RT Journal Article
SR Electronic
T1 Impact of a vaccine passport on first-dose SARS-CoV-2 vaccine coverage by age and area-level social determinants of health in the Canadian provinces of Quebec and Ontario: an interrupted time series analysis
JF CMAJ Open
JO CMAJ
FD Canadian Medical Association
SP E995
OP E1005
DO 10.9778/cmajo.20220242
VO 11
IS 5
A1 Anato, Jorge Luis Flores
A1 Ma, Huiting
A1 Hamilton, Mackenzie A.
A1 Xia, Yiqing
A1 Harper, Sam
A1 Buckeridge, David
A1 Brisson, Marc
A1 Hillmer, Michael P.
A1 Malikov, Kamil
A1 Kerem, Aidin
A1 Beall, Reed
A1 Wagner, Caroline E.
A1 Racine, Étienne
A1 Baral, Stefan
A1 Dubé, Ève
A1 Mishra, Sharmistha
A1 Maheu-Giroux, Mathieu
YR 2023
UL http://www.cmajopen.ca/content/11/5/E995.abstract
AB Background: In Canada, all provinces implemented vaccine passports in 2021 to reduce SARS-CoV-2 transmission in non-essential indoor spaces and increase vaccine uptake (policies active September 2021–March 2022 in Quebec and Ontario). We sought to evaluate the impact of vaccine passport policies on first-dose SARS-CoV-2 vaccination coverage by age, and area-level income and proportion of racialized residents.Methods: We performed interrupted time series analyses using data from Quebec’s and Ontario’s vaccine registries linked to census information (population of 20.5 million people aged ≥ 12 yr; unit of analysis: dissemination area). We fit negative binomial regressions to first-dose vaccinations, using natural splines adjusting for baseline vaccination coverage (start: July 2021; end: October 2021 for Quebec, November 2021 for Ontario). We obtained counterfactual vaccination rates and coverage, and estimated the absolute and relative impacts of vaccine passports.Results: In both provinces, first-dose vaccination coverage before the announcement of vaccine passports was 82% (age ≥ 12 yr). The announcement resulted in estimated increases in coverage of 0.9 percentage points (95% confidence interval [CI] 0.4–1.2) in Quebec and 0.7 percentage points (95% CI 0.5–0.8) in Ontario. This corresponds to 23% (95% CI 10%–36%) and 19% (95% CI 15%–22%) more vaccinations over 11 weeks. The impact was larger among people aged 12–39 years. Despite lower coverage in lower-income and more-racialized areas, there was little variability in the absolute impact by area-level income or proportion racialized in either province.Interpretation: In the context of high vaccine coverage across 2 provinces, the announcement of vaccine passports had a small impact on first-dose coverage, with little impact on reducing economic and racial inequities in vaccine coverage. Findings suggest that other policies are needed to improve vaccination coverage among lower-income and racialized neighbourhoods and communities.