Comparison of COVID-19 vaccination rollout approaches across Canada: case studies of four diverse provinces

Pillar 8
Public Health, Health Systems and Social Policy Impacts

Our team observed significant differences in provincial vaccination campaigns: for example, Nova Scotia was the only province to state explicit coverage goals and adhere to plans tying coverage to the relaxation of public health measures. Both Nova Scotia and British Columbia implemented fully centralized vaccination booking systems in contrast to Saskatchewan, which initially pursued a highly centralized approach, but later devolved some responsibility to community pharmacies. Ontario, in alignment with its decentralized health system, pursued a regionalized approach primarily led by its existing public health unit network. Our analysis concludes that explicit goals, centralized booking, and flexible delivery strategies improved uptake.

Vaccination remains a key tool for protecting Canadians against COVID-19 and other diseases. Rates of coverage with primary and booster doses of COVID-19 vaccine have varied significantly across jurisdictions and population groups. During the COVID-19 pandemic, each province and territory designed and implemented its own vaccination campaign. Research shows that the ways in which health services, such as vaccinations, are administered impact utilization/uptake, yet there has been little comparative examination of Canadian vaccination campaigns. It is imperative to identify campaign lessons to inform ongoing and future vaccination efforts.

Starting with four pilot provinces (British Columbia, Saskatchewan, Ontario, Nova Scotia) selected for diversity in their COVID-19 experience and policy approaches, sociodemographic profiles, and underlying health system organization, we performed comprehensive case studies of provincial/territorial vaccination campaigns followed by cross-case analysis to identify key similarities and differences, as well as to assess the relationship between campaign features and vaccine uptake. Specifically, we collected data regarding the following campaign components: underlying principles and goals; governance and authority; transparency and diversity of communications; activities to strengthen infrastructure and workforce capacity; and entitlement and access. Initially, we focused on rollout of the primary two-dose vaccination series to adults between December 2020 and December 2021. Details regarding the four provincial campaigns can be found side-by-side in the Supplementary Tables.

Ongoing research will analyze the vaccination campaign activities of all 13 provinces/territories through late fall/early winter of 2023.

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