The key word to battling COVID-19 vaccine hesitancy in low-income populations is access: to communities, information and vaccine supply, says Dr. Latif Murji, Scarborough Health Network health equity co-ordinator and physician lead for its first-of-a-kind VaxFacts Clinic.
“What I’m talking about with access, it’s having the vaccine available and meeting people where they’re at,” Dr. Murji said. “It’s going to neighbourhoods in communities where vaccine uptake is low and having popups in local apartment complexes, schools, factories and places of front-line work.”
The Public Health Agency of Canada has reported that among Canadians with annual incomes of $25,000 or less, 24 per cent were considered COVID-vaccine hesitant, compared to 11 per cent of those with incomes between $50,000 and $75,000 and six-10 per cent of those with incomes over $75,000. There was also a higher level of hesitancy among Canadians with less education. For Scarborough specifically, 64 per cent of households would qualify for the province’s Low-Income Workers Tax Credit.
Dr. Murji noted that low-income Canadians are less likely to have a family doctor or primary care physician and are often part of other marginalized groups, meaning many miss out on direct health-care access, including health information from a trusted professional. But another access gap is information.
“Physicians are often appearing on mainstream media, but these may not be the same platforms that are being accessed by marginalized groups,” Dr. Murji said.
Proven public health interventions have included community and business-led mobile vaccine operations, targeted communications strategies to local ethnic media, door-to-door outreach and financial supports such as paid sick leave.
A local success story has been Dr. Murji’s VaxFacts Clinic in Scarborough, where residents are connected directly with doctors of multiple languages and ethnic backgrounds, with extended hours for those who work multiple jobs and no OHIP coverage.
Dr. Murji said they’ve seen more than 800 patients, with more than 80 per cent deciding to get vaccinated for COVID-19 after conversations assuring them about vaccines, their safety and evidence.
He said that while these interventions work, communities, governments and health officials must continue to be creative to reach the 11 per cent of eligible Ontarians who have still not gotten vaccinated as of Nov. 2.
“The majority of unvaccinated people are not antivaxxers," Dr. Murji said. "Many still don't quite feel comfortable making the choice to get vaccinated and we need to get creative with our approach to help them get there."