ArticleCMAJ open
Impact of a vaccine passport on first-dose SARS-CoV-2 vaccine coverage by age and area-level social determinants of health in the Canadian provinces of Quebec and Ontario: an interrupted time series analysis.
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6 citing papers in PubMed.
- A scoping review of vaccine certificate implementation in Canada and OECD countries during the COVID-19 pandemic: Outcomes and lessons learned.Human vaccines & immunotherapeutics · 2026Article
- Refining the role of behavioural and social sciences in pandemic response post-COVID-19.Nature human behaviour · 2026Review
- Evaluating COVID-19 vaccination policy in Québec (Canada) using a data-driven dynamic transmission model.PLoS computational biology · 2025Article
- A Canadian multi-province study of COVID-19 vaccine coverage along area-level social determinants in 2021.Public health in practice (Oxford, England) · 2025Article
- Using Human-Centered Design in Community-Based Public Health Research: Insights from the ECHO Study on COVID-19 Vaccine Hesitancy in Montreal, Canada.International journal of environmental research and public health · 2025Article
- Which Curve Are We Flattening? The Disproportionate Impact of COVID-19 Among Economically Marginalized Communities in Ontario, Canada, Was Unchanged From Wild-Type to Omicron.Open forum infectious diseases · 2023Article
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17 authors.
Jorge Luis Flores AnatoDepartment of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont.
Huiting MaDepartment of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont.
Mackenzie A HamiltonDepartment of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont.
Yiqing XiaDepartment of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont.
Sam HarperDepartment of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont.
David BuckeridgeDepartment of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont.
Marc BrissonDepartment of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont.
Michael P HillmerDepartment of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont.
Kamil MalikovDepartment of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont.
Aidin KeremDepartment of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont.
Reed BeallDepartment of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont.
Caroline E WagnerDepartment of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont.
Étienne RacineDepartment of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont.
Stefan BaralDepartment of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont.
Ève DubéDepartment of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont.
Sharmistha MishraDepartment of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont.
Mathieu Maheu-GirouxDepartment of Epidemiology and Biostatistics (Flores Anato, Xia, Harper, Buckeridge, Racine, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Ma, Hamilton, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Centre de Recherche du CHU de Québec and Département de médecine sociale et préventive (Brisson), Université Laval, Québec, Que.; Ontario Ministry of Health (Hillmer, Malikov, Kerem); Institute of Health Policy, Management and Evaluation (Hillmer), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Beall), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Bioengineering (Wagner), McGill University, Montréal, Que.; Direction des risques biologiques (Racine, Dubé), Institut national de santé publique du Québec, Ville de Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Département d'anthropologie (Dubé), Faculté des sciences sociales, Université Laval, Québec, Que.; Division of Infectious Diseases, Department of Medicine (Mishra), University of Toronto, Toronto, Ont. mathieu.maheu-giroux@mcgill.ca.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn Canada, all provinces implemented vaccine passports in 2021 to reduce SARS-CoV-2 transmission in non-essential indoor spaces and increase vaccine uptake (policies active September 2021-March 2022 in Quebec and Ontario). We sought to evaluate the impact of vaccine passport policies on first-dose SARS-CoV-2 vaccination coverage by age, and area-level income and proportion of racialized residents.
methodsWe performed interrupted time series analyses using data from Quebec's and Ontario's vaccine registries linked to census information (population of 20.5 million people aged ≥ 12 yr; unit of analysis: dissemination area). We fit negative binomial regressions to first-dose vaccinations, using natural splines adjusting for baseline vaccination coverage (start: July 2021; end: October 2021 for Quebec, November 2021 for Ontario). We obtained counterfactual vaccination rates and coverage, and estimated the absolute and relative impacts of vaccine passports.
resultsIn both provinces, first-dose vaccination coverage before the announcement of vaccine passports was 82% (age ≥ 12 yr). The announcement resulted in estimated increases in coverage of 0.9 percentage points (95% confidence interval [CI] 0.4-1.2) in Quebec and 0.7 percentage points (95% CI 0.5-0.8) in Ontario. This corresponds to 23% (95% CI 10%-36%) and 19% (95% CI 15%-22%) more vaccinations over 11 weeks. The impact was larger among people aged 12-39 years. Despite lower coverage in lower-income and more-racialized areas, there was little variability in the absolute impact by area-level income or proportion racialized in either province.
interpretationIn the context of high vaccine coverage across 2 provinces, the announcement of vaccine passports had a small impact on first-dose coverage, with little impact on reducing economic and racial inequities in vaccine coverage. Findings suggest that other policies are needed to improve vaccination coverage among lower-income and racialized neighbourhoods and communities.
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