Results of MI4 Overcoming Barriers to COVID-19 Vaccination Research Funding Program

People in prison are a key population for early COVID-19 vaccination. While vaccine uptake rates have been historically low in correctional facilities, studies have shown that prison vaccination programs have the potential to increase vaccine uptake if partnered with education. With the overall goal of increasing COVID-19 vaccine uptake among people incarcerated in prison, we will design a COVID-19 educational intervention, informed by the needs and expectations of people in prison. Correctional-facility nurses will be then be trained to deliver the educational intervention, and its impact on overall knowledge of COVID-19, awareness of COVID-19 vaccines, and willingness to get vaccinated in prison will be evaluated. If the educational intervention is found to improve willingness to get vaccinated, it could be disseminated throughout the Canadian correctional system (federal and provincial/territorial prisons) to improve vaccine uptake among ~40,000 individuals, and simultaneously adapted for correctional facility staff as they serve as important vectors of COVID-19 transmission in the correctional system.

The availability of vaccines to prevent COVID-19 is imminent. However, this would neither reduce the risk nor eliminate COVID-19 unless most people agree to be vaccinated. Unfortunately, fears about vaccines, some of which originate in conspiracy-anti-vaccine groups promoting misinformation, are common and may prevent or delay people from being vaccinated. To maximize the uptake of COVID-19 vaccines, pro-vaccination strategies are key. We propose to adapt measures shown effective to enhance vaccine uptake in non-COVID vaccines, and integrate the knowledge learned from our work at the MUHC on influenza vaccine in people living with rheumatic diseases. We propose a multifaceted strategy with the aim of: 1) assessing current perceptions and beliefs about COVID vaccines; 2) informing and engaging community members and health care workers empowering them as trustworthy and responsible sources of information on COVID-19 vaccines; and 3) developing a decision aid tool tailored to and targeting specific at risk and under-vaccinated groups. To achieve this, we assembled a group of McGill researchers and practitioners with diverse and complementary expertise. Our collaborative work will provide insight into optimal ways to address misconceptions about COVID-19 vaccination, and engage community members to help champion COVID-19 vaccine uptake.

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As Canada approaches 300,000 COVID-19 infections and 11,000 deaths, the need to stop the spread of the virus has become increasingly critical. Although younger individuals (aged 20-39) have lower hospitalization and death rates than older adults, they have high rates of infection and may be less willing to accept a vaccine because they consider the disease to be less dangerous for themselves. It is of concern that nearly 45% of Canadians, especially younger adults, will not be willing to accept a COVID-19 vaccine. Vaccination will be the best method to control the pandemic in the future and protect those at higher risk of hospitalisation and death (e.g., elderly, those with chronic diseases). Therefore, achieving high rates of vaccination coverage among younger adults is very important in the long run to protect not only themselves but also others.

We will develop a brief video that will promote the vaccine’s protection of others (altruism) e.g., family, friends, the community, the elderly on increasing younger adults’ willingness to get a COVID-19 vaccine. Participants will be 2270 younger adults (aged 20 to 39) who will complete a short online survey before and after viewing the video. Our research team is partnering in this study with key agencies, e.g., Public Health Agency of Canada (PHAC), National Advisory Committee on Immunization (NACI), and the Institut National de Santé Publique du Québec (INSPQ) to help communicate our findings to the general population.

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By the time a COVID-19 vaccine is in the hands of a clinician to be administered to the first Canadian, it will have covered a vast distance from the lab bench through pharmaceutical R&D, safety and efficacy testing, industrial production, a public information campaign, and much else. The enormous time and effort that will have gone into a new vaccine, however, will do nothing to alleviate the pandemic if the vaccine doesn’t cover the final inches to the recipient’s arm. A COVID vaccine will only be effective at reducing the pandemic if we can overcome most of the resistance to taking it, but an October survey found that only 39% of Canadians would take a vaccine as soon as one became available – down from 46% in July. “Vaccine hesitancy” is widely attributed to inadequate or misleading information, but public information efforts have, on the whole, failed to reduce it. Recent research suggests, instead, that vaccine hesitancy is rooted in a lack of trust in social institutions, including science itself. The purpose of this project is to investigate Canadians’ attitudes to a COVID vaccine and develop a trust-based strategy for increasing uptake of the vaccine once it is available. Overcoming COVID vaccine hesitancy is essential to ending the pandemic; this project will contribute significantly to achieving that goal in Canada.

Patients with cardiovascular disease are at a substantially higher risk of complications and death due to the novel SARS-CoV2 virus infection (COVID-19). Mass vaccination of patients with cardiovascular (CV) disease and those at high risk of cardiovascular disease represents a healthcare policy priority to reduce the morbidity and mortality associated with COVID-19. Our study aims to identify the perception and barriers to COVID-19 vaccination in the high CV risk patient through the use of a dedicated survey. We will then develop educational tools for patients and healthcare providers that address these barriers, and deploy the tools in the CV clinics of the McGill University Health Centre (MUHC). Once vaccines are approved, we will also track vaccine acceptance among cardiovascular patients at the MUHC. The deployment of this strategy in the MUHC CV clinic, which see 1,200 patients per month, would serve an optimal area to provide education around COVID-19 vaccination among patients at risk of CV. Our primary hypothesis is that there will be significant concerns for patients regarding the perceived risks of vaccinations and this perception of risk will be associated with a reduction in the likelihood of accepting a vaccination. We secondarily hypothesize that the deployment of patient and provider specific educational tools will be associated with a high acceptance COVID-19 vaccination. This information will serve as the foundation for future CIHR grant applications focused on strategies to facilitate COVID-19 vaccination among high CV risk patients.

Given the devastating impact on health and the economy wrought by the novel coronavirus (COVID-19), a safe vaccine that works will be a game-changer. Indeed, several vaccines are likely to be available for public use in the next months. However, there are substantial potential barriers related to vaccine acceptance, distribution and administration that may impair the effective use of this long sought-after vaccine. These barriers require prompt solutions in order to safely and effectively protect Canadians. In the COVERS study, we aim to identify and address these barriers, propose and develop solutions. We will focus mainly on children and their families given that physical distancing is often challenging in this population and given that fear for children’s safety has been reported as major limiting factor to widespread vaccination. Our study will determine the main barriers and solutions for COVID-19 vaccine administration, we will develop educational videos and a position paper that will summarize our recommendations.

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