Vaccines for all: A formative evaluation of a multistakeholder community-engaged COVID-19 vaccine outreach clinic for migrant communities

Mobilizing COVID-19 Vaccination Partnerships for Newcomer Refugees and Immigrants in the Calgary, Canada Area, 2021-2022

The COVID-19 public health emergency challenged the capacity for public health systems to vaccinate newcomer refugees and immigrants in the Calgary, Canada, area. In response, community-health partnerships emerged in 2021-2022 to provide accessible, culturally responsive, and adapted services for community members. This research highlights community mobilization and partnerships' role in COVID-19 vaccine delivery for newcomer refugees and immigrants, including challenges faced and lessons learned. Researchers conducted structured interviews with Government Assisted Refugees (GARs), and semi-structured interviews with Privately Sponsored Refugees (PSRs), private refugee sponsors, and diverse health and community informants involved in COVID-19 vaccine responses. Thematic analysis highlighted themes related to partnership development, strategies and actions of partnerships, alignment with World Health Organization recommendations, and partnership benefits and challenges. Multiple newcomer-specific vaccination models were developed through various community-based partnerships. The roles of community partners included information translation and transmission, outreach, and advocacy. Partnerships faced challenges, including existing infrastructure and inequitable policies for COVID-19 vaccine distribution. These existing elements required substantial advocacy to be more equitable in their outcomes. This research highlights how gaps in the public health system during early vaccination efforts catalyzed communities to mobilize and drove the creation of community-health partnerships in the Calgary area. These partnerships were effective at facilitating vaccine uptake through innovative, community-informed and culturally-responsive approaches. A key concern remains that, despite learnings and changes to COVID-19 vaccination systems, the health system has not sufficiently integrated changes to address equity in the long term.

An exploration of COVID-19 vaccination models for newcomer refugees and immigrants in Calgary, Canada

BACKGROUND

The World Health Organization stresses the need for tailored COVID-19 models of vaccination to meet the needs of diverse populations and ultimately reach high rates of vaccination. However, little evidence exists on how COVID-19 models of vaccination operated in the novel context of the pandemic, how vulnerable populations, such as refugees, experience COVID-19 vaccination systems in high-income countries, and what lessons may be learned from vaccination efforts with vulnerable populations. To address this gap, this study explored COVID-19 vaccine delivery models available to newcomer refugees and immigrants, and refugee experiences across different COVID-19 vaccine delivery models in Calgary, Canada, and surrounding area in 2021 and 2022, to understand the barriers, strengths, and strategies of models to support access to COVID-19 vaccination for newcomer refugees and immigrants.

METHODS

Researchers conducted structured interviews with Government Assisted Refugees (n = 39), and semi-structured interviews with Privately Sponsored Refugees (n = 6), private refugee sponsors (n = 3), and stakeholders involved in vaccination systems (n = 13) in 2022. Thematic analysis was conducted to draw out themes related to barriers, strengths, and strategies of vaccine delivery models and the intersections with patient experiences.

RESULTS

Newcomer refugee and immigrant focused vaccination models and strategies were explored. They demonstrated how partnerships between organizations, multi-pronged approaches, and culturally responsive services were crucial to navigate ongoing and emergent factors, such as vaccine hesitancy, mandates, and other determinants of under-vaccination. Many vaccination models presented through interviews were not specific to refugees and included immigrants, temporary residents, ethnocultural community members, and other vulnerable populations in their design.

CONCLUSIONS

Increasing COVID-19 vaccine uptake for newcomer refugees and immigrants, is complex and requires trust, ongoing information provision, and local partnerships to address ongoing and emerging factors. Three key policy implications were drawn. First, findings demonstrated the need for flexible funding to offer outreach, translation, cultural interpretation, and to meet the basic needs of patients prior to engaging in vaccinations. Second, the research showed that embedding culturally responsive strategies within services ensures community needs are met. Finally, collaborating with partners that reflect the diverse needs of communities is crucial for the success of any health efforts serving newcomers.