COVID-19 vaccine coverage and factors associated with vaccine uptake among 23 247 adults with a recent history of homelessness in Ontario, Canada: a population-based cohort study

Shariff, Salimah Z.; Richard, Lucie; Hwang, Stephen W.; Kwong, Jeffrey C.; Forchuk, Cheryl; Dosani, Naheed; Booth, Richard

doi:10.1016/s2468-2667(22)00037-8

Cited by 35 publications

(46 citation statements)

References 19 publications

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“…US-based estimates place coverage among PEH 11.0%–37.2% lower than the general US population 31 32. Another recent Canadian study suggests vaccination rates among Ontario PEH who use healthcare are 25% lower than that of adult Ontarians 33…”

Section: Background and Rationalementioning

confidence: 99%

Ku-gaa-gii pimitizi-win, the COVID-19 cohort study of people experiencing homelessness in Toronto, Canada: a study protocol

et al. 2022

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IntroductionInitial reports suggest people experiencing homelessness (PEH) are at high risk for SARS-CoV-2 infection and associated morbidity and mortality. However, there have been few longitudinal evaluations of the spread and impact of COVID-19 among PEH. This study will estimate the prevalence and incidence of COVID-19 infections in a cohort of PEH followed prospectively in Toronto, Canada. It will also examine associations between individual-level and shelter-level characteristics with COVID-19 infection, adverse health outcomes related to infection and vaccination. Finally, the data will be used to develop and parameterise a mathematical model to characterise SARS-CoV-2 transmission dynamics, and the transmission impact of interventions serving PEH.Design, methods and analysisKu-gaa-gii pimitizi-win will follow a random sample of PEH from across Toronto (Canada) for 12 months. 736 participants were enrolled between June and September 2021, and will be followed up at 3-month intervals. At each interval, specimens (saliva, capillary blood) will be collected to determine active SARS-CoV-2 infection and serologic evidence of past infection and/or vaccination, and a detailed survey will gather self-reported information, including a detailed housing history. To examine the association between individual-level and shelter-level characteristics on COVID-19-related infection, adverse outcomes, and vaccination, shelter and healthcare administrative data will be linked to participant study data. Healthcare administrative data will also be used to examine long-term (up to 5 years) COVID-19-related outcomes among participants.Ethics and disseminationEthical approval was obtained from the Unity Health Toronto and University of Toronto Health Sciences Research Ethics Boards (# 20-272). Ku-gaa-gii pimitizi-win was designed in collaboration with community and service provider partners and people having lived experience of homelessness. Findings will be reported to groups supporting Ku-gaa-gii pimitizi-win, Indigenous and other community partners and service providers, funding bodies, public health agencies and all levels of government to inform policy and public health programs.

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Section: Background and Rationalementioning

confidence: 99%

Ku-gaa-gii pimitizi-win, the COVID-19 cohort study of people experiencing homelessness in Toronto, Canada: a study protocol

et al. 2022

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“…Systematic reviews have already shown that previous seasonal influenza vaccination history is a strong predictive factor for individuals to accept a COVID-19 vaccine, both for themselves and their children (Galanis, Vraka, et al, 2021; Galanis, Vraka, Siskou, Konstantakopoulou, Katsiroumpa, & Kaitelidou, 2022a; Li et al, 2021; Luo et al, 2021; Shamshirsaz et al, 2021). Moreover, recent studies expand this evidence by confirming that COVID-19 vaccination uptake is more common among individuals that are already vaccinated against the seasonal influenza (Doran et al, 2022; Galanis, Moisoglou, et al, 2021; Galanis, Vraka, Siskou, Konstantakopoulou, Katsiroumpa, Moisoglou, et al, 2022; Gilboa et al, 2021; Shariff et al, 2022). Influenza vaccination during the COVID-19 pandemic is crucial since may have a protective role against the COVID-19 pandemic by reducing SARS-CoV-2 infection rate, hospitalization, severity of COVID-19, admission to intensive care unit and mortality (Wang et al, 2021; Zeynali Bujani et al, 2021).…”

Section: Discussionmentioning

confidence: 88%

Psychosocial predictors of COVID-19 vaccine uptake among pregnant women: a cross-sectional study in Greece

Galanis

Vraka

Katsiroumpa

et al. 2022

Preprint

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Background: Unvaccinated pregnant women with symptomatic COVID-19 have been found to have a higher risk of iatrogenic preterm births, intensive care unit admission, and invasive ventilation. Objective: To estimate the vaccination rate of pregnant women against the COVID-19 and to evaluate psychosocial factors associated with vaccine uptake among them. Methods: We conducted an anonymous cross-sectional study with a convenience sample in Greece from December 2021 to March 2022. We measured socio-demographic data of pregnant women, COVID-19-related vaccination status, worry about the side effects of COVID-19 vaccines, trust in COVID-19 vaccines, and COVID-19-related stress. Results: The study population included 812 pregnant women with a mean age of 31.6 years. Among the pregnant women, 58.6% had received a COVID-19 vaccine. The most important reasons that pregnant women were not vaccinated were doubts about the safety and effectiveness of COVID-19 vaccines (31.4%), fear that COVID-19 vaccines could be harmful to fetus (29.4%), and fear of adverse side effects of COVID-19 vaccines (29.4%). Increased danger and contamination fears, increased fears about economic consequences, and higher levels of trust in COVID-19 vaccines were related with COVID-19 vaccine uptake. On the other hand, increased compulsive checking and reassurance seeking and increased worry about the adverse side effects of COVID-19 vaccines reduced the likelihood of pregnant women being vaccinated against the COVID-19. Conclusions: An understanding of the psychosocial factors associated with COVID-19 vaccine uptake in pregnant women is paramount to persuade women to get vaccinated against the COVID-19. There is a need for targeted educational campaigns to increase knowledge about COVID-19 vaccines and reduce COVID-19 vaccine hesitancy in pregnancy.

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“…One study examines uptake among US military veterans attending homelessness centres; this was conducted much earlier in the vaccination campaign, and reports that 46% of homeless veterans were vaccinated in August 2021, as compared to 51% of all veterans [18]. Two recent studies in Ontario, Canada, and Denmark used database mining to derive coverage estimates for homeless individuals, which were similar to those in our Streets stratum [19, 20].…”

Section: Discussionmentioning

confidence: 96%

“…No official French data for COVID-19 vaccine coverage in migrants, homeless, or roofless populations exist. Few global data are available on vaccine uptake among PEH/PH; we identified only three quantitative [18][19][20] studies and no reports on drivers of or barriers to COVID-19 vaccination.…”

Section: Introductionmentioning

confidence: 99%

Drivers and prevalence of COVID-19 vaccine uptake among homeless and precariously housed people in France: a cross-sectional population-based study

Roederer¹,

Mollo

VINCENT³

et al. 2022

Preprint

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Background Few global data exist regarding COVID-19 vaccine coverage in people experiencing homelessness (PEH) or precariously housed (PH) who are at high risk for COVID-19 infection, hospitalization, and death. Given the absence of documented French data, we aimed to determine COVID-19 vaccine coverage in PEH/PH in France, and its drivers. Methods We carried out a cross-sectional study following a two-stage cluster-sampling design in Ile-de-France and Marseille, France, in late 2021. Participants aged over 18 years were recruited where they slept the previous night and then stratified for analysis into three housing groups (Streets, Accommodated, and Housed). Interviews were conducted face-to-face in the participant's preferred language. Multilevel univariate and multivariable logistic regression models were built. Findings 3,690 individuals were surveyed: 855 in the Housed stratum, 2,321 in the Accommodated stratum and 514 in the Streets stratum. 76.2% (95%CI 74.3-78.1) reported receiving at least one COVID-19 vaccine dose. Vaccine uptake varied by stratum, with uptake highest (85.6%; reference) in Housed, followed by Accommodated (75.4%; AOR=0.79; 95%CI 0.51-1.09 vs Housed) and lowest in Streets (42.0%; AOR=0.38; 95%CI 0.25-0.57 vs Housed). Use for vaccine certificate, socioeconomic drivers, and vaccine hesitancy explained vaccine coverage. Interpretation In France, PEH/PH are less likely than the general population likely to receive COVID-19 vaccines; with the most excluded being the least likely. The influence of both structural drivers and vaccine beliefs in PEH/PH reinforce the importance of targeted outreach, on-site vaccination and sensitisation activities to further vaccine uptake. Funding Sante Publique France, Agence Nationale de Recherches sur le Sida/Capnet, Agence Regionale de Sante-Ile de France, Medecins Sans Frontieres, and Societe de Pathologie Infectieuse de Langue Francaise.

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COVID-19 vaccine coverage and factors associated with vaccine uptake among 23 247 adults with a recent history of homelessness in Ontario, Canada: a population-based cohort study

Cited by 35 publications

References 19 publications

Ku-gaa-gii pimitizi-win, the COVID-19 cohort study of people experiencing homelessness in Toronto, Canada: a study protocol

Ku-gaa-gii pimitizi-win, the COVID-19 cohort study of people experiencing homelessness in Toronto, Canada: a study protocol

Psychosocial predictors of COVID-19 vaccine uptake among pregnant women: a cross-sectional study in Greece

Drivers and prevalence of COVID-19 vaccine uptake among homeless and precariously housed people in France: a cross-sectional population-based study

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