51社区黑料

Reprinted with permission from 51社区黑料News. See original here

by Robyn Stubbs

A 51社区黑料 study is pushing back against the 鈥渆asy narrative鈥� that not getting vaccinated is entirely a personal decision.

Rather, vaccine hesitancy in Canada comes down to significant cultural, administrative, institutional and governance barriers that reinforce mistrust and create inequitable access to vaccines, say 51社区黑料researchers.

Published in the journal Vaccine,  to map how barriers emerge across four areas: cultural and community norms, governance structures, laws and budgets, and institutional design. 

KEY FINDINGS: 

• Top鈥慸own decisions, weak transparency and mixed messages reduce trust.
• Poor data systems and a lack of race-based data limits targeted action. 
• Rigid processes, staffing gaps, and inconvenient clinic hours reduce access.
• Removing ID barriers and providing culturally safe, anti-racist vaccine delivery helps vaccine uptake.
• Peer- and community-led models improve access but lack stable funding.

鈥淚t鈥檚 an easy narrative to say someone just chooses not to get vaccinated, but that鈥檚 unfair and incomplete. If the systems build in extra steps, you may not be 鈥榓nti-vax鈥�, but you're not going to get vaccinated just the same,鈥� says Haaris Tiwana, health sciences researcher and lead author of the study.

鈥淎 single mother who works nine to five can鈥檛 get to a clinic that only runs nine to five. Someone without a family doctor may turn to the internet for information and get misinformation. Someone who can鈥檛 get a translator will go to other community members who may not be well informed. These are not individual failings. These are structural barriers.鈥�

The study found cultural mistrust, religious concerns and social norms strongly shape vaccine views. Many refugees, Indigenous peoples and racialized communities carry deep mistrust rooted in discrimination and negative experiences with the healthcare system, Tiwana says.

Inconsistent messaging and a lack of transparency into how and who makes public health decisions around vaccines only compounds the problem. Top-down vaccination strategies fail because they exclude marginalized communities from decision making, leaving community organizations to fill gaps with little funding or influence, explains Tiwana. 

鈥淧eople want to feel heard. Trusted messengers like elders, faith leaders or community advocates often have as much influence as public health messaging, and sometimes more,鈥� Tiwana says.

鈥淲e found that community鈥憀ed and peer鈥憆un clinics consistently increase access and trust yet remain chronically underfunded and excluded from formal decision鈥憁aking.鈥�

Administrative rules, like identification requirements and eligibility criteria, also makes getting vaccinated more difficult, especially for marginalized people or newcomers to Canada who don鈥檛 yet have access to primary health-care coverage programs, Tiwana says. 

Provinces, territories and even regional health authorities have different messaging and requirements around vaccinations, which only sows more frustration and mistrust, he adds. 

Finally, the study found the way healthcare services are delivered directly impacts vaccination rates. Many sites are hard to reach or operate on schedules that don鈥檛 fit work schedules or caregiving demands. 

Community-led solutions hold key to vaccination trust

The study found lack of culturally safe care can reinforce mistrust, while weak data systems, staffing shortages and rigid practices make equitable access even more difficult.  

鈥淚t鈥檚 important not just label people as anti-vax or vaccine hesitant,鈥� says Julia Smith, adjunct health sciences professor and co-author of the study. 鈥淲e need to ask why they are not vaccinated and ensure they have access to vaccination services where they feel safe.鈥�

Interpersonal and community networks are often just as or more effective than scientific evidence for building vaccination trust, she adds. 

When community organizations partner with local health authorities, like culturally tailored or after鈥慼ours clinics in B.C., for example, people are more likely to ask questions, understand risks and benefits, and ultimately choose vaccination, says Tiwana. 

鈥淭hose community groups are an important way to let people ask the questions they need to ask, in a safe and culturally appropriate space,鈥� he says. 鈥淲e need policies, budgets, and practices to reflect lived experience and engage people at the community level.鈥� 

STUDY RECOMMENDATIONS:

• Involve affected communities directly in planning and messaging. 
• Ensure identification rules and eligibility criteria don鈥檛 exclude newcomers, undocumented people or those without stable housing.
• Support community鈥憀ed programming beyond short鈥憈erm crisis budgets. 
• Train providers, expand translation supports, and adapt care to religious or cultural contexts (for example, offering vaccination outside fasting hours).
• Develop coordinated systems to track disparities and guide equitable policy. 

This research was carried out by the  as part of Canada's Immuno-Engineering and Biomanufacturing Hub. The BRC is funded by the Canada Biomedical Research Fund and Biomedical Research Infrastructure Fund/BC Knowledge Development Fund.