ArticleBMC public health2026
Institutional factors influencing vaccine access in Canada: a scoping review.
Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhile existing literature has examined vaccine access primarily at individual and community levels in Canada, there remains limited synthesis and knowledge consolidation of how institutional factors shape vaccine access. Where institutional influences have been explored, prior reviews have been limited in scope to specific vaccine programs, populations, or single jurisdictions. This scoping review addresses this gap by systematically mapping how formal and informal institutional factors across federal and provincial governance structures shape vaccine access among all vaccine types and populations in Canada.
methodsThe review adhered to PRISMA Extension for Scoping Reviews (PRISMA-ScR) and Joanna Briggs Institute (JBI) methodological frameworks. Database searches identified English-language sources published 2004-2024. Screening and data extraction were conducted through Zotero, Covidence, and Microsoft Excel. Included sources (n = 134) underwent iterative inductive-deductive thematic coding. Finally, descriptive analysis synthesized findings into narrative summaries categorizing institutional factors as barriers or facilitators.
resultsSix institutional barriers in Canada to vaccine access were identified: inconsistent vaccine supply and availability, public funding and coordination structures, geographic constraints, regulatory prioritization mechanisms, vaccine hesitancy, and information access inequities. Four facilitators demonstrated effectiveness: expanded vaccinator scope of practice, technological advancements, targeted vaccination initiatives, and inter-institutional and community collaboration.
conclusionsThis review extends current evidence on factors influencing vaccine access through consolidation of evidence on institutional determinants of vaccine access in Canada across disciplines, governance levels, and vaccine types with an explicit application of North's institutional theory framework. Findings support evidence-based policy development and health systems strengthening to advance vaccine equity. Priority interventions include harmonization of cross-jurisdictional frameworks, sustainable funding models for community-based delivery, and enhanced data infrastructure supporting equitable access.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.