Vaccine Distribution Approaches for Equity-Deserving and At-Risk Populations during COVID-19: Best Practices and Lessons Learned in Canada

The World Health Organization has stated that one of the worst threats to overcoming COVID-19 is vaccine hesitancy. Vaccine hesitancy amongst underserved and at-risk communities is an ongoing challenge in Canada. Public confidence in vaccine safety and effectiveness and the principles of equity need to be considered in vaccine distribution since it can result in poorer health outcomes, increased COVID incidence and less vaccination in underserved communities. Approaches for the effective distribution of vaccines for equity-seeking and at-risk individuals are urgently needed. This pan-Canadian study of British Columbia, Alberta, Manitoba, Ontario, Quebec, Nova Scotia, and Newfoundland will identify effective vaccine distribution approaches and advance knowledge on how to design and implement these approaches to meet the needs of communities and reduce the risk of health and social inequalities during and after COVID-19. An exploratory, multi-methods, case study design will be used to conduct a cross-case analysis of seven provinces in Canada. Each case will comprise of: (1) qualitative interviews with policymakers and public health officials; (2) quantitative data analysis of populations served by vaccine distribution approaches; and (3) focus groups with regional stakeholders, providers, patients, and caregivers within effective vaccine distribution models. A thematic analysis of interviews and quantitative data analysis will help identify effective approaches. Focus groups with equity-deserving individuals, caregivers, healthcare providers and other key informants will identify the factors (provincial/federal, structural, community, family, personal) that were enablers or barriers to implementing vaccine distribution programs. A cross-case-study analysis will be done to identify similarities and differences. The outcome of this study will be recommendations for the implementation of equitable and effective vaccine distribution approach(es) in Canada.