COVID-19 vaccine hesitancy among marginalized populations in the U.S. and Canada: Protocol for a scoping review

  1. Peter A. Newman
  2. Luke Reid
  3. Suchon Tepjan
  4. Sophia Fantus
  5. Kate Allan
  6. Thabani Nyoni
  7. Adrian Guta
  8. Charmaine C. Williams

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Abstract

Despite the development of safe and highly efficacious COVID-19 vaccines, extensive barriers to vaccine deployment and uptake threaten the effectiveness of vaccines in controlling the pandemic. Notably, marginalization produces structural and social inequalities that render certain populations disproportionately vulnerable to COVID-19 incidence, morbidity, and mortality, and less likely to be vaccinated. The purpose of this scoping review is to provide a comprehensive overview of definitions/conceptualizations, elements, and determinants of COVID-19 vaccine hesitancy among marginalized populations in the U.S. and Canada.

Materials and methods

The proposed scoping review follows the framework outlined by Arksey and O’Malley, and further developed by the Joanna Briggs Institute. It will comply with reporting guidelines from the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The overall research question is: What are the definitions/conceptualizations and factors associated with vaccine hesitancy in the context of COVID-19 vaccines among adults from marginalized populations in the U.S. and Canada. Search strategies will be developed using controlled vocabulary and selected keywords, and customized for relevant databases, in collaboration with a research librarian. The results will be analyzed and synthesized quantitatively (i.e., frequencies) and qualitatively (i.e., thematic analysis) in relation to the research questions, guided by a revised WHO Vaccine Hesitancy Matrix.

Discussion

This scoping review will contribute to honing and advancing the conceptualization of COVID-19 vaccine hesitancy and broader elements and determinants of underutilization of COVID-19 vaccination among marginalized populations, identify evidence gaps, and support recommendations for research and practice moving forward.

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  1. Version published to 10.1371/journal.pone.0266120
  2. ScreenIT

    SciScore for 10.1101/2022.03.15.22272438: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Experimental Models: Organisms/Strains
    SentencesResources
    The proposed scoping review is guided by the framework described by Arksey and O’Malley [70], and further developed by the Joanna Briggs Institute [71].
    O’Malley
    suggested: None
    Software and Algorithms
    SentencesResources
    The research sub-questions are: Information sources and search strategy: We developed the following list of databases to search in consultation with a specialist research librarian: Medline, Embase,
    Medline
    suggested: (MEDLINE, RRID:SCR_002185)
    Embase
    suggested: (EMBASE, RRID:SCR_001650)
    Cochrane CENTRAL, Cochrane Covid-19 Study Register, PsychINFO, Sociological Abstracts, and the International Bibliography of the Social Sciences (IBSS).
    Cochrane CENTRAL
    suggested: (Cochrane Central Register of Controlled Trials, RRID:SCR_006576)
    Based on Cochrane Rapid Reviews Methods Group guidance [74], once a threshold of ≥ 90% is achieved, remaining titles and abstracts will be assessed by one reviewer; all excluded titles and abstracts will then be reviewed by the lead researcher.
    Cochrane Rapid Reviews
    suggested: None

    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:
    Strengths and limitations: This scoping review will only include peer-reviewed articles published from January 2020 focused on COVID-19 vaccines; however previous and concurrent research on the phenomenon of VH for other vaccines may provide helpful information. WHO [44,64], the Vaccine Confidence Project [63,65], and other researchers [46] indicate the importance of examining VH specific to a particular vaccine and contextual factors. The review will be inclusive of the U.S. and Canada given similarities as high-income countries and western democracies with the world’s longest international border and a high degree of economic integration, and their collaboration in response to the COVID-19 pandemic, including availability of free COVID-19 vaccination [80]; nevertheless, distinct healthcare systems, histories, and ideologies may constitute important differences around VH among marginalized populations, which we will also explore. Finally, challenges in determining which populations may be most accurately characterized by marginalization may result in omission of some subpopulations. In order to support rigor, we apply an a priori definition of “marginalization” and an initial list of potential populations subsumed within this definition (based on peer-reviewed and government sources [76,79]); and we will use a rigorous process of screening and consensus in the context of ongoing team meetings to adjudicate conflicts in inclusion/exclusion.

    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.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2022.03.15.22272438 on medRxiv