Determinants of COVID-19 Vaccine Acceptance and Uptake in a Transborder Population at the Mexico-Guatemala Border, September-November 2021

Int J Environ Res Public Health. 2022 Jun 6;19(11):6919. doi: 10.3390/ijerph19116919.


Assessing COVID-19 vaccination uptake of transborder populations is critical for informing public health policies. We conducted a probability (time-venue) survey of adults crossing from Mexico into Guatemala from September to November 2021, with the objective of describing COVID-19 vaccination status, willingness to get vaccinated, and associated factors. The main outcomes were receipt of ≥1 dose of a COVID-19 vaccine, being fully vaccinated, and willingness to get vaccinated. We assessed the association of outcomes with sociodemographic characteristics using logistic regressions. Of 6518 participants, 50.6% (95%CI 48.3,53.0) were vaccinated (at least one dose); 23.3% (95%CI 21.4,25.2) were unvaccinated but willing to get vaccinated, and 26.1% (95%CI 24.1,28.3) were unvaccinated and unwilling to get vaccinated. Those living in Mexico, independent of country of birth, had the highest proportion vaccinated. The main reason for unwillingness was fear of side effects of COVID-19 vaccines (47.7%, 95%CI 43.6,51.9). Education level was positively associated with the odds of partial and full vaccination as well as willingness to get vaccinated. People identified as Catholic had higher odds of getting vaccinated and being fully vaccinated than members of other religious groups or the non-religious. Further studies should explore barriers to vaccination among those willing to get vaccinated and the motives of the unwilling.

Keywords: COVID-19; Mexico–Guatemala Border; international borders; social determinants; vaccination; vaccine acceptance.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • COVID-19 Vaccines*
  • COVID-19* / prevention & control
  • Cross-Sectional Studies
  • Guatemala
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Mexico
  • Vaccination


  • COVID-19 Vaccines

Grants and funding

This survey was funded by the Centers for Disease Control and Prevention of the United States of America (GRANT: NU50CK000493) through the CDC–Mexico Cooperative Agreement for Surveillance, Epidemiology, and Laboratory Capacity with Fundación México-Estados Unidos para la Ciencia (FUMEC).