A qualitative investigation of facilitators and barriers to accessing COVID-19 vaccines among Racialized and Indigenous Peoples in Canada

Abstract

Structural and systemic inequalities can contribute to susceptibility to COVID-19 disease and limited access to vaccines. Recognizing that Racialized and Indigenous Peoples may experience unique barriers to COVID-19 vaccination, this study explored early COVID-19 vaccine accessibility, including barriers and potential solutions to vaccine access, for these communities in Canada. We conducted semi-structured interviews about challenges to accessing COVID-19 vaccination with Racialized and Indigenous Peoples, including linguistic minorities and newcomers, in Spring 2021, just as COVID-19 vaccines were becoming more widely available in Canada. Participants were purposely selected from respondents to a Canadian national online survey. Three researchers analyzed the interviews for emergent themes using a descriptive content analysis approach in NVivo. At the time of the interview, interview participants (N = 27) intended to receive (n = 15) or had received (n = 11) at least one vaccine dose, or did not state their status (n = 1). Participants described multiple barriers to COVID-19 vaccination that they personally experienced and/or anticipated they or others could experience – including technology requirements, language barriers, lack of identification documentation, and travel challenges – as well as related solutions. These were organized into three broad categories: 1) COVID-19 disease and vaccination information, 2) vaccination booking procedures, and 3) vaccination sites. These structural and systemic barriers during the initial months of vaccine rollout substantially restricted participants’ COVID-19 vaccination access, even when they were eager to get vaccinated, and should be addressed early in vaccine rollouts to facilitate optimal uptake for everyone everywhere

Decisions and Decisional Needs of Canadians From all Provinces and Territories During the COVID-19 Pandemic: Population-Based Cross-sectional Surveys

“…However, not all information is accessible. Racialized and Indigenous Canadians described that the barriers to understanding COVID-19 public health information were the use of unfamiliar medical terminology, limited to English or French, and requiring technology to access the information (eg, the internet, television) [ 51 ]. Hence, our findings indicate the importance of monitoring and better supporting those experiencing SDC with plain-language interventions designed to ensure accessibility for all Canadians.…”

Flames of transformation: Igniting better mental and physical health for racialized and gendered North Americans

“…Research with BIPOC communities in Canada illustrates that amongst those who held off from immediate vaccination, logistics such as long distances and difficulties with securing appointment time, accounted for lower vaccine uptake ( 108 ). Furthermore, some BIPOC were unable to be vaccinated because of a lack of access to online technologies, cold chain medical equipment, language barriers, and lack of identification documentation ( 108 , 109 ). Finally, other BIPOC felt they needed more information about COVID-19 and the science behind vaccines ( 108 ).…”

Characteristics of immunisation support programmes in Canada: a scoping review and environmental scan

“…12 13 Other barriers include access to technology (eg, to book appointments); language barriers; lack of identification documentation; and travel challenges. 11 Stark differences among the vaccine-related support needs of populations in Canada necessitate tailored, individualised support regarding immunisation. 14 The general public's ability to make informed decisions about immunisation is dependent on access to clear, evidence-based information.…”

“…The COVID-19 vaccine rollout in Canada resulted in a prioritisation of individuals from different high-risk groups 9 ; however, disparities in health services due to cultural and language barriers 10 precluded some ethnic groups from timely participation in the COVID-19 vaccine campaign. 11 Barriers experienced by marginalised persons, including Indigenous peoples in Canada, predominately stem from historical and ongoing mistreatment, racism and culturally inappropriate care by the healthcare system. 12 13 Other barriers include access to technology (eg, to book appointments); language barriers; lack of identification documentation; and travel challenges.…”

“…12 13 Other barriers include access to technology (eg, to book appointments); language barriers; lack of identification documentation; and travel challenges. 11 …”