Research Library

Refugee decisions to vaccinate for COVID-19 are a complex interplay of factors which include individual perceptions, access barriers, trust, and COVID-19 specific factors, which contribute to lower vaccine uptake. To address this, the WHO calls for localized solutions to increase COVID-19 vaccine uptake for refugees and evidence to inform future vaccination efforts. However, limited evidence engages directly with refugees about their experiences with COVID-19 vaccinations. To address this gap, researchers conducted qualitative interviews (N = 61) with refugees (n = 45), sponsors of refugees (n = 3), and key informants (n = 13) connected to local COVID-19 vaccination efforts for refugees in Calgary. Thematic analysis was conducted to synthesize themes related to vaccine perspectives, vaccination experiences, and patient intersections with policies and systems. Findings reveal that refugees benefit from ample services that are delivered at various stages, that are not solely related to vaccinations, and which create multiple positive touch points with health and immigration systems. This builds trust and vaccine confidence and promotes COVID-19 vaccine uptake. Despite multiple factors affecting vaccination decisions, a key reason for vaccination was timely and credible information delivered through trusted intermediaries and in an environment that addressed refugee needs and concerns. As refugees placed trust and relationships at the core of decision-making and vaccination, it is recommended that healthcare systems work through trust and relationships to reach refugees. This can be targeted through culturally responsive healthcare delivery that meets patients where they are, including barrier reduction measures such as translation and on-site vaccinations, and educational and outreach partnerships with private groups, community organizations and leaders. Refugee decisions to vaccinate for COVID-19 are a complex interplay of factors which include individual perceptions, access barriers, trust, and COVID-19 specific factors, which contribute to lower vaccine uptake. To address this, the WHO calls for localized solutions to increase COVID-19 vaccine uptake for refugees and evidence to inform future vaccination efforts. However, limited evidence engages directly with refugees about their experiences with COVID-19 vaccinations. To address this gap, researchers conducted qualitative interviews (N = 61) with refugees (n = 45), sponsors of refugees (n = 3), and key informants (n = 13) connected to local COVID-19 vaccination efforts for refugees in Calgary. Thematic analysis was conducted to synthesize themes related to vaccine perspectives, vaccination experiences, and patient intersections with policies and systems. Findings reveal that refugees benefit from ample services that are delivered at various stages, that are not solely related to vaccinations, and which create multiple positive touch points with health and immigration systems. This builds trust and vaccine confidence and promotes COVID-19 vaccine uptake. Despite multiple factors affecting vaccination decisions, a key reason for vaccination was timely and credible information delivered through trusted intermediaries and in an environment that addressed refugee needs and concerns. As refugees placed trust and relationships at the core of decision-making and vaccination, it is recommended that healthcare systems work through trust and relationships to reach refugees. This can be targeted through culturally responsive healthcare delivery that meets patients where they are, including barrier reduction measures such as translation and on-site vaccinations, and educational and outreach partnerships with private groups, community organizations and leaders.
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The World Health Organization stresses the need for tailored COVID-19 models of vaccination to meet the needs of diverse populations and ultimately reach high rates of vaccination. However, little evidence exists on how COVID-19 models of vaccination operated in the novel context of the pandemic, how vulnerable populations, such as refugees, experience COVID-19 vaccination systems in high-income countries, and what lessons may be learned from vaccination efforts with vulnerable populations. To address this gap, this study explored COVID-19 vaccine delivery models available to newcomer refugees and immigrants, and refugee experiences across diferent COVID-19 vaccine delivery models in Calgary, Canada, and surrounding area in 2021 and 2022, to understand the barriers, strengths, and strategies of models to support access to COVID-19 vaccination for newcomer refugees and immigrants. Structured interviews with Government Assisted Refugees (n=39), and semistructured interviews with Privately Sponsored Refugees (n=6), private refugee sponsors (n=3), and stakeholders involved in vaccination systems (n=13) were conducted in 2022. Thematic analysis was conducted to draw out themes related to barriers, strengths, and strategies of vaccine delivery models and the intersections with patient experiences. Newcomer refugee and immigrant focused vaccination models and strategies were explored. They demonstrated how partnerships between organizations, multi-pronged approaches, and culturally responsive services were crucial to navigate ongoing and emergent factors, such as vaccine hesitancy, mandates, and other determinants of under-vaccination. Many vaccination models presented through interviews were not specific to refugees and included immigrants, temporary residents, ethnocultural community members, and other vulnerable populations in their design. Increasing COVID-19 vaccine uptake for newcomer refugees and immigrants, is complex and requires trust, ongoing information provision, and local partnerships to address ongoing and emerging factors. Three key policy implications were drawn. The World Health Organization stresses the need for tailored COVID-19 models of vaccination to meet the needs of diverse populations and ultimately reach high rates of vaccination. However, little evidence exists on how COVID-19 models of vaccination operated in the novel context of the pandemic, how vulnerable populations, such as refugees, experience COVID-19 vaccination systems in high-income countries, and what lessons may be learned from vaccination efforts with vulnerable populations. To address this gap, this study explored COVID-19 vaccine delivery models available to newcomer refugees and immigrants, and refugee experiences across diferent COVID-19 vaccine delivery models in Calgary, Canada, and surrounding area in 2021 and 2022, to understand the barriers, strengths, and strategies of models to support access to COVID-19 vaccination for newcomer refugees and immigrants. Structured interviews with Government Assisted Refugees (n=39), and semistructured interviews with Privately Sponsored Refugees (n=6), private refugee sponsors (n=3), and stakeholders involved in vaccination systems (n=13) were conducted in 2022. Thematic analysis was conducted to draw out themes related to barriers, strengths, and strategies of vaccine delivery models and the intersections with patient experiences. Newcomer refugee and immigrant focused vaccination models and strategies were explored. They demonstrated how partnerships between organizations, multi-pronged approaches, and culturally responsive services were crucial to navigate ongoing and emergent factors, such as vaccine hesitancy, mandates, and other determinants of under-vaccination. Many vaccination models presented through interviews were not specific to refugees and included immigrants, temporary residents, ethnocultural community members, and other vulnerable populations in their design. Increasing COVID-19 vaccine uptake for newcomer refugees and immigrants, is complex and requires trust, ongoing information provision, and local partnerships to address ongoing and emerging factors. Three key policy implications were drawn.
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What can be learned about the healthcare access of undocumented workers? How can health equity be advanced through sensitivity to the process of precaritization and the precarities informing their lives? Thailand and Spain are the only countries in the world that offer the same healthcare access to undocumented migrants as citizens. Most European countries only offer emergency services: France, the Netherlands, Portugal, Spain, and Switzerland allow undocumented migrants to access similar services to citizens if they meet conditions (proof of identity; length of residence in the country). European cities such as Ghent, Frankfurt, and Dusseldorf, offer barrier-free healthcare. Throughout the USA, Federally Qualified Health Centers support care to the uninsured regardless of immigration status. In Canada, Ontario and Quebec, provide a base level of healthcare access to undocumented migrants, and a small number of stand-alone community-based clinics offer additional care and specialized services. To promote healthcare for undocumented migrants in Alberta, barrier-free access to vaccination, COVID-19 treatment, and proof of vaccinations are essential, but an equity lens to healthcare service— informed by analytic understanding and robust approach to precaritization as a social determinant, is most needed. What can be learned about the healthcare access of undocumented workers? How can health equity be advanced through sensitivity to the process of precaritization and the precarities informing their lives? Thailand and Spain are the only countries in the world that offer the same healthcare access to undocumented migrants as citizens. Most European countries only offer emergency services: France, the Netherlands, Portugal, Spain, and Switzerland allow undocumented migrants to access similar services to citizens if they meet conditions (proof of identity; length of residence in the country). European cities such as Ghent, Frankfurt, and Dusseldorf, offer barrier-free healthcare. Throughout the USA, Federally Qualified Health Centers support care to the uninsured regardless of immigration status. In Canada, Ontario and Quebec, provide a base level of healthcare access to undocumented migrants, and a small number of stand-alone community-based clinics offer additional care and specialized services. To promote healthcare for undocumented migrants in Alberta, barrier-free access to vaccination, COVID-19 treatment, and proof of vaccinations are essential, but an equity lens to healthcare service— informed by analytic understanding and robust approach to precaritization as a social determinant, is most needed.
This publication has no Abstract to dispaly

This study explored refugee experiences in Calgary and surrounding area to understand barriers, strengths, and strategies of various models to support access to COVID-19 vaccination. This study explored refugee experiences in Calgary and surrounding area to understand barriers, strengths, and strategies of various models to support access to COVID-19 vaccination.
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Due to the ongoing conflict in Syria, approximately 50,000 Syrian refugees arrived in Canada between 2015 and 2020. Upon arrival, Syrians needed to find housing, employment, healthcare, and language training. They also had to address psychosocial needs, such as cultivating social supports and establishing a sense of safety, which are critical for mitigating trauma and stress related to resettlement. In March 2020, the global COVID-19 pandemic was declared, and disproportionately impacted refugees by compounding pre-existing and systemic health, social, and economic inequities. Refugees are identified as particularly vulnerable during the pandemic due to the precarious working, living, economic, and health conditions they often face. Only three Canadian studies to date have explored Syrian refugee experiences during COVID-19: one used quantitative methods, the other focused on postnatal women, and one explored housing stability. Therefore, there is a dearth of qualitative information regarding how Syrian refugees in Canada have been impacted by the pandemic, especially regarding their psychosocial adaptation during this period. This study explored the impact of the COVID-19 pandemic for Syrian refugees in Canada and identified supports needed, from the perspectives of Syrian refugees themselves. This study is embedded within a broader community-based participatory research project investigating psychosocial adaptation with the Syrian refugee community and used qualitative description and thematic analysis to examine semi-structured interviews conducted with 10 Syrian refugees. Due to the ongoing conflict in Syria, approximately 50,000 Syrian refugees arrived in Canada between 2015 and 2020. Upon arrival, Syrians needed to find housing, employment, healthcare, and language training. They also had to address psychosocial needs, such as cultivating social supports and establishing a sense of safety, which are critical for mitigating trauma and stress related to resettlement. In March 2020, the global COVID-19 pandemic was declared, and disproportionately impacted refugees by compounding pre-existing and systemic health, social, and economic inequities. Refugees are identified as particularly vulnerable during the pandemic due to the precarious working, living, economic, and health conditions they often face. Only three Canadian studies to date have explored Syrian refugee experiences during COVID-19: one used quantitative methods, the other focused on postnatal women, and one explored housing stability. Therefore, there is a dearth of qualitative information regarding how Syrian refugees in Canada have been impacted by the pandemic, especially regarding their psychosocial adaptation during this period. This study explored the impact of the COVID-19 pandemic for Syrian refugees in Canada and identified supports needed, from the perspectives of Syrian refugees themselves. This study is embedded within a broader community-based participatory research project investigating psychosocial adaptation with the Syrian refugee community and used qualitative description and thematic analysis to examine semi-structured interviews conducted with 10 Syrian refugees.
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Racialized, low-income, and migrant communities in East and Northeast Calgary were disproportionately impacted by COVID-19, yet faced vaccine access barriers. This article is a formative evaluation of a low-barrier, community-engaged vaccine outreach clinic in Calgary, Alberta, Canada, on June 5–6, 2021. Stakeholder respondents felt the clinic was effective (99.2%), efficient (96.9%), patient-centered (92.3%), and safe (90.8%), and that the outreach model was scalable 94.6% (123/130). Suggested improvements include increased time for clinic planning and promotion, more multilingual staff, and further efforts to reduce accessibility barriers, such as priority check-in for people with disabilities. These findings support the value of community-engaged outreach to improve vaccine equity among other marginalized newcomer communities. Racialized, low-income, and migrant communities in East and Northeast Calgary were disproportionately impacted by COVID-19, yet faced vaccine access barriers. This article is a formative evaluation of a low-barrier, community-engaged vaccine outreach clinic in Calgary, Alberta, Canada, on June 5–6, 2021. Stakeholder respondents felt the clinic was effective (99.2%), efficient (96.9%), patient-centered (92.3%), and safe (90.8%), and that the outreach model was scalable 94.6% (123/130). Suggested improvements include increased time for clinic planning and promotion, more multilingual staff, and further efforts to reduce accessibility barriers, such as priority check-in for people with disabilities. These findings support the value of community-engaged outreach to improve vaccine equity among other marginalized newcomer communities.
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This study explored refugee experiences with COVID-19 vaccination in Calgary and area in 2021-2022 by interviewing refugees, sponsors of refugees and COVID-19 vaccination system stakeholders This study explored refugee experiences with COVID-19 vaccination in Calgary and area in 2021-2022 by interviewing refugees, sponsors of refugees and COVID-19 vaccination system stakeholders
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Heritage language schools in Edmonton, AB are grassroots organizations that provide various services for newcomers, such as language classes, employment opportunities, community connections, and day care. 25 heritage language schools were studied during the COVID-19 pandemic, and results showed that the schools gave important support to temporary foreign workers (TFWs), combatted anti-Asian racism, and supported front-line workers. Heritage language schools in Edmonton, AB are grassroots organizations that provide various services for newcomers, such as language classes, employment opportunities, community connections, and day care. 25 heritage language schools were studied during the COVID-19 pandemic, and results showed that the schools gave important support to temporary foreign workers (TFWs), combatted anti-Asian racism, and supported front-line workers.
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This cross-sectional study examines the healthcare experiences of Albertans during the COVID-19 pandemic, with a focus on comparing experiences between those born in and outside Canada. The study collected 10,175 surveys in October 2020, with nearly 10% of respondents reporting their status as born outside Canada. The study found that foreign-born Albertans experienced more delays in care and had less access to healthcare services than Canadian-born Albertans. The study highlights the need for policy and practice changes to address the healthcare disparities faced by immigrant populations during the pandemic. This cross-sectional study examines the healthcare experiences of Albertans during the COVID-19 pandemic, with a focus on comparing experiences between those born in and outside Canada. The study collected 10,175 surveys in October 2020, with nearly 10% of respondents reporting their status as born outside Canada. The study found that foreign-born Albertans experienced more delays in care and had less access to healthcare services than Canadian-born Albertans. The study highlights the need for policy and practice changes to address the healthcare disparities faced by immigrant populations during the pandemic.
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This community-based research study provides new data collected from 25 in-depth individual interviews with immigrant women HCAs who were working in LTC in Calgary, Alberta between January 1 and March 30, 2021. The data, analysed through the lens of intersectional exclusion, highlight how the pandemic has impacted the working lives of immigrant women employed in LTC facilities on a daily basis, as well as their suggestions for enhancing their safety and employment conditions. Two key themes emerged during the process of data analysis: (a) HCA experiences of economic exclusion and workplace precarity—many of which pre-dated the pandemic but have been exacerbated by current policies and practices that prioritize profits over quality of community care, and (b) experiences of broader social exclusion, many of which are tied to being considered “just HCAs” who are doing “immigrant’s work”, rather than including HCAs in broader conversations about how to reform and improve the LTC sector for future. Concluding thoughts discuss how to improve policy to support low wage workers within LTC in order to address intersectional inequalities and to better support front-line care workers during current and future health pandemic recovery efforts. This community-based research study provides new data collected from 25 in-depth individual interviews with immigrant women HCAs who were working in LTC in Calgary, Alberta between January 1 and March 30, 2021. The data, analysed through the lens of intersectional exclusion, highlight how the pandemic has impacted the working lives of immigrant women employed in LTC facilities on a daily basis, as well as their suggestions for enhancing their safety and employment conditions. Two key themes emerged during the process of data analysis: (a) HCA experiences of economic exclusion and workplace precarity—many of which pre-dated the pandemic but have been exacerbated by current policies and practices that prioritize profits over quality of community care, and (b) experiences of broader social exclusion, many of which are tied to being considered “just HCAs” who are doing “immigrant’s work”, rather than including HCAs in broader conversations about how to reform and improve the LTC sector for future. Concluding thoughts discuss how to improve policy to support low wage workers within LTC in order to address intersectional inequalities and to better support front-line care workers during current and future health pandemic recovery efforts.
This publication has no Abstract to dispaly