Changing Attitudes and Motivations Around Coronavirus Disease 2019 Vaccination Within an Agricultural Community in Southwest Guatemala.

Guatemala has one of the lowest coronavirus disease 2019 vaccination rates in the Americas, with rural communities experiencing disproportionately low coverage. A 2021-2022 vaccine knowledge and behaviors survey of households in a rural community in southwest Guatemala revealed that access was a significant barrier, particularly among women and those who did not work outside the home. For the present study, a follow-up survey was conducted in 2023 to assess changes in vaccine access, hesitancy, and motivations. Both surveys were completed by 199 people. Among those eligible for vaccination at enrollment, the proportion vaccinated increased from 47% to 77%. The primary motivations for vaccination remained protecting family and friends, although concern for personal health increased. Regression models did not identify significant predictors of vaccine uptake, although household size approached significance. The findings highlight the importance of ongoing efforts to improve vaccine access and information, particularly in addressing the significant proportion of individuals who are uncertain about their motivations for vaccination.