Community Mobilization to Promote Vaccine Confidence During a Global Public Health Emergency: Insights from Peel Region and Toronto (Ontario, Canada) a Qualitative Study.

Background: The Ontario government launched the High Priority Communities Strategy (HPCS) in December 2020, funding community agencies operating in neighborhoods disproportionately affected by COVID-19 in Durham, Peel, Toronto, York, and Ottawa. Community-led task forces and networks also formed with the aim to increase vaccine confidence and uptake among minoritized communities. Objectives: To explore how community-led task forces, networks and agencies mobilized and engaged faith-based and ethno-racial communities in Peel Region and Toronto to improve vaccine confidence and uptake, including perceived facilitators and barriers. Design: Multi-method qualitative study. Methods: Between June 2023 and March 2024, we conducted ten online focus groups with three task forces and six HPCS-funded community agencies, as well as four key-informant interviews with representatives from two task forces and one network. We used thematic analysis to explore respondents' perceptions and experiences. Results: Three key themes emerged. First, community-led task forces, the network and agencies used community mobilization strategies, such as tailored outreach, mitigating vaccine access barriers and leveraging trusted community voices, to improve vaccine confidence and uptake. Second, fostering a sense of community was central to their work, enabled through member engagement and power (knowledge and resource) sharing for collective impact. Third, sustaining community-led efforts was a challenge. The volunteer-driven task forces and network lacked the capacity to formally evaluate their activities or long-term infrastructure, and most disbanded post-pandemic. However, community agencies pivoted to preventative and primary care initiatives under HPCS. Conclusion: Community-led structures contributed to promoting vaccine uptake among ethno-racial and faith-based communities in hotspot areas. Facilitators included the use of trusted messengers and power sharing, while barriers included short-term funding and challenges sustaining efforts over time. Long-term sustainability of these efforts requires continued investment, sustained infrastructure, and strong community partnerships. Lessons from these findings can help strengthen community-led responses to future public health emergencies.