Abstract
Background: During Québec’s first vaccination rollout, Parc-Extension, the neighbourhood with the greatest population density and immigrant population in Montréal and one of the poorest regions in Canada, had a lower proportion of vaccinated individuals compared to the city’s average (19.9% vs 30.8%). However, by August 2021, PE’s first dose vaccination rate surpassed Montreal’s (77.9% vs 74%).
Objective: To identify factors that members belonging to an immigrant dense neighbourhood describe as contributing to vaccine decision making.
Methodology: We operated under a critical realist paradigm using the socio-ecological model as a sensitizing construct. Using convenience and purposive sampling, we recruited PE residents who had lived in PE during the pandemic and conducted semi-structured interviews. We developed a codebook by open coding 10 transcripts. Using the codebook, we performed thematic content analysis. To ensure rigour, two co-authors coded the transcripts and discrepancies were resolved during analysis meetings.
Results: We conducted 47 semi-structured interviews (27 in French, 17 in English, and 3 in Urdu) between June and October 2022. We interviewed 31 community residents and 15 community organizers. Our semi-structured interviews illustrated the following factors that contribute to vaccine decision making: (i) individual level (personal beliefs), (ii) interpersonal (vaccine information from friends and family), (iii) organizational (community organizations maintaining a relationship with community residents, services being provided in various languages and in a culturally tailored manner) and (iv) structural (lack of governmental support for immigrants and asylum seekers for essential needs).
Discussion: PE residents reported numerous factors, from individual to structural factors, that influenced their decision to get vaccinated and their access to health and social services. Improving access to knowledge regarding COVID-19 vaccines amongst immigrant groups requires a holistic approach and trusting partnerships between governments and community organizations that consider social determinants of health.