COVID-19 Vaccination Uptake Among Individuals With Immune-mediated Inflammatory Diseases in Ontario, Canada, Between December 2020 and October 2021: A Population-based Analysis

Abstract

Objective We assessed COVID-19 vaccine uptake among individuals with immune-mediated inflammatory diseases (IMID) and the Ontario general population. Methods We studied all residents 16 years and older who were alive and enrolled in Ontario's universal health insurance plan as of December 14, 2020 when vaccination commenced (n=12,435,914). Individuals with rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PsA), psoriasis (PsO), and inflammatory bowel disease (IBD) were identified using established disease-specific case definitions applied to health administrative data. Vaccination status was extracted from the provincial COVaxON registry. Weekly cumulative proportions of first and second doses up until October 3, 2021 were expressed as the vaccinated percentage of each disease group, and compared to the general Ontario population, and stratified by age. Results By October 3, 2021, the cumulative percentage with at least one dose was 82.1% for the general population, 88.9% for RA, 87.4% for AS, 90.6% for PsA, 87.3% for PsO, and 87.0% for IBD. There was also a higher total cumulative percentage with two doses among IMIDs (83.8-88.2%) vs the general population (78.0%). The difference was also evident when stratifying by age. Individuals with IMIDs in the youngest age group initially had earlier uptake than the general population but remain the lowest age group with two doses (70.6% in the general population vs. 73.7-79.2% across IMID groups). Conclusion While implementation of COVID-19 vaccination programs has differed globally, these Canadian estimates are the first to reassuringly show higher COVID-19 vaccine uptake among individuals with IMIDs.

Attitudes toward coronavirus disease 2019 vaccination in people with multiple sclerosis

“…16 A study relying on administrative claims data in Ontario, Canada assessed uptake of COVID-19 vaccine as of October 2021 among individuals with several immune-mediated inflammatory diseases (IMID) including rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, psoriasis, and inflammatory bowel disease as compared to the general population. 17 Eighty-two percent of the general Ontario population had received at least one dose of the COVID-19 vaccine, whereas uptake ranged from 87.3% to 90.6% in those with an IMID.…”

Vaccine effectiveness against SARS-CoV-2 infection and severe outcomes among individuals with immune-mediated inflammatory diseases tested between March 1 and Nov 22, 2021, in Ontario, Canada: a population-based analysis

“…The details of the immunisation rollout in Ontario has been previously reported. 17 Briefly, due to low vaccine supply, Ontario initially had a slow and low vaccine uptake between December, 2020, and March, 2021, during which time vaccines were prioritised for residents and staff of long-term care and retirement homes, health-care workers, and adults aged 80 years and older. By March, 2021, vaccination of residents was largely prioritised by age (in decreasing age group increments) in rapid succession, resulting in a rapid increase in vaccine uptake of one and two doses among all age groups between March and July, 2021.…”

“…By March, 2021, vaccination of residents was largely prioritised by age (in decreasing age group increments) in rapid succession, resulting in a rapid increase in vaccine uptake of one and two doses among all age groups between March and July, 2021. 17 Administration of third doses started in September, 2021. 18 Most people with immunemediated inflammatory diseases in Ontario were given the BNT162b2 (Pfizer-BioNTech) vaccine (>70%) and the mRNA-1273 (Moderna) vaccine (>18%) as part of their initial two doses, and few patients (<10%) received the Covishield vaccine (also known as ChAdOx1 nCoV-19; Oxford-AstraZeneca).…”

“…[10][11][12][13][14] Although policy and clinical recommendations on COVID-19 vaccination for people with immune-mediated inflammatory diseases have largely been driven by research on immunogenicity, 15,16 understanding how well these vaccines work in broader immune-mediated inflammatory disease populations remains a priority, especially because they are under-represented in clinical studies. Therefore, we aimed to estimate the vaccine effectiveness of mRNA-based COVID-19 vaccines against SARS-CoV-2 infection and severe COVID-19 outcomes among individuals with a selection of immune-mediated inflammatory diseases in Ontario, Canada, over the period March to November, 2021, during which there was rapid uptake of vaccinations in the province, 17 and the predominant circulating SARS-CoV-2 variants were alpha (B.1.1.7; March to June, 2021) and delta (B.1.617.2; June to November, 2021). 1…”

SARS-CoV-2 vaccination willingness and predictors in patients with chronic inflammatory rheumatic diseases (CIRD) and without CIRD

“…This was very recently confirmed in a large Canadian study which showed a high COVID-19 vaccine uptake among individuals with immune-mediated inflammatory diseases. 44 …”