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Vaccine hesitancy among immigrants increases risk of health disparities

Migrants rights organization combats vaccine hesitancy by advocating for all migrants regardless of status.
Over nine million immigrants, refugees, and migrants live in Canada, representing hundreds of cultures and languages and account for 80 per cent of the population growth.

A recent study on the COVID-19 pandemic and immigrant health in Canada revealed that in comparison to their Canadian-born counterparts, immigrants had double the odds of experiencing three health concerns: perceived risk in accessing health care, the stigma of being targeted as risky “others” and hesitancy about the COVID-19 vaccine.

The study supported by the University of Toronto used publicly available data from Statistics Canada. The study showed that minority groups had higher levels of COVID-19 vaccine hesitancy in Canada, conveying that this could lead to underutilization of needed health services despite having a publicly funded health care system.

“…what the COVID-19 pandemic brings to the forefront is that both exposures to health hazards and access to health-enhancing resources are fundamentally different based on nativity, class, race and many other social positions,” the author Shen Lin states. 

Disparities that could lead to serious health problems

Over nine million immigrants, refugees, and migrants live in Canada, representing hundreds of cultures and languages and account for 80 per cent of the population growth. Their risk of exposure to COVID-19 is higher as migrants are heavily represented in essential industries such as personal support worker, nurse aide; where extensive interaction with the public, and living in overcrowded multi-generational housing is prevalent. 

This report found disparities in the occurrence of COVID-19-related health issues and reasons for vaccination refusal by nativity, income and education. 

Canada welcomed over 341,000 permanent residents, including 30,000 resettled refugees in 2019 and the number is increasing each year. The report suggests Canada’s COVID-19 vaccination plan should include migrants and displaced populations-regardless of their legal status—to address their increased fear, stigma and vaccine hesitancy in this turbulent time. 

The Migrant Rights Network in Canada is running a campaign on vaccines for all. They assert that vaccines must be free; not require a health card, be accessible, and not be mandatory for any sector. Undocumented migrants should not live in fear that their personal information can be shared with federal immigration enforcement by accessing healthcare. 

“We work with migrants — so people without permanent resident status, including work permit holders, study permit holders, refugees, asylum seekers and undocumented people,” said Syed Hussan, Executive Director of the Migrant Workers Alliance for Change.

“It is not that our people have greater ‘perception’ of risk or stigma but a reality of it. Many people are turned away from vaccine access because they don’t have health cards, in addition, services are denied because of lack of language access, distance from services (for example, for rural migrant workers), etc.”

The report reinforces that vaccine hesitancy should not be blamed upon individuals. The government must be held accountable for equitable access to COVID-19 vaccines. They also need to ensure that vulnerable people can have their justified questions about vaccine safety answered and have adequate resources and trustworthy health information.

A recent study published by the Canadian Medical Association Journal showed how getting vaccines cannot be framed as one’s personal choice, as there is scientific proof that unvaccinated people raise the risk of infection among the vaccinated people. 

Higher vaccine hesitancy among immigrants

One in every five immigrants in Canada expressed concerns about vaccination soon after the COVID-19 vaccine became available. This made them two times more likely to be affected by the burden of vaccine hesitancy, risk perception of accessing health care and fear of being targeted than their native-born Canadians, according to this study. 

Apart from being migrants to Canada, the sample population also has less educational achievement and dominant financial needs in comparison to their Canadian-born peers. Health-promoting resources are fundamentally unavailable for these groups, and they are at higher risk for infection and adverse clinical outcomes. 

After two years of the pandemic, Canada’s vaccination rate is impressive with more than 84.68 per cent of the population vaccinated with at least one dose. While the rollout of vaccines in Canada is considered to be successful, widespread concern regarding vaccine uptake, accessibility, and equity remains. 

Hussan added that while Canada is planning to grant permanent resident status to 1.3 million people in the next three years, it will also issue over 2.5 million temporary permits in the same period. Hussan also notes that there will be an additional 500,000 undocumented people in the country.

These form the majority of new migrants in the country and most of them won’t have universal health coverage for part of or the entirety of the time they are here. 

“Our position has been that everyone in the country, regardless of immigration status or health card should have access to universal medical coverage for free, which is accessible,” Hussan said. 

Blaming the pandemic on foreign “others” 

The study reports that more than one-quarter of the immigrants in Canada were afraid of being targeted as risky “others” as the government relaxed public health measures, showing the growing xenophobia and anti-immigrant sentiment sparked by the pandemic. Burdened with this anticipated stigma, their well-being and mental health could significantly deteriorate. Due to this, health and mental health disparities which are already prevalent among the immigrant and refugee populations could worsen. 

“…the excess fear may be partly ignited by the framing of ‘foreign virus’ that mistakenly blames the pandemic on foreign ‘others.’”

The anticipation and presumed risk newcomers felt became their reality. In a recent report, Statistics Canada revealed police-reported hate crimes targeting the east or southeast Asian population nearly doubled in 2021 compared to the year before.

According to this report, in 2020, the number of reported hate crimes increased most in Ontario (+316 incidents), British Columbia (+198 incidents), Quebec (+86 incidents), and Alberta (+84 incidents). 

The risk of being targeted persists two years into the pandemic. New Canadian Media tried to reach out to at least three migrant persons in March 2022 who were reluctant to get vaccinated, none of them wanted to talk about it openly and refused to be identified. One claimed they have difficulty breathing and do not have enough information to trust that the vaccine won’t exacerbate it. As the government is relaxing the vaccine mandate, they hope they can carry on without taking the vaccine.