Abstract
BackgroundDuring the first wave of the H1N1 influenza pandemic in 2009, Aboriginal populations in Canada experienced disproportionate rates of infection, particularly in the province of Manitoba. To protect those thought to be most at-risk, health authorities in Manitoba listed all Aboriginal people, including Metis, among those able to receive priority access to the novel vaccine when it first became available. Currently, no studies exist that have investigated the attitudes, influences, and vaccine behaviors among Aboriginal communities in Canada. This paper is the first to systematically connect vaccine behavior with the attitudes and beliefs that influenced Metis study participants’ H1N1 vaccine decision-making.MethodsResearchers held focus groups (n = 17) with Metis participants in urban, rural, and remote locations of Manitoba following the conclusion of the H1N1 pandemic. Participants were asked about their vaccination decisions and about the factors that influenced their decisions. Following data collection, responses were coded into the broad categories of a social-ecological model, nuanced by categories stemming from earlier research. Responses were then quantified to show the most influential factors in positively or negatively affecting the vaccine decision.ResultsMedia reporting, the influence of peer groups, and prioritization all had positive and negative influential effects on decision making. Whether vaccinated or not, the most negatively influential factors cited by participants were a lack of knowledge about the vaccine and the pandemic as well as concerns about vaccine safety. Risk of contracting H1N1 influenza was the biggest factor in positively influencing a vaccine decision, which in many cases trumped any co-existing negative influencers.ConclusionsMetis experiences of colonialism in Canada deeply affected their perceptions of the vaccine and pandemic, a context that health systems need to take into account when planning response activities in the future. Participants felt under-informed about most aspects of the vaccine and the pandemic, and many vaccine related misconceptions and fears existed. Recommendations include leveraging doctor-patient interactions as a site for sharing vaccine-related knowledge, as well as targeted, culturally-appropriate, and empowering public information strategies to supply reliable vaccine and pandemic information to potentially at-risk Aboriginal populations.
Highlights
During the first wave of the H1N1 influenza pandemic in 2009, Aboriginal populations in Canada experienced disproportionate rates of infection, in the province of Manitoba
The emergence and rapid spread of an H1N1 influenza virus in the spring of 2009 prompted health systems around the world to support the development of a novel vaccine as part of their response strategies
The quantity of research that examines attitudes of particular ethnic groups towards novel vaccines is quite limited [6,7,8,9,10,11,12,13], and an even greater gap exists for studies that investigate vaccine behaviors and related attitudes among Aboriginal communities in Canada
Summary
During the first wave of the H1N1 influenza pandemic in 2009, Aboriginal populations in Canada experienced disproportionate rates of infection, in the province of Manitoba To protect those thought to be most at-risk, health authorities in Manitoba listed all Aboriginal people, including Metis, among those able to receive priority access to the novel vaccine when it first became available. In the Canadian province of Manitoba, a number of northern First Nation reserves experienced extraordinarily high rates of infection during the first wave of H1N1 (April 12 to August 29, 2009) This likely contributed to provincial health officials deciding to put all Aboriginal persons—First Nations, Metis, and Inuit—on the province’s H1N1 vaccine priority list [1,2]. This paper is the first to systematically document vaccine behavior with the attitudes and beliefs that influenced Metis people’s decisions to be vaccinated against H1N1 or not
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