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

Jesse I R Jenkinson; Ruby Sniderman; Evie Gogosis; Michael Liu; Rosane Nisenbaum; Cheryl Pedersen; Olivia Spandier; Tadios Tibebu; Allison Dyer; Frank Crichlow; Lucie Richard; Aaron Orkin; Naomi Thulien; Tara Kiran; Jolen Kayseas; Stephen W Hwang

doi:10.1136/bmjopen-2022-064225

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 Aug 17;12(8):e064225. doi: 10.1136/bmjopen-2022-064225.

Authors

Jesse I R Jenkinson¹, Ruby Sniderman², Evie Gogosis³, Michael Liu^{3

4}, Rosane Nisenbaum^{3

5}, Cheryl Pedersen³, Olivia Spandier³, Tadios Tibebu³, Allison Dyer³, Frank Crichlow^{3

6}, Lucie Richard³, Aaron Orkin^{7

8}, Naomi Thulien^{3

5}, Tara Kiran^{3

9}, Jolen Kayseas¹⁰, Stephen W Hwang^{3

11}

Affiliations

¹ MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, Ontario, Canada jesse.jenkinson@unityhealth.to.
² Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada.
³ MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, Ontario, Canada.
⁴ Harvard Medical School, Boston, Massachusetts, USA.
⁵ Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
⁶ South Riverdale Community Health Centre, Toronto, Ontario, Canada.
⁷ Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
⁸ Inner City Health Associates, Toronto, Ontario, Canada.
⁹ Department of Family and Community Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
¹⁰ Department of Languages, Literature and Culture, Toronto Metropolitan University, Toronto, Ontario, Canada.
¹¹ Division of General Internal Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.

Abstract

Introduction: People experiencing homelessness are at high risk for COVID-19 and poor outcomes if infected. Vaccination offers protection against serious illness, and people experiencing homelessness have been prioritised in the vaccine roll-out in Toronto, Canada. Yet, current COVID-19 vaccination rates among people experiencing homelessness are lower than the general population. This study aims to characterise reasons for COVID-19 vaccine uptake and hesitancy among people experiencing homelessness, to identify strategies to overcome hesitancy and provide public health decision-makers with information to improve vaccine confidence and uptake in this priority population.

Methods and analysis: The Ku-gaa-gii pimitizi-win qualitative study (formerly the COVENANT study) will recruit up to 40 participants in Toronto who are identified as experiencing homelessness at the time of recruitment. Semistructured interviews with participants will explore general experiences during the COVID-19 pandemic (eg, loss of housing, social connectedness), perceptions of the COVID-19 vaccine, factors shaping vaccine uptake and strategies for supporting enablers, addressing challenges and building vaccine confidence.

Ethics and dissemination: Approval for this study was granted by Unity Health Toronto Research Ethics Board. Findings will be communicated to groups organising vaccination efforts in shelters, community groups and the City of Toronto to construct more targeted interventions that address reasons for vaccine hesitancy among people experiencing homelessness. Key outputs will include a community report, academic publications, presentations at conferences and a Town Hall that will bring together people with lived expertise of homelessness, shelter staff, leading scholars, community experts and public health partners.

Keywords: COVID-19; preventive medicine; public health; qualitative research.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19 Vaccines / therapeutic use
COVID-19* / epidemiology
COVID-19* / prevention & control
Housing
Humans
Ill-Housed Persons*
Pandemics

Substances

COVID-19 Vaccines