This is a summary, written by members of the CITF Secretariat, of:

Jenkinson JIR, Sniderman R, Gogosis E, Liu M, Nisenbaum R, Pedersen C, Spandier O, Tibebu T, Dyer A, Crichlow F, Richard L, Orkin A, Thulien N, Kiran T, Kayseas J, Hwang SW. Exploring COVID-19 vaccine uptake, confidence and hesitancy among people  experiencing homelessness  in Toronto, Canada: protocol  for the Ku-gaa-gii pimitizi-win qualitative study. BMJ Open. 2022 August 17. doi: 10.1136/bmjopen-2022-06422.

The results and/or conclusions contained in the research do not necessarily reflect the views of all CITF members.

In a paper published in BMJ Open, Drs. Jesse Jenkinson, Stephen Hwang (MAP Centre for Urban Health Solutions, University of Toronto) and colleagues outlined their study protocol for characterizing COVID-19 vaccine uptake and hesitancy among people experiencing homelessness in Toronto. This protocol applies to a new qualitative study that expands on the CITF-funded Ku-gaa-gii pimitizi-win study (formerly COVENANT), focused on the prevalence and incidence of COVID-19 infection in this priority population.

Research shows that people experiencing homelessness are at higher risk of SARS-CoV-2 infection and more severe cases of COVID-19 in comparison to the general population. Vaccination is promoted as one of the best means of protection against severe disease and death, especially with new variants of SARS-CoV-2 being so highly transmissible. As such, people experiencing homelessness have been prioritized in vaccine roll-outs across Canada.

Still, current COVID-19 vaccination rates among these individuals are lower than in the general population, and vaccine hesitancy (which encompasses delays in acceptance of vaccination, or outright refusal despite vaccine availability) may explain the lack of uptake.

Key points:

  • The aims of the Ku-gaa-gii pimitizi-win qualitative study, as set out in the protocol, are to:
    • Identify the individual, community and structural drivers of COVID-19 vaccine uptake and hesitancy among people experiencing homelessness;
    • Invite people experiencing homelessness to propose solutions and strategies to reduce impediments to vaccination;
    • Develop strategies to build enablers to vaccine confidence and uptake.
  • The study will recruit up to 40 participants experiencing homelessness in Toronto from congregate settings (such as shelters) who participated in the Ku-gaa-gii pimitizi-win cohort study. Building on an existing cohort study enables the inclusion of participants with different gender, ethno/racial identities and vaccination statuses.
  • This study asks participants to identify strategies for improving vaccine uptake among people experiencing homelessness that reflect their own needs.
  • Peer researchers with lived experience of homelessness will be hired as part of the research team to provide more in-depth and nuanced data and to ensure that the strategies identified by the community are being supported.