Measuring inequalities in COVID-19 vaccination uptake and intent: results from the Canadian Community Health Survey 2021

Abstract

Background By July 2021, Canada had received enough COVID-19 vaccines to fully vaccinate every eligible Canadian. However, despite the availability of vaccines, some eligible individuals remain unvaccinated. Differences in vaccination uptake can be driven by health inequalities which have been exacerbated and amplified by the pandemic. This study aims to assess inequalities in COVID-19 vaccination uptake and intent in adults 18 years or older across Canada by identifying sociodemographic factors associated with non-vaccination and low vaccination intent using data drawn from the June to August 2021 Canadian Community Health Survey (CCHS). Methods The CCHS is an annual cross-sectional and nationally representative survey conducted by Statistics Canada, which collects health-related information. Since September 2020, questions about the COVID-19 pandemic are asked. Adjusted logistic regression models were fitted to examine associations between vaccination uptake or intent and sociodemographic and health related variables. Region, age, gender, level of education, Indigenous status, visible minority status, perceived health status, and having a regular healthcare provider were considered as predictors, among other factors. Results The analysis included 9,509 respondents. The proportion of unvaccinated was 11%. Non-vaccination was associated with less than university education (aOR up to 3.5, 95% CI 2.1–6.1), living with children under 12 years old (aOR 1.6, 95% CI 1.1–2.4), not having a regular healthcare provider (aOR 1.6, 95% CI 1.1–2.2), and poor self-perceived health (aOR 1.8, 95% CI 1.3–2.4). Only 5% of the population had low intention to get vaccinated. Being unlikely to get vaccinated was associated with the Prairies region (aOR 2.2, 95% CI 1.2–4.1), younger age groups (aOR up to 4.0, 95% CI 1.3–12.3), less than university education (aOR up to 3.8, 95% CI 1.9–7.6), not being part of a visible minority group (aOR 3.0, 95% CI 1.4–6.4), living with children under 12 years old (aOR 1.8, 95% CI 1.1–2.9), unattached individuals (aOR 2.6, 95% CI 1.1–6.1), and poor self-perceived health (aOR 2.0, 95% CI 1.3–2.9). Conclusions Disparities were observed in vaccination uptake and intent among various sociodemographic groups. Awareness of inequalities in COVID-19 vaccination uptake and intent is needed to determine the vaccination barriers to address in vaccination promotion strategies.

Strengthening access to and confidence in COVID-19 vaccines among equity-deserving populations across Canada: An exploratory qualitative study

“…This study examined the strategies used by the provincial authorities of six Canadian jurisdictions to expand COVID-19 vaccination uptake and confidence in populations recommended for vaccine prioritization by NACI (i.e., FNIM, Black communities, essential workers, people experiencing homelessness, and people with disabilities). While research into COVID-19 vaccine equity in Canada has gained great momentum (3, 33, 34), the scientific literature documenting the strategies and interventions for equity in COVID-19 vaccination and the factors influencing their implementation remains scarce, as indicated in a recent scoping review (35). Our work, therefore, makes an important contribution to this knowledge gap.…”

“…Furthermore, vaccine hesitancy was described as an intricate issue rooted in a lack of trust in the public health system and government authorities. (3,33,34), the scientific literature documenting the strategies and interventions for equity in COVID-19 vaccination and the factors influencing their implementation remains scarce, as indicated in a recent scoping review (35). Our work, therefore, makes an important contribution to this knowledge gap.…”

The effect of vaccine mandate announcements on vaccine uptake in Canada: An interrupted time series analysis

“…Lastly, demographic and socioeconomic characteristics known to be associated with vaccine uptake, such as race or ethnicity, level of education and income, were not available in provincial immunization registries [40] , [41] , [42] , [43] , [44] . Further studies are needed to investigate the effect of vaccine mandates on vaccine uptake in sub-population groups across socioeconomic strata.…”

Decision‐Making Around COVID‐19 Public Health Measures and Implications for Self‐Care Activities: Experiences of Persons With Rheumatoid Arthritis

“…[9][10][11][12][13][14][15] Variations in attitudes and decisions about public health measures (eg, staying home while sick, wearing face masks in public spaces, physically distancing, and taking a COVID-19 vaccination) also exist within and across general populations. [16][17][18][19] In a cross-sectional survey in Alberta, Canada, Lang et al found that willingness for COVID-19 vaccination was much greater (68%) than in other Canadian surveys, which reported that only 39% of Canadians would get a COVID-19 vaccine as soon as available. 16,20 Furthermore, reports circulate of some Canadians' frustrations with adopting public health measures.…”

“…Reports indicate that attitudes toward adopting public health measures are generally favorable among persons with rheumatic diseases; however, degrees of hesitancy are also present 9–15 . Variations in attitudes and decisions about public health measures (eg, staying home while sick, wearing face masks in public spaces, physically distancing, and taking a COVID‐19 vaccination) also exist within and across general populations 16–19 . In a cross‐sectional survey in Alberta, Canada, Lang et al found that willingness for COVID‐19 vaccination was much greater (68%) than in other Canadian surveys, which reported that only 39% of Canadians would get a COVID‐19 vaccine as soon as available 16,20 .…”