Choudhary Rewa, Carter Emily, Monzon Jose, Stewart Allison, Slotnick Jennifer, Samayoa Jerez Leslie L, Rodriguez Araujo David S, Zielinski-Gutierrez Emily, Suchdev Parminder S
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA.
Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA.
Vaccines (Basel). 2023 Mar 28;11(4):745. doi: 10.3390/vaccines11040745.
The Republic of Guatemala's reported COVID-19 vaccination coverage is among the lowest in the Americas and there are limited studies describing the disparities in vaccine uptake within the country. We performed a cross-sectional ecological analysis using multi-level modeling to identify sociodemographic characteristics that were associated with low COVID-19 vaccination coverage among Guatemalan municipalities as of 30 November 2022. Municipalities with a higher proportion of people experiencing poverty (β = -0.25, 95% CI: -0.43--0.07) had lower vaccination coverage. Municipalities with a higher proportion of people who had received at least a primary education (β = 0.74, 95% CI: 0.38-1.08), children (β = 1.07, 95% CI: 0.36-1.77), people aged 60 years and older (β = 2.94, 95% CI: 1.70-4.12), and testing for SARS-CoV-2 infection (β = 0.25, 95% CI: 0.14-0.36) had higher vaccination coverage. In the simplified multivariable model, these factors explained 59.4% of the variation in COVID-19 vaccination coverage. Poverty remained significantly associated with low COVID-19 vaccination coverage in two subanalyses restricting the data to the time period of the highest national COVID-19-related death rate and to COVID-19 vaccination coverage only among those aged 60 years or older. Poverty is a key factor associated with low COVID-19 vaccination and focusing public health interventions in municipalities most affected by poverty may help address COVID-19 vaccination and health disparities in Guatemala.
危地马拉共和国报告的新冠疫苗接种覆盖率在美洲处于最低水平，且国内关于疫苗接种差异的研究有限。我们进行了一项横断面生态分析，采用多层次建模来确定截至2022年11月30日与危地马拉各市新冠疫苗接种覆盖率低相关的社会人口特征。贫困人群比例较高的市（β = -0.25，95%置信区间：-0.43--0.07）疫苗接种覆盖率较低。至少接受过小学教育的人群比例较高的市（β = 0.74，95%置信区间：0.38-1.08）、儿童（β = 1.07，95%置信区间：0.36-1.77）、60岁及以上人群（β = 2.94，95%置信区间：1.70-4.12）以及进行过新冠病毒感染检测的市（β = 0.25，95%置信区间：0.14-0.36）疫苗接种覆盖率较高。在简化的多变量模型中，这些因素解释了新冠疫苗接种覆盖率变化的59.4%。在两项子分析中，将数据限制在全国新冠相关死亡率最高的时间段以及仅60岁及以上人群的新冠疫苗接种覆盖率时，贫困仍然与新冠疫苗接种覆盖率低显著相关。贫困是与新冠疫苗接种率低相关的关键因素，将公共卫生干预重点放在受贫困影响最严重的市可能有助于解决危地马拉的新冠疫苗接种和健康差异问题。
