COVID-19 vaccine coverage among immigrants and refugees in Alberta: A population-based cross-sectional study

Abstract

Background Studies have shown that immigrants have lower vaccination rates than the Canadian-born population. We sought to assess COVID-19 vaccine coverage and factors associated with uptake among foreign-born immigrants relative to the non-immigrant population in Alberta, Canada. Methods In this cross-sectional study, we analysed population-based linked administrative health data from Alberta to examine vaccine coverage for 3 931 698 Albertans, of which 731 217 were immigrants. We calculated COVID-19 vaccination coverage as the proportion of eligible Albertans with a record of receiving at least one dose of a COVID-19 vaccine as of November 29, 2021. We used multivariable logistic regression to examine the association of vaccine coverage with migration status (immigrants: four categories based on time since migration and non-immigrants) adjusting for socio-demographic variables. Results Overall, COVID-19 vaccination coverage was 78.2% (95% confidence interval (CI) = 78.1%-78.3%) among immigrants and 76.0% (95% CI = 75.9%-76.0%) among non-immigrants. Coverage among immigrants differed by continent of origin, with North America, Oceania, and Europe having the lowest coverage. Although vaccine coverage was relatively uniform across neighbourhood income quintiles for immigrants, immigrants living in rural areas had lower vaccine coverage compared to non-immigrants living in rural areas. Multivariable logistic regression analysis showed a significant interaction between age category and migration status. While immigrants below 50 years of age generally had significantly higher vaccine coverage compared to non-immigrants, there was some variation based on time since migration. Immigrants above 50 years of age showed significantly lower coverage compared to non-immigrants of the same age. Conclusions Public health interventions should focus on older immigrants, immigrants living in rural areas, and immigrants from specific continental backgrounds in order to improve COVID-19 vaccination coverage.

Navigating vaccination choices: The intersecting dynamics of institutional trust, belonging and message perception among Congolese migrants in the UK (A reflexive thematic analysis)

“…Migrants suffered disproportionately during the COVID-19 pandemic, facing heightened health risks (1)(2)(3)(4), poorer health outcomes (1,(5)(6)(7)(8) and lower vaccine uptake rates (9)(10)(11)(12)(13)(14)(15), compared to nonmigrant communities. There is an urgent need to critically examine the structural factors underpinning these inequitable outcomes, to guide the design of inclusive interventions and policies which can advance health and vaccine equity.…”

How did we protect children against COVID-19 in Iran? Prevalence of COVID-19 and vaccination in the socio-economic context of COVID-19 epidemic

“…Our findings also showed that 24.6% of Afghan participants, compared to 4.7% of Iranian respondents, believed vaccination was ineffective against COVID-19. In this regard, a study in Canada found higher rates of non-vaccination in children 12–17 years old in immigrant communities compared to non-immigrants [ 37 ]. Other studies have highlighted factors associated with COVID-19 vaccination in immigrants, including the inequality in vaccination and lower access to health care in low-income groups, such as refugees and immigrants, and barriers such as lack of knowledge of the benefits and risks of vaccines, social norms (such as the concept of “fatalism” expresses the belief that everything that happens in life is predetermined, it is not possible to go beyond this predetermination) [ 38 ] and effects, lack of information on how to access to the vaccine, and fear of being detained, imprisoned or deported [ 39 ].…”

COVID-19 Vaccine Uptake in Immigrant, Refugee, and Nonimmigrant Children and Adolescents in Ontario, Canada

“…Our findings of higher vaccine coverage in immigrants is consistent with a study of adolescents and adults from Alberta, Canada, which found higher vaccine coverage (78% vs 76%) in immigrants compared with nonimmigrants. However, it did not distinguish immigrants and refugees, assess generations, or include children . In our study, refugees, and particularly refugee children, were more likely to be undervaccinated, which is consistent with data on routine and COVID-19 immunizations in European refugees .…”

“…However, it did not distinguish immigrants and refugees, assess generations, or include children. 50 In our study, refugees, and particularly refugee children, were more likely to be undervaccinated, which is consistent with data on routine and COVID-19 immunizations in European refugees. 10 While potential explanations include different countries of origin or socioeconomic status in refugees compared with other immigrants, we adjusted for both, suggesting an independent association between refugee status and undervaccination.…”