks than adults with chronic diseases, while no differences were found between the two groups regarding other hesitancy aggregate indicators. Among adults with chronic diseases, those with more education and enrolled with a social insurance institution were less complacent of COVID-19, while education was positively associated with convenience across both groups. Less complacency with COVID-19 and more confidence in the vaccine were associated with higher vaccine acceptance across both groups. Among adults living with chronic diseases, the odds ratios of vaccine acceptance were higher for less complacency (OR = 2.4, p = 0.007) than for confidence (OR = 2.0, p = 0.001). Odds ratios of vaccine acceptance in these two hesitancy indicators were similar among healthy adults (OR = 3.3, p = <0.005) and higher than for adults with comorbidities. Conclusions. Confidence in the vaccine and complacency regarding COVID-19 risks play an important role for vaccine acceptance in Mexico City, particularly among healthy adults. The perception of risk regarding COVID-19 is more important than confidence in vaccine safety and effectiveness. Promotion of COVID-19 vaccines needs to focus on decreasing complacency with COVID-19 and increasing vaccine confidence, particularly among healthy adults.

Vaccination status and attitudes towards COVID-19 vaccination in patients undergoing active cancer treatment in a referral center in Mexico: a survey study

“…However, a more recent survey conducted during the early vaccination rollout period in Mexico City (May-June 2021) found that the prevalence of vaccine hesitancy was 6% among the general population [20], similar to the percentage of patients in our study who had not received any vaccine dose against COVID-19. Finally, a later survey conducted among healthy adults and adults with chronic diseases in Mexico City (December 2021) found that 10.3% of adults with chronic diseases were not vaccinated against COVID-19 [21]. Therefore, patients with cancer undergoing active cancer treatment in our center appear to be less reluctant to COVID-19 vaccination than expected.…”

COVID-19 vaccine hesitancy prevalence in Mexico: A systematic review and metanalysis

“…The only study directly comparing VH between healthy adults and those living with comorbidities suggest a significantly higher prevalence of VH among those living with comorbidities. [29] VH in higher-risk populations in Mexico may be higher compared to other Latin American countries, particularly in older adults. [36] In a study among US residents, 18 % of respondents with chronic conditions reported VH.…”

“…González-Block et al studied VH among those living with a chronic disease including hypertension, gastritis, diabetes, cancer and pulmonary, renal, or cardiovascular disease. [29] Refusal was higher among healthy adults compared to adults with chronic diseases (15 % vs 7 %, respectively). Confidence, complacency, and convenience was similar between groups, healthy adults, and those living with chronic conditions; COVID-19 risk perception was higher among adults with chronic disease.…”

Estimation of vaccination coverage and associated factors in older Mexican adults

“…When these variables make vaccine uptake difficult, we are referring to vaccine hesitancy. There is evidence that a higher trust in safety and efficacy alongside a high perception of contagion risk between populations could increase the probability of vaccine uptake for COVID-19 [ 37 ] and influenza [ 38 ]. It is therefore important to further investigate the role of these variables in older adults for pneumococcus, influenza, and Td vaccines.…”