SARS-CoV-2 seroprevalence, vaccination, and hesitancy in agricultural workers in Guatemala

BackgroundDuring the COVID-19 pandemic, serological tests to screen populations have provided better estimates of the cumulative incidence of infection. This study evaluated the seroprevalence of SARS-CoV-2 in agricultural workers in rural Guatemala, their COVID-19 vaccine uptake and vaccination attitudes. MethodsA cross-sectional study was undertaken from August to November of 2021, in agricultural workers at a sugar plantation in Guatemala. A questionnaire was used to collect demographic, previous COVID-19 infection, vaccination, and attitudes toward vaccination. Serological testing was performed to detect SARS-CoV-2 IgM and IgG. ResultsOf the 4,343 study participants, 1,279 (29.4%) were seropositive for SARS-CoV-2 compared to 2.3% who reported previous COVID-19 infection. COVID-19 vaccine coverage was 85% for the first dose and 21.9% for second dose. Vaccine refusal was 0.6%, and 13.9% expressed some degree of vaccine hesitancy. Vaccine hesitant workers or those refusing were less likely to have had the COVID-19 vaccine. Main reasons to get the vaccine were to protect family, coworkers, and community. ConclusionAgricultural workers in countries like Guatemala have suffered a high incidence of asymptomatic and undetected SARS-CoV-2 infection. Most have received the COVID-19 vaccine, but there are moderate degrees of vaccine hesitancy that require better public health information to overcome it.