COVID-19 vaccination campaign, knowledge, and trust in Duran, Ecuador: a cross-sectional study

Background: The COVID-19 pandemic, resulting in 6.9 million deaths, exposed global health system inequities despite the approval of over nine vaccines in 2022. Methods: The cross-sectional study examined factors affecting the accessibility and equity of SARS-CoV-2 vaccinations in Duran, Ecuador. Demographic surveys conducted in September–October 2021 evaluated self-reported access to COVID-19 vaccines. Equity was assessed using survey questions on trust, knowledge, and risk perception for vaccine acceptance, employing descriptive statistics and Fisher's Exact and Wilcoxon tests. Findings: Among the 341 individuals surveyed, 83.9 % received at least one vaccine, with no disparities based on demographics, and vaccination status was unrelated to age, gender, or occupation. A significantly higher odds ratio was found for vaccinated individuals on the willingness to receive another COVID-19 vaccine compared to individuals not vaccinated (OR: 12.206, 99 % CI [4.545–32.784]). Notable findings include 60.8 % confidence in vaccine effectiveness, and recognition of COVID-19 severity (78.3 %) and infection possibility (76 %). However, in a population with a relatively high prevalence of chronic diseases like obesity (19.4 %), diabetes (18.8 %), and hypertension (32 %), no significant correlation was found between participants' answers to self-perceived risk of SARS-CoV-2 infection and high-risk groups susceptibility to severe diseases. Moreover, 70.1 % of respondents claim knowledge about the virus, but 41.1 % did not know at least one of three transmission ways asked and nearly 50 % were unaware of the incubation period. Participants reported trust in healthcare professionals for COVID-19 information and guidance (73.6 %), and some reliance on the internet and social media as reliable sources of information (40 %). Neither trust scores or knowledge scores were significantly correlated to demographics or clinical variables. Interpretation: Despite an 84.97 % national vaccination rate in Ecuador and a similarly high vaccination rate in Duran, demographic and educational factors influence health practices and warrant further attention. Trust in authorities is notable in this population, but communication strategies should continue to enhance awareness and knowledge about COVID-19, particularly in high-risk groups. The complex interplay of risk-perception, virus knowledge, and susceptibility understanding highlights the need for targeted communication in public health programs.