Did inequalities in COVID-19 vaccination resolve over time? Insights from the Canadian Community Health Survey

Abstract

Introduction

Disparities in COVID-19 vaccination coverage emerged during the vaccination campaign. This study aimed to assess whether inequalities in COVID-19 vaccination coverage in Canada persisted or resolved throughout the vaccine rollout.

Methods

Using data from the Canadian Community Health Survey, the analysis included people 18 and older from all ten provinces. Vaccination coverage for at least one dose of a COVID-19 vaccine was determined in three periods: June 2021–February 2022 (n = 28,182), February–June 2022 (n = 25,742), and July–December 2022 (n = 23,119). Statistically significant gaps across groups were assessed using non-overlapping 95 % confidence intervals (CI).

Results

In June 2021–February 2022, coverage for at least one dose (95 % CI) was 85.5 % (79.0–90.3) for off-reserve First Nations people, 85.7 % (79.6–90.1) for Métis people, 79.6 % (72.1–85.4) for Black people, 83.0 % (72.9–89.9) for Arab people, and 92.9 % (92.3–93.5) for White people. By July–December 2022, coverage was 87.4 % (80.2–92.3), 90.5 % (85.5–93.8), 92.1 % (87.2–95.2), 95.6 % (90.6–98.0), and 95.1 % (94.5–95.6), respectively, in the same populations. The gap between off-reserve First Nations and White people remained significant, at 7.4 percentage points (pp.) in the first period and 7.6 pp. in the third period. As for Métis and White people, the gap decreased from 7.3 pp. to 4.6 pp. In the first period, the gap compared to White people was 13.4 pp. for Black people and 9.9 pp. for Arab people, and resolved in the third period. Significant gaps also remained across age groups, levels of educational attainment, household income, for those residing in rural areas, those living with children under 12 years old, and those without a regular healthcare provider.

Conclusion

Despite efforts to address them, several inequalities persisted throughout the vaccine rollout, underscoring the need for refined strategies to reach all population segments. As Canadian vaccination registries do not collect sociodemographic data beyond date of birth, sex and place of residence, survey data is needed to measure these disparities.