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.

Clinical and Economic Impact of COVID-19 on Plantation Workers: Preliminary Results from the Guatemala Agricultural Workers and Respiratory Illness Impact (AGRI) Study

We evaluated the clinical and socioeconomic burdens of respiratory disease in a cohort of Guatemalan banana plantation workers. All eligible workers were offered enrollment from June 15-December 30, 2020, and annually, then followed for influenza-like illnesses (ILI) through: 1) self-reporting to study nurses, 2) sentinel surveillance at health posts, and 3) absenteeism. Workers with ILI submitted nasopharyngeal swabs for influenza, RSV, and SARS-CoV-2 testing, then completed surveys at days 0, 7, and 28. Through October 10, 2021, 1,833 workers developed 169 ILIs (12.0/100 person-years) and 43 (25.4%) of these ILIs were laboratory-confirmed SARS-CoV-2 (3.1/100 person-years). Workers with SARS-CoV-2-positive ILI reported more anosmia (p<0.01), dysgeusia (p<0.01), difficulty concentrating (p=0.01), and irritability (p=0.01), and greater clinical and well-being severity scores (Flu-iiQ) than test-negative ILIs; they also had greater absenteeism (p<0.01) and lost income (median US$127.1, p<0.01). These results support the prioritization of Guatemalan farm workers for COVID-19 vaccination.