DLSPH Researchers Study Canadian Vaccine Distribution From an Equity Lens
DLSPH researchers and colleagues from across Canada are studying the distribution of COVID-19 vaccines in seven Canadian jurisdictions to learn the best ways of reaching equity-deserving and at-risk populations.
Prof. Monica Aggarwal and her team received $500,000 from the Canadian Institutes of Health Research for a year-long study that will advance knowledge on how to design and implement strategies to meet the needs of diverse communities. The study is focused on equity-deserving populations (i.e., Black; racialized; 2SLGBTQ+ and low-income communities; immigrants; those experiencing housing precarity or with low levels of English/French fluency; and at-risk populations (children under the age of 12).
In announcing the CIHR award on March 4, the Hon. Jean-Yves Duclos, Minister of Health, said, “We are committed to getting all Canadians through the COVID-19 pandemic safely. These new research projects will provide evidence to guide our efforts in addressing the needs of communities who continue to experience disproportionate impacts from the pandemic while ensuring that our health care works for everyone.”
Vaccine hesitancy among underserved, at-risk communities is an ongoing challenge in Canada and around the world. “Researchers must learn how best to reach these populations, not only to fight COVID-19 today but also to be better prepared for future variants or future pandemics,” says Aggarwal, a professor in DLSPH’s Division of Clinical Public Health. Experts expect that future mass vaccination efforts will be needed again in the coming months and years.
The team will study how vaccine distribution approaches influence the uptake and acceptance of COVID-19 vaccines in British Columbia, Alberta, Manitoba, Ontario, Quebec, Nova Scotia, and Newfoundland.
They will use a mixed-methods approach to examine the factors that may influence different vaccine distribution approaches, compare vaccination rates for various populations associated with different vaccine delivery channels, and provide recommendations for future vaccine distribution approaches.
“There’s been a lot of research on the factors that influence vaccination uptake and acceptance, however the literature on equitable vaccine distribution approaches for diverse and at-risk individuals is limited,” “Our understanding of the factors that influence these approaches is even more scarce.”
Aggarwal hypothesizes that some vaccine distribution channels are more effective than others in reaching equity-deserving and at-risk populations groups.
“I would think that a vaccine-hesitant individual might be more willing to listen to their family doctor or nurse practitioners or their team of providers compared to a random health care professional in a hospital or mass vaccination clinic,” she says. “The foundation of trust between the provider and patient is fundamental to overcoming vaccine hesitancy and is much more embedded in certain approaches compared to others.”
Vaccine distribution approaches have evolved across Canada, resulting in differing vaccination rates. The study will use the Socio-Ecological Model approach to explore the role of individual, interpersonal, organizational, community, contextual and policy factors that influence the success or failure of various vaccine distribution approaches across the seven jurisdictions.
“I am really interested in understanding why Newfoundland and Labrador have the highest vaccination rates in Canada,” she says. “What vaccine distribution approaches did they use? How effective were these approaches in vaccinating equity deserving and at-risk populations? What were the barriers and facilitators? What can we learn from their experience as we design future vaccination distribution strategies?
“I am also excited about having the opportunity to co-design recommendations in focus groups with individuals with lived experience, caregivers, healthcare providers, public health experts, policymakers. Our study will draw attention to the voice of equity-deserving populations and at-risk populations who will have a key role in providing input on the design of recommendations for policymakers, which may someday influence decisions about equitable vaccine distribution strategies in Canada and abroad.”
The team includes co-principal investigators Profs. Alan Katz at the University of Manitoba; Fariba Aghajafari at the University of Calgary; Kris Aubrey-Bassler at Memorial University of Newfoundland; Mylaine Breton at Universite de Sherbrooke; Noah Ivers at U of T’s Faculty of Medicine and Women’s College Hospital; Ruth Martin-Misener at Dalhousie University; Ross Upshur at DLSPH; and Sabrina Wong at the University of British Columbia.
Photo: Prof. Monica Aggarwal