Vaccine Outreach Integrating Community Engagement & Science (VOICES): Addressing COVID‑19 Vaccine Hesitancy and Promoting Uptake among Racialized Sexual and Gender Minority Populations
The rapid development of COVID‑19 vaccines is a huge scientific achievement; to be effective, however, people must get the vaccine. With disparities in COVID‑19 infections and severe disease outcomes among marginalized populations in Canada, vaccination is crucial; yet racialized sexual and gender minority people are among those least likely to be vaccinated-they are also under-represented in pandemic response planning. Systemic discrimination, economic and health inequities, and past unethical medical research heighten distrust of vaccines and health authorities, posing barriers to COVID‑19 vaccination. “Vaccine hesitancy” (VH)-delays in acceptance or refusal of vaccination, even when vaccines are available-is often attributed to anti-vaxxers and ‘deficits’ in scientific literacy among ‘lay people’. However, WHO and leading research emphasize the need to examine multilevel drivers of VH among specific populations and locations-structural factors (e.g. sociocultural, historical, health system, economic); social and community influences (e.g. community norms about vaccination, COVID‑19 stigma)-and for specific vaccines, such as COVID-19. VOICES, an ethnoracially-, gender-, and sexually-diverse multidisciplinary team, will apply a Public Understanding of Science framework and mixed methods-an online survey with discrete choice analysis, follow-up community focus groups, and participatory video to: 1) Explore local understandings of COVID‑19 and VH among racialized sexual and gender minority communities in the Greater Toronto & Hamilton Area; 2) Examine multilevel structural and social factors associated with VH; and 3) Engage with community partners in knowledge mobilization to reduce COVID‑19 VH and promote informed decision-making. VOICES will accelerate the availability of high-quality and real-time evidence to support Canada’s COVID‑19 response by enhancing public and ‘expert’ understanding, dialogue, and COVID‑19 vaccination among marginalized populations.