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Study shows COVID-19 vaccination rate is lower among urban Aborigines. Why?

COVID-19 vaccination rates among urban Ontario Indigenous people were lower than in the general population, despite priority adoption, a new study finds.

The study, published Tuesday in the Canadian Medical Association Journal (CMAJ), found that between March 2020 and December 2021, two-dose COVID-19 vaccine intake for First Nations, Inuit and Métis people living in Toronto and London, Ontario occurred percent less than the total population.

However, the study also showed that COVID-19 testing rates in the two cities in the indigenous community were 10 percent higher compared to local and provincial rates.

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Researchers looked at data from 1,087 Aboriginal people aged 15 and over in Toronto and London.

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“Indigenous peoples were one of the top three priority groups for vaccine access in Ontario, along with health workers and people living in long-term care homes, but despite this prioritization, we still see significant gaps,” said co-author Janet Smylie, GP at St Michael’s Hospital and Professor at the University of Toronto.

Third-dose booster rates also continue to lag significantly for this group, she said.


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Barriers to accessing culturally safe health centers, systemic racism in hospitals, and a lack of trust in biomedicine due to discriminatory colonial policies are responsible for lower immunization coverage, Smylie said.

As of last week, more than 86 percent of Canadians ages five and older have been fully vaccinated with two doses. And almost half of the general population has been boosted with a third dose.

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Jaris Swidrovich, a First Nations pharmacist and assistant professor at the University of Toronto who was not involved in the study, said he was concerned but not surprised by the low intake, as documented by the CMAJ research.

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He said that a strong history of experimentation, current policies and practices such as forced sterilization of Indigenous women, and experiences of “racist healthcare” were all likely factors that contributed.

“There are certainly a number of very valid reasons why tribal peoples may choose to either delay or not receive vaccination,” he said.

Because tribal peoples have historically not been prioritized for other basic needs such as drinking water, housing and education, prioritizing vaccination during a global pandemic has raised skepticism and questions, Swidrovich added.

“Are they experimenting on me again? Are we going to see how the vaccine works inside us first before it’s offered to the general population across Canada?” he said.


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According to the federal government, First Nations communities across Canada have been disproportionately affected by the COVID-19 pandemic.

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In January 2022, the Omicron variant of COVID-19 increased the rate of reported active cases, but has since declined.

As of December 2021, Canada’s National Advisory Committee on Immunization (NACI) has strongly recommended COVID-19 vaccine boosters for adults in First Nations, Métis and Inuit communities.

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Facing the threat of another potential wave this fall and winter, Smylie said she was genuinely concerned about the risks to the Indigenous community, particularly those living in low-income and overcrowded environments.

Smylie said the best way to increase uptake of vaccines is to rely on community-led efforts and social networks, which have helped reduce mistrust of vaccines during the pandemic.


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Swidorich also noted the success of COVID-19 vaccination campaigns in both urban and non-urban settings, where vaccinations are provided in a more comfortable and culturally sensitive atmosphere.

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He said public health messaging and how vaccines are promoted to target audiences are important.

“We have absolutely seen the success of improving Aboriginal immunization rates through Aboriginal-led programs and Aboriginal-led clinics, whether urban or non-urban.”


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