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Individual and Environmental Correlations with Vaccination Status in Canada: The COHESION study
Neda Firouraghi1,2,3, Ève Dubé4, Benoit Thierry5
1Department of Infectious Disease Epidemiology and International Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine (LSHTM), London, UK. neda.firouraghi@lshtm.ac.uk.
Summary
COVID-19 vaccination rates vary significantly by neighborhood characteristics, with rural areas showing higher non-vaccination. Trust in health authorities and urban living are linked to increased vaccination, while rural greenness shows a complex association.
Area of Science:
- Public Health
- Epidemiology
- Sociology
Background:
- Vaccination is crucial, yet hesitancy persists due to various factors.
- Understanding non-vaccination requires examining individual, social, and environmental influences.
- Previous studies often overlook the role of neighborhood characteristics and urbanization degree.
Purpose of the Study:
- To investigate the association between neighborhood characteristics, urbanization, and COVID-19 vaccination status.
- To identify demographic, socioeconomic, and environmental correlates of non-vaccination.
- To provide a nuanced perspective on factors influencing vaccine uptake.
Main Methods:
- Utilized data from the COHESION cohort, CANUE, and StatCan datasets.
- Employed modified Poisson regression and stratified modeling by urbanization degree.
- Analyzed associations between individual (demographics, trust, political leaning) and environmental (greenness, neighborhood metrics) variables with vaccination status in 18,355 participants.
Main Results:
- Non-vaccination was highest in rural areas (29.51%) and lowest in large urban centers (15.18%).
- Higher trust in health authorities, high income, student status, and left-leaning political views were associated with lower non-vaccination.
- Visible minority status was linked to higher non-vaccination prevalence; rural greenness showed a complex, positive association with non-vaccination.
Conclusions:
- COVID-19 vaccination decisions are influenced by a complex interplay of individual, social, and environmental factors, particularly urbanization.
- Targeted public health interventions are needed for specific populations, especially those in rural and remote areas.
- Context-specific structural factors, rather than direct causality, likely explain observed associations.
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