COVID-19 vaccine coverage among immigrants and refugees in Alberta: a population-based cross-sectional study
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Abstract
Introduction
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 analyzed 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 higher among immigrants (78.2%; 95% CI: 78.1%-78.3%) compared to non-immigrants (76.0%; 95% CI: 75.9%-76.0%). 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 neighborhood 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.
Conclusion
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.
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SciScore for 10.1101/2022.04.11.22273644: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics not detected. Sex as a biological variable Biologic sex at birth was categorized into male and female. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:These might include co-designing tailored approaches according to local needs, leveraging the role of social media, reconsidering current models for vaccine distribution,(30) and partnering with local …
SciScore for 10.1101/2022.04.11.22273644: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics not detected. Sex as a biological variable Biologic sex at birth was categorized into male and female. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:These might include co-designing tailored approaches according to local needs, leveraging the role of social media, reconsidering current models for vaccine distribution,(30) and partnering with local community-based organizations,(26) faith leaders, and underserved communities, including immigrant communities either directly or through local partners.(31) Communication through text messages, mass media, or telephone, as well as offering vaccines on a walk-in basis can attract diverse and hard-to-reach populations.(32) Strengths and limitations: This is one of the few studies in Canada to investigate vaccine coverage across different age groups of immigrant populations in comparison to non-immigrant populations. We used population-based immunization, immigrant, and resident registries to derive our coverage estimates, ensuring a large and complete dataset for analysis. Our study has some limitations. Our dataset likely included individuals who moved out of Alberta without reporting this to the provincial health insurance registry, which may have resulted in an underestimation of vaccine coverage in all groups. Thus, our denominator is larger than reported by Alberta Health,(33) which applies aggregate weights to offset the population inflation, an approach that was not possible for our individual-level data. We did attempt to remove non-residents from our denominator through other approaches. For instance, we tried excluding individuals aged 50 years and over who had not used...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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