What impacts COVID-19 vaccine uptake in Métis Citizens in Ontario? A population-based data linkage study.

Individual decisions about vaccination are affected by many factors including previous experiences with vaccination, risk/benefit assessments of vaccination and the ease of access to vaccination among the general population. Broader factors also impact this decision among Indigenous peoples, including historic, institutional and political factors, yet little is known about factors affecting vaccination decisions among Métis. Accounting for one third of Indigenous people in Canada, the Métis are a distinct Indigenous identity with its own language and cultural traditions, alongside varied experiences with systemic racism and oppression as being neither accepted as White or First Nations. With COVID-19 vaccines rolling out across Canada and vaccine hesitancy high in minority populations including Métis, it is important to understand factors affecting COVID-19 vaccine uptake for Métis and support optimal uptake. The Métis have been referred to as "hidden" Indigenous peoples reflecting not only the history of the Métis but the lack of Métis-specific health research. It is particularly important to explore reasons for vaccinating or not among Métis as they have been shown to have higher rates of underlying medical conditions that increase the risk of severe illness from COVID-19, including COPD, asthma, congestive heart failure and diabetes, than the non-Indigenous population. This study will identify factors that impact COVID-19 vaccine uptake in Métis Citizens in Ontario. We will link a population-based survey led by the Métis Nation of Ontario that collected information on the psychological barriers to vaccination behaviour among Ontario Métis using a standard scale, to administrative data on uptake of COVID-19 vaccines in Ontario (COVax Ontario dataset). This research, along with consultations with MNO citizens, may inform efforts needed to ensure optimal uptake of COVID-19 vaccines in the Métis and support equitable access to the vaccines in Ontario.