COVID 19 vaccine uptake in children: understanding health inequities by using routine data

Vaccinating children is widely described as crucial step to end the COVID 19 pandemic.Surveys showed important inequities: Vaccine hesitancy was higher in persons from socioeconomically disadvantaged backgrounds and persons originating from certain regions of the world. The aim of this study is to describe the vaccine uptake in Ontario in immigrant and non-immigrant children for the adolescent and the pediatric vaccine campaign. We would like to test the main predictors for vaccine uptake in children and adolescents who are migrants and children of migrants (second generation). The study is designed as a retrospective population-based cohort study. Children meeting the following criteria are included in the study: children 1) in possession of an Ontario health Card issued no later than on January first, 2021 2) living in Ontario since the beginning of the pandemic and 3) aged 4 to 17 years on January, first 2021. For all study participants, a database with the sociodemographic and clinical variables will be created using linked administrative health and demographic data at the Institute for Clinical Evaluative Sciences (ICES). Around 10 integrated databases will be used including the national COVID vaccine database, the COVID infections registry, the chronic disease registries, the Permanent Resident Databases and the Census database and the primary care and maternity databases.Crude rates will be compared using standardized differences. Negative binomial models will be used to explore predictors of immunization status. We expect a study population of about 2.5 million children and adolescents. Of those, about 25% will be children of migrants (second generation) and about 6% immigrants. We expect to detect important health inequities in the uptake of COVID 19 vaccines in children In Ontario. We hypothesize that the strongest predictor of vaccine uptake in migrant children is the region of birth. The results of this study will help to detect important health inequities. The results of this study will help to tailor future vaccine campaigns better to the needs of migrant children and children of migrants.