Efforts expanded with Stage 3 (May to June 2021) prioritizing pregnant women in the second or third trimester and persons 50 years or older. In Stage 2 (February to May 2021), vaccination efforts were prioritized to municipalities with concentrated COVID-19 mortality, starting with those 60 years old and older ( 11, 13).

In Stage 1, Mexico vaccinated 100% of their healthcare personnel (1.25 million people) between December 2020 and February 2021 ( 12). Mexico developed five stages for vaccination rollout ( 11). In Mexico, SARS-CoV-2 has caused over 5.5 million cases of COVID-19 ( 10). Due to the high COVID-19 burden among PWID, there is a need to expand COVID-19 vaccination efforts for this population ( 2, 8, 9).

Additionally, PWID have limited access to health care services and often experience stigma and discrimination that perpetuates medical mistrust, contributing to poor health care utilization ( 6, 7). PWID may experience severe COVID-19 illness due to comorbid conditions, including chronic kidney, liver and lung diseases ( 1, 3– 5). In a previous study of people who inject drugs (PWID) in Tijuana and San Diego, SARS-CoV-2 prevalence was 37.5%, which was higher than the general population in both cities ( 2). Individuals with a diagnosis of substance use disorder, including opioid use disorder, have significantly higher risk of acquiring SARS-CoV-2 and worse clinical outcomes than other COVID-19 patients ( 1).

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