Globally, the SARS-CoV-2 pandemic was catastrophic. In Mexico, the effects were shocking. In Guerrero, the most vulnerable and low-income groups suffered the strongest effects. Indigenous peoples were drastically hit partly because they live far from health services. The lack of information prevented them from taking preventive measures. This population implemented its own sanitary measures to control access to the communities and resorted to traditional medicine and the use of traditional plant-based remedies. Despite the benefits of vaccination against SARS-CoV-2, of the 75 million people vaccinated in the country, less than one million had a complete scheme in 2022. We evaluated vaccination coverage against SARS-CoV-2 in indigenous women in Guerrero with childbirth or pregnancy in the last three years. This cross-sectional study (December 2021 to January 2022) included five Me'phaa communities in Acatepec and six Ñomndaa communities in Xochistlahuaca, Guerrero. Trained female interviewers administered the questionnaires in the local language. We measured the number of women with one vaccination dose and their demographic and cultural characteristics. A bivariate and multivariate analysis identified associations using cluster-adjusted odds ratios (ORna) with 95% confidence intervals (95%CI). A total of 1125 women participated (Acatepec = 512 and Xochistlahuaca = 613). Some 475 women (42%) had at least one shot (Acatepec = 48% or 245/512 and Xochistlahuaca 38% or 230/613). Women with secondary education (ORna 1.95, 95%CI 1.39-3.24), social security coverage (ORna 1.97, 95%CI 1.44-4.09), having a history of COVID-19 cases at home (ORna 1.87, 95%CI 1.80-4.39) and being accompanied of their husbands for antenatal care (ORna 2.02 95%CI 1.38-2.68) were more likely to receive one dose. The main reason for avoiding vaccination was fear of it (44%, 286/650). In the indigenous regions of Guerrero, vaccination coverage was low, particularly among those women with higher risk factors for poor maternal health outcomes.
