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COVID-19 Vaccination Hesitancy in Mexico City Across Risk Groups. Complacency, Confidence and Convenience Challenges in the Transition to Endemic Control

35 Pages Posted: 12 Apr 2022

See all articles by Miguel Ángel Gonzalez-Block

Miguel Ángel Gonzalez-Block

Anahuac University

Emilio Gutiérrez-Calderón

National Autonomous University of Mexico (UNAM)

Elsa Sarti

Academia Nacional de Medicina



Introduction: SARS-COV-2 vaccination is critical to reduce COVID-19 mortality. Monitoring of vaccine hesitancy is important after high vaccination rates are achieved in the pandemic and as boosters and new vaccines are rolled out aiming towards endemic control. We measured vaccine hesitancy across risk groups after high vaccination rates had been achieved.

Methods: A random household survey was applied to 486 individuals in Mexico City, distributed equally across older adults, adults living with chronic diseases and healthy adults. Differences in means were analyzed for confidence, complacency, and convenience variables. Aggregate indicators were constructed for each of the three domains and their association to socioeconomic and demographic conditions and to vaccination acceptance were analyzed using analysis of variance and multiple logistic analysis.

Results: Up to 90.1% of adults reported having received at least one dose of a SARS-COV-2 vaccine. Healthy adults are more complacent and older adults more confident relative to other risk groups. Adults living with chronic diseases express greater convenience with respect to older adults. Less complacent adults living with chronic diseases are more likely to have been vaccinated (OR=4.164) while confidence plays less of a role to induce vaccine acceptance (OR=2.197 to 2.588 across risk groups).

Discussion: Vaccination is recognized as a tool against infection rather than to protect against hospitalization and death. High vaccination rates are being achieved more out fear of COVID-19 mortality than out of confidence in the vaccine. As mortality rates drop it is likely that complacency will increase, leading to rejection of vaccine boosters or of new vaccines and hance to the resurgence of COVID-19. Our results are indicative of likely scenarios across urban Mexico and for other urban regions of the world.

Conclusions: Promotion of the COVID-19 vaccine needs to focus on decreasing complacency and increasing confidence, particularly among adults living with chronic diseases, with opportunities to improve convenience across all risk groups.

Funding: The study was funded by the Asociación Mexicana de la Industria de Innovación
Farmacéutica (AMIIF).

Declaration of Interest: The authors declare n o conflict of interest.

Ethical Approval: The protocol was approved by research ethics committee of the Faculty of Health Sciences of Anahuac University, Project No. 202112.

Keywords: COVID-19, Vaccination, vaccine hesitancy, Mexico

Suggested Citation

Gonzalez-Block, Miguel Ángel and Gutiérrez-Calderón, Emilio and Sarti, Elsa, COVID-19 Vaccination Hesitancy in Mexico City Across Risk Groups. Complacency, Confidence and Convenience Challenges in the Transition to Endemic Control. Available at SSRN: or

Emilio Gutiérrez-Calderón

National Autonomous University of Mexico (UNAM) ( email )

Elsa Sarti

Academia Nacional de Medicina ( email )


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