CoChat
Sign Up
Cited by 4Vaccine Coverage and HesitancySARS-CoV-2 and COVID-19 ResearchCOVID-19 epidemiological studies

Socio-demographic determinants of COVID-19 vaccine uptake in Ontario: Exploring differences across the Health Region model

Open access
Mundo Ortiz, Ariel, Nasri, Bouchra·2024·Vaccine
DOI 10.1016/j.vaccine.2024.02.045
Open this paper in CoChat — free account

Abstract

The COVID-19 pandemic continues to be a worldwide public health concern. Although vaccines against this disease were rapidly developed, vaccination uptake has not been equal across all the segments of the population, particularly in the case of underrepresented groups. However, there are also differences in vaccination across geographical areas, which might be important to consider in the development of future public health vaccination policies. In this study, we examined the relationship between vaccination status (having received the first dose of a COVID-19 vaccine), socio-economic strata, and the Health Regions for individuals in Ontario, Canada. Our results show that between October of 2021 and January of 2022, individuals from underrepresented communities were three times less likely to be vaccinated than White/Caucasian individuals across the province of Ontario, and that in some cases, within these groups, individuals in low-income brackets had significantly higher odds of vaccination when compared to their peers in high income brackets. Finally, we identified significantly lower odds of vaccination in the Central, East and West Health Regions of Ontario within certain underrepresented groups. This study shows that there is an ongoing need to better understand and address differences in vaccination uptake across diverse segments of the population of Ontario that the pandemic has largely impacted.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1016/j.vaccine.2024.02.045

Cites

4 of 4 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 66

  1. [4]4. Mackey K, Ayers CK, Kondo KK, et al. Racial and ethnic disparities in COVID-19-related infections, hospitalizations, and deaths. Annals of Internal Medicine . 2021;174(3):362-373. doi:10.7326/m20-6306 · DOI
  2. [5]5. Microbe TL. COVID-19 vaccines: The pandemic will not end overnight. The Lancet Microbe . 2021;2(1):e1. doi:10.1016/s2666-5247(20)30226-3 · DOI
  3. [6]6. Davis CJ, Golding M, McKay R. Efficacy information influences intention to take COVID-19 vaccine. British Journal of Health Psychology . 2022;27(2):300-319. doi:https://doi.org/10.1111/bjhp.12546 · DOI
  4. [7]7. Bogoch II, Halani S. COVID-19 vaccines: A geographic, social and policy view of vaccination efforts in ontario, canada. Cambridge Journal of Regions, Economy and Society . Published online November 2022. doi:10.1093/cjres/rsac043 · DOI
  5. [8]8. Tanne JH. Covid-19: FDA panel votes to authorise pfizer BioNTech vaccine. BMJ . Published online December 2020:m4799. doi:10.1136/bmj.m4799 · DOI
  6. [10]10. Li Q, Wang J, Tang Y, Lu H. Next-generation COVID-19 vaccines: Opportunities for vaccine development and challenges in tackling COVID-19. Drug Discoveries & Therapeutics . 2021;15(3):118-123. doi:10.5582/ddt.2021.0105 · DOI
  7. [11]11. Dolgin E. COVID vaccine immunity is waning - how much does that matter? Nature . 2021;597(7878):606607. doi:10.1038/d41586-021-02532-4 · DOI · Paper page
  8. [12]12. Gerretsen P, Kim J, Caravaggio F, et al. Individual determinants of COVID-19 vaccine hesitancy. Inbaraj LR, ed. PLOS ONE . 2021;16(11):e0258462. doi:10.1371/journal.pone.0258462 · DOI
  9. [13]13. Yamey G, Garcia P, Hassan F, et al. It is not too late to achieve global covid-19 vaccine equity. BMJ . Published online March 2022:e070650. doi:10.1136/bmj-2022-070650 · DOI · Paper page
  10. [14]14. Nafilyan V, Dolby T, Razieh C, et al. Sociodemographic inequality in COVID-19 vaccination coverage among elderly adults in england: A national linked data study. BMJ Open . 2021;11(7):e053402. doi:10.1136/bmjopen-2021-053402 · DOI
  11. [15]15. Willis DE, Andersen JA, Bryant-Moore K, et al. COVID-19 vaccine hesitancy: Race/ethnicity, trust, and fear. Clinical and Translational Science . 2021;14(6):2200-2207. doi:10.1111/cts.13077 · DOI
  12. [16]16. Skirrow H, Barnett S, Bell S, et al. Women's views on accepting COVID-19 vaccination during and after pregnancy, and for their babies: A multi-methods study in the UK. BMC Pregnancy and Childbirth . 2022;22(1). doi:10.1186/s12884-021-04321-3 · DOI
  13. [17]17. Stoler J, Enders AM, Klofstad CA, Uscinski JE. The limits of medical trust in mitigating COVID-19 vaccine hesitancy among black americans. Journal of General Internal Medicine . 2021;36(11):3629-3631. doi:10.1007/s11606-021-06743-3 It is made available under a CC-BY 4.0 International license . is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) medRxiv preprint doi: https://doi.org/10.1101/2023.08.04.23293662; this version posted August 8, 2023. The copyright holder for this preprint · DOI
  14. [18]18. Khubchandani J, Sharma S, Price JH, Wiblishauser MJ, Sharma M, Webb FJ. COVID-19 vaccination hesitancy in the united states: A rapid national assessment. Journal of Community Health . 2021;46(2):270-277. doi:10.1007/s10900-020-00958-x 349 350 · DOI
  15. [19]19. Guay M, Maquiling A, Chen R, et al. Measuring inequalities in COVID-19 vaccination uptake and intent: Results from the canadian community health survey 2021. BMC Public Health . 2022;22(1). doi:10.1186/s12889022-14090-z 351 352 · DOI
  16. [20]20. Muhajarine N, Adeyinka DA, McCutcheon J, Green KL, Fahlman M, Kallio N. COVID-19 vaccine hesitancy and refusal and associated factors in an adult population in saskatchewan, canada: Evidence from predictive modelling. Gesser-Edelsburg A, ed. PLOS ONE . 2021;16(11):e0259513. doi:10.1371/journal.pone.0259513 353 354 · DOI
  17. [21]21. Hussain B, Latif A, Timmons S, Nkhoma K, Nellums LB. Overcoming COVID-19 vaccine hesitancy among ethnic minorities: A systematic review of UK studies. Vaccine . 2022;40(25):3413-3432. doi:10.1016/j.vaccine.2022.04.030 355 356 · DOI
  18. [22]22. Mosby I, Swidrovich J. Medical experimentation and the roots of COVID-19 vaccine hesitancy among indigenous peoples in canada. Canadian Medical Association Journal . 2021;193(11):E381-E383. doi:10.1503/cmaj.210112 357 358 · DOI
  19. [23]23. Bogart LM, Ojikutu BO, Tyagi K, et al. COVID-19 related medical mistrust, health impacts, and potential vaccine hesitancy among black americans living with HIV. JAIDS Journal of Acquired Immune Deficiency Syndromes . 2021;86(2):200-207. doi:10.1097/qai.0000000000002570 359 360 · DOI
  20. [24]24. Freeman D, Loe BS, Chadwick A, et al. COVID-19 vaccine hesitancy in the UK: The oxford coronavirus explanations, attitudes, and narratives survey (oceans) II. Psychological Medicine . 2020;52(14):3127-3141. doi:10.1017/s0033291720005188 361 362 · DOI
  21. [25]25. Malik AA, McFadden SM, Elharake J, Omer SB. Determinants of COVID-19 vaccine acceptance in the US. EClinicalMedicine . 2020;26:100495. doi:10.1016/j.eclinm.2020.100495 363 364 · DOI
  22. [26]26. Nguyen KH, Nguyen K, Corlin L, Allen JD, Chung M. Changes in COVID-19 vaccination receipt and intention to vaccinate by socioeconomic characteristics and geographic area, united states, january 6 - march 29, 2021. Annals of Medicine . 2021;53(1):1419-1428. doi:10.1080/07853890.2021.1957998 365 366 · DOI
  23. [27]27. Mollalo A, Tatar M. Spatial modeling of COVID-19 vaccine hesitancy in the united states. International Journal of Environmental Research and Public Health . 2021;18(18):9488. doi:10.3390/ijerph18189488 367 368 · DOI
  24. [28]28. Yang TC, Matthews SA, Sun F. Multiscale dimensions of spatial process: COVID-19 fully vaccinated rates in u.s. counties. American Journal of Preventive Medicine . 2022;63(6):954-961. doi:10.1016/j.amepre.2022.06.006 369 370 · DOI
  25. [29]29. Tiu A, Susswein Z, Merritt A, Bansal S. Characterizing the spatiotemporal heterogeneity of the COVID-19 vaccination landscape. American Journal of Epidemiology . 2022;191(10):1792-1802. doi:10.1093/aje/kwac080 371 372 · DOI
  26. [30]30. Bhuiyan MAN, Davis TC, Arnold CL, et al. Using the social vulnerability index to assess COVID-19 vaccine uptake in louisiana. GeoJournal . Published online December 2022. doi:10.1007/s10708-022-10802-5 373 374 · DOI
  27. [31]31. Wood AJ, MacKintosh AM, Stead M, Kao RR. Predicting future spatial patterns in COVID-19 booster vaccine uptake. Published online September 2022. doi:10.1101/2022.08.30.22279415 375 376 · DOI
  28. [32]32. Choi KH, Denice PA, Ramaj S. Vaccine and COVID-19 trajectories. Socius: Sociological Research for a Dynamic World . 2021;7:237802312110529. doi:10.1177/23780231211052946 377 378 · DOI
  29. [33]33. McKinnon B, Quach C, Dubé Ève, Nguyen CT, Zinszer K. Social inequalities in COVID-19 vaccine acceptance and uptake for children and adolescents in montreal, canada. Vaccine . 2021;39(49):7140-7145. doi:10.1016/j.vaccine.2021.10.077 379 380 · DOI
  30. [36]36. Muratov S, Lee J, Holbrook A, et al. Regional variation in healthcare spending and mortality among senior high-cost healthcare users in ontario, canada: A retrospective matched cohort study. BMC Geriatrics . 2018;18(1). doi:10.1186/s12877-018-0952-7 385 386 · DOI
  31. [37]37. Dong L, Sahu R, Black R. Governance in the transformational journey toward integrated healthcare: The case of ontario. Journal of Information Technology Teaching Cases . Published online December 2022:204388692211473. doi:10.1177/20438869221147313 387 388 · DOI
  32. [40]40. Rotenberg S, Downer MB, Brown H, et al. COVID-19 Vaccination for People with Disabilities . Ontario COVID-19 Science Advisory Table; 2021. doi:10.47326/ocsat.2021.02.35.1.0 393 394 · DOI
  33. [41]41. Ashcroft R, Donnelly C, Lam S, et al. A qualitative examination of primary care team's participation in the distribution of the COVID-19 vaccination. Published online June 2023. doi:10.21203/rs.3.rs-3016276/v1 395 396 · DOI
  34. [43]43. Sethuram C, McCutcheon T, Liddy C. An environmental scan of ontario health teams: A descriptive study. BMC Health Services Research . 2023;23(1). doi:10.1186/s12913-023-09102-6 399 400 · DOI
  35. [44]44. Sargent RH, Laurie S, Weakland LF, et al. Use of random domain intercept technology to track COVID-19 vaccination rates in real time across the united states: Survey study. Journal of Medical Internet Research . 2022;24(7):e37920. doi:10.2196/37920 401 402 · DOI
  36. [45]45. Kim JH, Bell GA, Ratcliffe HL, et al. Predictors of patient-reported quality of care in low- and middle-income countries: A four-country survey of person-centered care. International Journal for Quality in Health Care . 2021;33(3). doi:10.1093/intqhc/mzab110 403 404 · DOI
  37. [46]46. Seeman N, Ing A, Rizo C. Assessing and responding in real time to online anti-vaccine sentiment during a flu pandemic. Healthcare Quarterly . 2010;13(sp):8-15. doi:10.12927/hcq.2010.21923 405 406 · DOI
  38. [47]47. Nguyen KH, Anneser E, Toppo A, Allen JD, Parott JS, Corlin L. Disparities in national and state estimates of COVID-19 vaccination receipt and intent to vaccinate by race/ethnicity, income, and age group among adults ≥ 18 years, united states. Vaccine . 2022;40(1):107-113. doi:10.1016/j.vaccine.2021.11.040 407 408 · DOI
  39. [48]48. Shih SF, Wagner AL, Masters NB, Prosser LA, Lu Y, Zikmund-Fisher BJ. Vaccine hesitancy and rejection of a vaccine for the novel coronavirus in the united states. Frontiers in Immunology . 2021;12. doi:10.3389/fimmu.2021.558270 409 410 · DOI
  40. [49]49. Cénat JM, Noorishad PG, Farahi SMMM, et al. Prevalence and factors related to COVID-19 vaccine hesitancy and unwillingness in canada: A systematic review and meta-analysis. Journal of Medical Virology . 2022;95(1). doi:10.1002/jmv.28156 411 412 · DOI
  41. [50]50. Deming WE, Stephan FF. On a least squares adjustment of a sampled frequency table when the expected marginal totals are known. The Annals of Mathematical Statistics . 1940;11(4):427-444. doi:10.1214/aoms/1177731829 413 414 · DOI · Paper page
  42. [51]51. Lumley T. Complex Surveys . John Wiley & Sons; 2011. 415 416
  43. [52]52. Wickham H, Averick M, Bryan J, et al. Welcome to the tidyverse. Journal of Open Source Software . 2019;4(43):1686. doi:10.21105/joss.01686 417 418 · DOI · Paper page
  44. [54]54. Arel-Bundock V. modelsummary: Data and model summaries in R. Journal of Statistical Software . 2022;103(1):1-23. doi:10.18637/jss.v103.i01 421 422 It is made available under a CC-BY 4.0 International license . is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) medRxiv preprint doi: https://doi.org/10.1101/2023.08.04.23293662; this version posted August 8, 2023. The copyright holder for this preprint · DOI
  45. [55]55. Sjoberg DD, Whiting K, Curry M, Lavery JA, Larmarange J. Reproducible summary tables with the gtsummary package. The R Journal . 2021;13:570-580. doi:10.32614/RJ-2021-053 423 424 · DOI
  46. [56]56. Bolotin JJAG Shelly AND Feld. Population-based estimate of hepatitis c virus prevalence in ontario, canada. PLOS ONE . 2018;13(1):1-10. doi:10.1371/journal.pone.0191184 425 426 · DOI
  47. [58]58. Carter MA, Biro S, Maier A, Shingler C, Guan TH. COVID-19 vaccine uptake in southeastern ontario, canada: Monitoring and addressing health inequities. Journal of Public Health Management and Practice . 2022;28(6):615-623. doi:10.1097/phh.0000000000001565 431 432 · DOI
  48. [59]59. Basta NE, Sohel N, Sulis G, et al. Factors associated with willingness to receive a COVID-19 vaccine among 23, 819 adults aged 50 years or older: An analysis of the canadian longitudinal study on aging. American Journal of Epidemiology . 2022;191(6):987-998. doi:10.1093/aje/kwac029 · DOI
  49. [60]60. Cénat JM, Noorishad PG, Bakombo SM, et al. A systematic review on vaccine hesitancy in black communities in canada: Critical issues and research failures. Vaccines . 2022;10(11):1937. doi:10.3390/vaccines10111937 433 434 · DOI · Paper page
  50. [61]61. Cénat JM, Farahi SMMM, Bakombo SM, et al. Vaccine mistrust among black individuals in canada: The major role of health literacy, conspiracy theories, and racial discrimination in the healthcare system. Journal of Medical Virology . 2023;95(4). doi:10.1002/jmv.28738 435 436 · DOI
  51. [62]62. Njoku A, Joseph M, Felix R. Changing the narrative: Structural barriers and racial and ethnic inequities in COVID-19 vaccination. International Journal of Environmental Research and Public Health . 2021;18(18):9904. doi:10.3390/ijerph18189904 437 438 · DOI · Paper page
  52. [64]64. Gill M, Datta D, Gregory P, Austin Z. COVID-19 vaccination in high-risk communities: Case study of brampton, ontario. Canadian Pharmacists Journal / Revue des Pharmaciens du Canada . 2022;155(6):345351. doi:10.1177/17151635221123042 441 442 · DOI
  53. [65]65. Hawkins D. Differential occupational risk for COVID-19 and other infection exposure according to race and ethnicity. American Journal of Industrial Medicine . 2020;63(9):817-820. doi:10.1002/ajim.23145 443 444 445 446 · DOI
  54. [66]66. Côté D, Durant S, MacEachen E, et al. A rapid scoping review of COVID-19 and vulnerable workers: Intersecting occupational and public health issues. American Journal of Industrial Medicine . 2021;64(7):551566. doi:10.1002/ajim.23256 · DOI
  55. [67]67. Rao A, Ma H, Moloney G, et al. A disproportionate epidemic: COVID-19 cases and deaths among essential workers in toronto, canada. Annals of Epidemiology . 2021;63:63-67. doi:10.1016/j.annepidem.2021.07.010 447 448 · DOI · Paper page
  56. [68]68. Mishra S, Stall NM, Ma H, et al. A Vaccination Strategy for Ontario COVID-19 Hotspots and Essential Workers . Ontario COVID-19 Science Advisory Table; 2021. doi:10.47326/ocsat.2021.02.26.1.0 449 450 · DOI
  57. [69]69. Nguyen KH, Yankey D, Coy KC, et al. COVID-19 vaccination coverage, intent, knowledge, attitudes, and beliefs among essential workers, united states. Emerging Infectious Diseases . 2021;27(11):2908-2913. doi:10.3201/eid2711.211557 451 452 · DOI
  58. [70]70. Shah TI, Clark AF, Seabrook JA, Sibbald S, Gilliland JA. Geographic accessibility to primary care providers: Comparing rural and urban areas in southwestern ontario. The Canadian Geographer / Le Géographe canadien . 2019;64(1):65-78. doi:10.1111/cag.12557 453 454 · DOI
  59. [71]71. Crighton EJ, Ragetlie R, Luo J, To T, Gershon A. A spatial analysis of COPD prevalence, incidence, mortality and health service use in ontario. Health Rep . 2015;26(3):10-18. 455 456
  60. [72]72. Timony P, Houle SKD, Gauthier A, Waite NM. Geographic distribution of ontario pharmacists: A focus on rural and northern communities. Canadian Pharmacists Journal / Revue des Pharmaciens du Canada . 2022;155(5):267-276. doi:10.1177/17151635221115411 457 458 · DOI
  61. [73]73. Smylie J, McConkey S, Rachlis B, et al. Uncovering SARS-COV-2 vaccine uptake and COVID-19 impacts among first nations, inuit and métis peoples living in toronto and london, ontario. Canadian Medical Association Journal . 2022;194(29):E1018-E1026. doi:10.1503/cmaj.212147 459 460 It is made available under a CC-BY 4.0 International license . is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) medRxiv preprint doi: https://doi.org/10.1101/2023.08.04.23293662; this version posted August 8, 2023. The copyright holder for this preprint · DOI
  62. [74]74. Eissa A, Lofters A, Akor N, Prescod C, Nnorom O. Increasing SARS-CoV-2 vaccination rates among black people in canada. Canadian Medical Association Journal . 2021;193(31):E1220-E1221. doi:10.1503/cmaj.210949 461 462 · DOI
  63. [75]75. Etowa J, Hyman I. Unpacking the health and social consequences of COVID-19 through a race, migration and gender lens. Canadian Journal of Public Health . 2021;112(1):8-11. doi:10.17269/s41997-020-00456-6 463 464 · DOI
  64. [76]76. Patel A, Dean J, Edge S, Wilson K, Ghassemi E. Double burden of rural migration in canada? Considering the social determinants of health related to immigrant settlement outside the cosmopolis. International Journal of Environmental Research and Public Health . 2019;16(5):678. doi:10.3390/ijerph16050678 465 466 · DOI
  65. [78]78. DeRoo SS, Pudalov NJ, Fu LY. Planning for a COVID-19 vaccination program. JAMA . 2020;323(24):2458. doi:10.1001/jama.2020.8711 469 470 · DOI
  66. [79]79. Stephenson M, Olson SM, Self WH, et al. Ascertainment of vaccination status by self-report versus source documentation: Impact on measuring COVID-19 vaccine effectiveness. Influenza and Other Respiratory Viruses . 2022;16(6):1101-1111. doi:10.1111/irv.13023 471 472 · DOI

Cited by

Sorted by citations

Authors
Mundo Ortiz, A., & Nasri, B.
Affiliations
Centre de recherche en santé publique (CA)
Corresponding author
Nasri, Bouchra
ORCID
Nasri, Bouchra
Venue
Vaccine
Publisher
Elsevier BV
Published
2024-03
Volume
42
Issue
8
Pages
2106-2114
ISSN
0264-410X (ISSN-L)
DOI
10.1016/j.vaccine.2024.02.045
OpenAlex
W4392170213
Cited by
4
References
4
Citations by year
2026: 1 · 2025: 3
FWCI
1.82
Type
journal article
Language
en
Open access
Licence
Locations
  • Vaccine (publishedVersion, cc-by-nc-nd)
  • medRxiv (acceptedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
CRSNG
Topics
  • Social Sciences › Health › Vaccine Coverage and Hesitancy
  • Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
  • Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
Keywords
COVID-19 vaccine uptake, sociodemographic factors, health disparities, underrepresented groups, socioeconomic status, income inequality, health regions, Ontario, vaccination policy, racial and ethnic minorities
MeSH terms
COVID-19, COVID-19 Vaccines, Demography, Humans, Ontario, Vaccination, Pandemics

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review