Factors Impacting COVID-19 Vaccine Uptake and Confidence Among Immigrant and Refugee Populations in Canada

Objective: This study examines the barriers and facilitators to COVID-19 vaccination among immigrant and refugee populations, with a focus on informing primary healthcare stakeholders on effective strategies to address the health needs of these groups. Although conducted in Canada, the findings are relevant to countries facing similar challenges in promoting vaccine uptake among migrant communities. Methods: As part of an evaluation of best practices in COVID-19 vaccination promotion and provision, data were collected using in-depth key informant interviews with a cross-section of primary care stakeholders (n = 11). Main findings: Key barriers to vaccine promotion and provision included distrust of health and government services, misinformation, lack of vaccine confidence, and access or systems-level barriers. Effective facilitators were relationship-building and equity-driven approaches, such as community engagement and development, culturally and linguistically effective communication, one-on-one supports, and collaboration with community members as valued partners and staff. These strategies were identified as best practices that enhanced vaccine confidence and uptake. Conclusion: The risk and impacts of COVID-19 are disproportionately distributed worldwide, affecting migrant populations in many countries. Primary healthcare stakeholders must understand the barriers and facilitators to vaccine promotion to effectively address health inequalities. Increasing vaccine uptake and confidence among immigrant and refugee populations requires targeted and tailored approaches that are culturally responsive and equity-informed. These findings provide valuable insights for health systems globally, supporting efforts to reduce health inequities by using inclusive vaccination strategies.