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Romanchuk K, Linthwaite B, Cox J, Park H, Dussault C, Basta NE, Varsaneux O, Worthington J, Lebouché B, MacDonald SE, Ismail SJ, Kronfli N. Determinants of SARS-CoV-2 vaccine willingness among people incarcerated in 3 Canadian federal prisons: a cross-sectional study. CMAJ Open 2022; 10:E922-E929. [PMID: 36280247 PMCID: PMC9640165 DOI: 10.9778/cmajo.20210248] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Maximizing uptake of SARS-CoV-2 vaccines among people in prison is essential in mitigating future outbreaks. We aimed to determine factors associated with willingness to receive SARS-CoV-2 vaccination before vaccine availability. METHODS We chose 3 Canadian federal prisons based on their low uptake of influenza vaccines in 2019-2020. Participants completed a self-administered questionnaire on knowledge, attitude and beliefs toward vaccines. The primary outcome was participant willingness to receive a SARS-CoV-2 vaccine, measured using a 5-point Likert scale to the question, "If a safe and effective COVID-19 vaccine becomes available in prison, how likely are you to get vaccinated?" We calculated the association of independent variables (age, ethnicity, chronic health conditions, 2019-2020 influenza vaccine uptake and prison security level), identified a priori, with vaccine willingness using logistic regression and crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS We recruited 240 participants from Mar. 31 to Apr. 19, 2021 (median age 46 years; 19.2% female, 25.8% Indigenous). Of these, 178 (74.2%) were very willing to receive a SARS-CoV-2 vaccine. Participants who received the 2019-2020 influenza vaccine (adjusted OR 5.20, 95% CI 2.43-12.00) had higher odds of vaccine willingness than those who did not; those who self-identified as Indigenous (adjusted OR 0.27, 95% CI 0.11-0.60) and in medium- or maximum-security prisons (adjusted OR 0.36, 95% CI 0.12-0.92) had lower odds of vaccine willingness than those who identified as white or those in minimum-security prisons, respectively. INTERPRETATION Most participants were very willing to receive vaccination against SARS-CoV-2 before vaccine roll-out. Vaccine promotion campaigns should target groups with low vaccine willingness (i.e., those who have declined influenza vaccine, identify as Indigenous or reside in high-security prisons).
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Affiliation(s)
- Kathryn Romanchuk
- Centre for Outcomes Research and Evaluation (Romanchuk, Linthwaite, Cox, Park, Dussault, Lebouché, Kronfli), Research Institute of the McGill University Health Centre; Department of Epidemiology, Biostatistics and Occupational Health (Cox, Basta, Kronfli), School of Population and Global Health, McGill University; Department of Medicine (Cox, Lebouché, Kronfli), Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, Que.; Correctional Service Canada (Varsaneux, Worthington), Ottawa, Ont.; Department of Family Medicine (Lebouché), McGill University, Montréal, Que.; Faculty of Nursing (MacDonald), University of Alberta; School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Division of Immunization Programs and Pandemic Preparedness (Ismail), Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada and Metro City Medical Clinic, Ottawa, Ont
| | - Blake Linthwaite
- Centre for Outcomes Research and Evaluation (Romanchuk, Linthwaite, Cox, Park, Dussault, Lebouché, Kronfli), Research Institute of the McGill University Health Centre; Department of Epidemiology, Biostatistics and Occupational Health (Cox, Basta, Kronfli), School of Population and Global Health, McGill University; Department of Medicine (Cox, Lebouché, Kronfli), Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, Que.; Correctional Service Canada (Varsaneux, Worthington), Ottawa, Ont.; Department of Family Medicine (Lebouché), McGill University, Montréal, Que.; Faculty of Nursing (MacDonald), University of Alberta; School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Division of Immunization Programs and Pandemic Preparedness (Ismail), Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada and Metro City Medical Clinic, Ottawa, Ont
| | - Joseph Cox
- Centre for Outcomes Research and Evaluation (Romanchuk, Linthwaite, Cox, Park, Dussault, Lebouché, Kronfli), Research Institute of the McGill University Health Centre; Department of Epidemiology, Biostatistics and Occupational Health (Cox, Basta, Kronfli), School of Population and Global Health, McGill University; Department of Medicine (Cox, Lebouché, Kronfli), Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, Que.; Correctional Service Canada (Varsaneux, Worthington), Ottawa, Ont.; Department of Family Medicine (Lebouché), McGill University, Montréal, Que.; Faculty of Nursing (MacDonald), University of Alberta; School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Division of Immunization Programs and Pandemic Preparedness (Ismail), Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada and Metro City Medical Clinic, Ottawa, Ont
| | - Hyejin Park
- Centre for Outcomes Research and Evaluation (Romanchuk, Linthwaite, Cox, Park, Dussault, Lebouché, Kronfli), Research Institute of the McGill University Health Centre; Department of Epidemiology, Biostatistics and Occupational Health (Cox, Basta, Kronfli), School of Population and Global Health, McGill University; Department of Medicine (Cox, Lebouché, Kronfli), Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, Que.; Correctional Service Canada (Varsaneux, Worthington), Ottawa, Ont.; Department of Family Medicine (Lebouché), McGill University, Montréal, Que.; Faculty of Nursing (MacDonald), University of Alberta; School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Division of Immunization Programs and Pandemic Preparedness (Ismail), Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada and Metro City Medical Clinic, Ottawa, Ont
| | - Camille Dussault
- Centre for Outcomes Research and Evaluation (Romanchuk, Linthwaite, Cox, Park, Dussault, Lebouché, Kronfli), Research Institute of the McGill University Health Centre; Department of Epidemiology, Biostatistics and Occupational Health (Cox, Basta, Kronfli), School of Population and Global Health, McGill University; Department of Medicine (Cox, Lebouché, Kronfli), Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, Que.; Correctional Service Canada (Varsaneux, Worthington), Ottawa, Ont.; Department of Family Medicine (Lebouché), McGill University, Montréal, Que.; Faculty of Nursing (MacDonald), University of Alberta; School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Division of Immunization Programs and Pandemic Preparedness (Ismail), Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada and Metro City Medical Clinic, Ottawa, Ont
| | - Nicole E Basta
- Centre for Outcomes Research and Evaluation (Romanchuk, Linthwaite, Cox, Park, Dussault, Lebouché, Kronfli), Research Institute of the McGill University Health Centre; Department of Epidemiology, Biostatistics and Occupational Health (Cox, Basta, Kronfli), School of Population and Global Health, McGill University; Department of Medicine (Cox, Lebouché, Kronfli), Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, Que.; Correctional Service Canada (Varsaneux, Worthington), Ottawa, Ont.; Department of Family Medicine (Lebouché), McGill University, Montréal, Que.; Faculty of Nursing (MacDonald), University of Alberta; School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Division of Immunization Programs and Pandemic Preparedness (Ismail), Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada and Metro City Medical Clinic, Ottawa, Ont
| | - Olivia Varsaneux
- Centre for Outcomes Research and Evaluation (Romanchuk, Linthwaite, Cox, Park, Dussault, Lebouché, Kronfli), Research Institute of the McGill University Health Centre; Department of Epidemiology, Biostatistics and Occupational Health (Cox, Basta, Kronfli), School of Population and Global Health, McGill University; Department of Medicine (Cox, Lebouché, Kronfli), Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, Que.; Correctional Service Canada (Varsaneux, Worthington), Ottawa, Ont.; Department of Family Medicine (Lebouché), McGill University, Montréal, Que.; Faculty of Nursing (MacDonald), University of Alberta; School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Division of Immunization Programs and Pandemic Preparedness (Ismail), Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada and Metro City Medical Clinic, Ottawa, Ont
| | - James Worthington
- Centre for Outcomes Research and Evaluation (Romanchuk, Linthwaite, Cox, Park, Dussault, Lebouché, Kronfli), Research Institute of the McGill University Health Centre; Department of Epidemiology, Biostatistics and Occupational Health (Cox, Basta, Kronfli), School of Population and Global Health, McGill University; Department of Medicine (Cox, Lebouché, Kronfli), Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, Que.; Correctional Service Canada (Varsaneux, Worthington), Ottawa, Ont.; Department of Family Medicine (Lebouché), McGill University, Montréal, Que.; Faculty of Nursing (MacDonald), University of Alberta; School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Division of Immunization Programs and Pandemic Preparedness (Ismail), Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada and Metro City Medical Clinic, Ottawa, Ont
| | - Bertrand Lebouché
- Centre for Outcomes Research and Evaluation (Romanchuk, Linthwaite, Cox, Park, Dussault, Lebouché, Kronfli), Research Institute of the McGill University Health Centre; Department of Epidemiology, Biostatistics and Occupational Health (Cox, Basta, Kronfli), School of Population and Global Health, McGill University; Department of Medicine (Cox, Lebouché, Kronfli), Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, Que.; Correctional Service Canada (Varsaneux, Worthington), Ottawa, Ont.; Department of Family Medicine (Lebouché), McGill University, Montréal, Que.; Faculty of Nursing (MacDonald), University of Alberta; School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Division of Immunization Programs and Pandemic Preparedness (Ismail), Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada and Metro City Medical Clinic, Ottawa, Ont
| | - Shannon E MacDonald
- Centre for Outcomes Research and Evaluation (Romanchuk, Linthwaite, Cox, Park, Dussault, Lebouché, Kronfli), Research Institute of the McGill University Health Centre; Department of Epidemiology, Biostatistics and Occupational Health (Cox, Basta, Kronfli), School of Population and Global Health, McGill University; Department of Medicine (Cox, Lebouché, Kronfli), Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, Que.; Correctional Service Canada (Varsaneux, Worthington), Ottawa, Ont.; Department of Family Medicine (Lebouché), McGill University, Montréal, Que.; Faculty of Nursing (MacDonald), University of Alberta; School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Division of Immunization Programs and Pandemic Preparedness (Ismail), Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada and Metro City Medical Clinic, Ottawa, Ont
| | - Shainoor J Ismail
- Centre for Outcomes Research and Evaluation (Romanchuk, Linthwaite, Cox, Park, Dussault, Lebouché, Kronfli), Research Institute of the McGill University Health Centre; Department of Epidemiology, Biostatistics and Occupational Health (Cox, Basta, Kronfli), School of Population and Global Health, McGill University; Department of Medicine (Cox, Lebouché, Kronfli), Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, Que.; Correctional Service Canada (Varsaneux, Worthington), Ottawa, Ont.; Department of Family Medicine (Lebouché), McGill University, Montréal, Que.; Faculty of Nursing (MacDonald), University of Alberta; School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Division of Immunization Programs and Pandemic Preparedness (Ismail), Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada and Metro City Medical Clinic, Ottawa, Ont
| | - Nadine Kronfli
- Centre for Outcomes Research and Evaluation (Romanchuk, Linthwaite, Cox, Park, Dussault, Lebouché, Kronfli), Research Institute of the McGill University Health Centre; Department of Epidemiology, Biostatistics and Occupational Health (Cox, Basta, Kronfli), School of Population and Global Health, McGill University; Department of Medicine (Cox, Lebouché, Kronfli), Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, Que.; Correctional Service Canada (Varsaneux, Worthington), Ottawa, Ont.; Department of Family Medicine (Lebouché), McGill University, Montréal, Que.; Faculty of Nursing (MacDonald), University of Alberta; School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Division of Immunization Programs and Pandemic Preparedness (Ismail), Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada and Metro City Medical Clinic, Ottawa, Ont.
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Anand SS, Arnold C, Bangdiwala SI, Bolotin S, Bowdish D, Chanchlani R, de Souza RJ, Desai D, Kandasamy S, Khan F, Khan Z, Langlois MA, Limbachia J, Lear SA, Loeb M, Loh L, Manoharan B, Nakka K, Pelchat M, Punthakee Z, Schulze KM, Williams N, Wahi G. Seropositivity and risk factors for SARS-CoV-2 infection in a South Asian community in Ontario: a cross-sectional analysis of a prospective cohort study. CMAJ Open 2022; 10:E599-E609. [PMID: 35790229 PMCID: PMC9262348 DOI: 10.9778/cmajo.20220031] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Early in the COVID-19 pandemic, the South Asian community in the Greater Toronto Area (GTA) was identified as having risk factors for exposure and specific barriers to accessing testing and reliable health information, rendering them particularly vulnerable to SARS-CoV-2 infection. We sought to investigate the burden of SARS-CoV-2 infection among South Asian people in the GTA, and to characterize the demographic characteristics, risk perceptions and trusted sources of health information in this group. METHODS We conducted a cross-sectional analysis from the baseline assessment of participants in a prospective cohort study. Participants from the GTA were enrolled from Apr. 14 to July 28, 2021. Seropositivity for antispike and antinucleocapsid antibodies was determined from dried blood spots, and estimates of seropositivity were age and sex standardized to the South Asian population in Ontario. Demographic characteristics, risk perceptions and sources of COVID-19 information were collected via questionnaire and reported descriptively. RESULTS Among the 916 South Asian participants enrolled (mean age 41 yr), the age- and sex-standardized seropositivity was 23.6% (95% confidence interval 20.8%-26.4%). Of the 693 respondents to the questionnaire, 228 (32.9%) identified as essential workers, and 125 (19.1%) reported living in a multigenerational household. A total of 288 (49.4%) perceived that they were at high COVID-19 risk owing to their geographic location, and 149 (34.3%) owing to their type of employment. The top 3 most trusted sources of information related to COVID-19 included health care providers and public health, traditional media sources and social media. INTERPRETATION By the third wave of the COVID-19 pandemic, about one-quarter of a sample of South Asian individuals in Ontario had serologic evidence of prior SARS-CoV-2 infection. Insight into factors that put certain populations at risk can help future pandemic planning and disease control efforts.
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Affiliation(s)
- Sonia S Anand
- Department of Medicine (Anand, Bowdish, Punthakee, Schulze, Williams), McMaster University; Population Health Research Institute (Anand, Bangdiwala, de Souza, Desai, F. Khan, Z. Khan, Limbachia, Punthakee), Hamilton, Ont.; Department of Biochemistry, Microbiology and Immunology (Arnold, Langlois, Nakka, Pelchat), University of Ottawa, Ottawa, Ont.; Department of Health Research Methods, Evidence and Impact (Bangdiwala, de Souza, Kandasamy, Loeb, Manoharan), McMaster University, Hamilton, Ont.; Public Health Ontario (Bolotin); Dalla Lana School of Public Health (Bolotin, Loh), University of Toronto, Toronto, Ont.; Department of Pediatrics (Chanchlani, Wahi), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Lear), Simon Fraser University, Vancouver, BC; Department of Pathology and Molecular Medicine (Loeb), McMaster University, Hamilton, Ont.
| | - Corey Arnold
- Department of Medicine (Anand, Bowdish, Punthakee, Schulze, Williams), McMaster University; Population Health Research Institute (Anand, Bangdiwala, de Souza, Desai, F. Khan, Z. Khan, Limbachia, Punthakee), Hamilton, Ont.; Department of Biochemistry, Microbiology and Immunology (Arnold, Langlois, Nakka, Pelchat), University of Ottawa, Ottawa, Ont.; Department of Health Research Methods, Evidence and Impact (Bangdiwala, de Souza, Kandasamy, Loeb, Manoharan), McMaster University, Hamilton, Ont.; Public Health Ontario (Bolotin); Dalla Lana School of Public Health (Bolotin, Loh), University of Toronto, Toronto, Ont.; Department of Pediatrics (Chanchlani, Wahi), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Lear), Simon Fraser University, Vancouver, BC; Department of Pathology and Molecular Medicine (Loeb), McMaster University, Hamilton, Ont
| | - Shrikant I Bangdiwala
- Department of Medicine (Anand, Bowdish, Punthakee, Schulze, Williams), McMaster University; Population Health Research Institute (Anand, Bangdiwala, de Souza, Desai, F. Khan, Z. Khan, Limbachia, Punthakee), Hamilton, Ont.; Department of Biochemistry, Microbiology and Immunology (Arnold, Langlois, Nakka, Pelchat), University of Ottawa, Ottawa, Ont.; Department of Health Research Methods, Evidence and Impact (Bangdiwala, de Souza, Kandasamy, Loeb, Manoharan), McMaster University, Hamilton, Ont.; Public Health Ontario (Bolotin); Dalla Lana School of Public Health (Bolotin, Loh), University of Toronto, Toronto, Ont.; Department of Pediatrics (Chanchlani, Wahi), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Lear), Simon Fraser University, Vancouver, BC; Department of Pathology and Molecular Medicine (Loeb), McMaster University, Hamilton, Ont
| | - Shelly Bolotin
- Department of Medicine (Anand, Bowdish, Punthakee, Schulze, Williams), McMaster University; Population Health Research Institute (Anand, Bangdiwala, de Souza, Desai, F. Khan, Z. Khan, Limbachia, Punthakee), Hamilton, Ont.; Department of Biochemistry, Microbiology and Immunology (Arnold, Langlois, Nakka, Pelchat), University of Ottawa, Ottawa, Ont.; Department of Health Research Methods, Evidence and Impact (Bangdiwala, de Souza, Kandasamy, Loeb, Manoharan), McMaster University, Hamilton, Ont.; Public Health Ontario (Bolotin); Dalla Lana School of Public Health (Bolotin, Loh), University of Toronto, Toronto, Ont.; Department of Pediatrics (Chanchlani, Wahi), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Lear), Simon Fraser University, Vancouver, BC; Department of Pathology and Molecular Medicine (Loeb), McMaster University, Hamilton, Ont
| | - Dawn Bowdish
- Department of Medicine (Anand, Bowdish, Punthakee, Schulze, Williams), McMaster University; Population Health Research Institute (Anand, Bangdiwala, de Souza, Desai, F. Khan, Z. Khan, Limbachia, Punthakee), Hamilton, Ont.; Department of Biochemistry, Microbiology and Immunology (Arnold, Langlois, Nakka, Pelchat), University of Ottawa, Ottawa, Ont.; Department of Health Research Methods, Evidence and Impact (Bangdiwala, de Souza, Kandasamy, Loeb, Manoharan), McMaster University, Hamilton, Ont.; Public Health Ontario (Bolotin); Dalla Lana School of Public Health (Bolotin, Loh), University of Toronto, Toronto, Ont.; Department of Pediatrics (Chanchlani, Wahi), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Lear), Simon Fraser University, Vancouver, BC; Department of Pathology and Molecular Medicine (Loeb), McMaster University, Hamilton, Ont
| | - Rahul Chanchlani
- Department of Medicine (Anand, Bowdish, Punthakee, Schulze, Williams), McMaster University; Population Health Research Institute (Anand, Bangdiwala, de Souza, Desai, F. Khan, Z. Khan, Limbachia, Punthakee), Hamilton, Ont.; Department of Biochemistry, Microbiology and Immunology (Arnold, Langlois, Nakka, Pelchat), University of Ottawa, Ottawa, Ont.; Department of Health Research Methods, Evidence and Impact (Bangdiwala, de Souza, Kandasamy, Loeb, Manoharan), McMaster University, Hamilton, Ont.; Public Health Ontario (Bolotin); Dalla Lana School of Public Health (Bolotin, Loh), University of Toronto, Toronto, Ont.; Department of Pediatrics (Chanchlani, Wahi), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Lear), Simon Fraser University, Vancouver, BC; Department of Pathology and Molecular Medicine (Loeb), McMaster University, Hamilton, Ont
| | - Russell J de Souza
- Department of Medicine (Anand, Bowdish, Punthakee, Schulze, Williams), McMaster University; Population Health Research Institute (Anand, Bangdiwala, de Souza, Desai, F. Khan, Z. Khan, Limbachia, Punthakee), Hamilton, Ont.; Department of Biochemistry, Microbiology and Immunology (Arnold, Langlois, Nakka, Pelchat), University of Ottawa, Ottawa, Ont.; Department of Health Research Methods, Evidence and Impact (Bangdiwala, de Souza, Kandasamy, Loeb, Manoharan), McMaster University, Hamilton, Ont.; Public Health Ontario (Bolotin); Dalla Lana School of Public Health (Bolotin, Loh), University of Toronto, Toronto, Ont.; Department of Pediatrics (Chanchlani, Wahi), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Lear), Simon Fraser University, Vancouver, BC; Department of Pathology and Molecular Medicine (Loeb), McMaster University, Hamilton, Ont
| | - Dipika Desai
- Department of Medicine (Anand, Bowdish, Punthakee, Schulze, Williams), McMaster University; Population Health Research Institute (Anand, Bangdiwala, de Souza, Desai, F. Khan, Z. Khan, Limbachia, Punthakee), Hamilton, Ont.; Department of Biochemistry, Microbiology and Immunology (Arnold, Langlois, Nakka, Pelchat), University of Ottawa, Ottawa, Ont.; Department of Health Research Methods, Evidence and Impact (Bangdiwala, de Souza, Kandasamy, Loeb, Manoharan), McMaster University, Hamilton, Ont.; Public Health Ontario (Bolotin); Dalla Lana School of Public Health (Bolotin, Loh), University of Toronto, Toronto, Ont.; Department of Pediatrics (Chanchlani, Wahi), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Lear), Simon Fraser University, Vancouver, BC; Department of Pathology and Molecular Medicine (Loeb), McMaster University, Hamilton, Ont
| | - Sujane Kandasamy
- Department of Medicine (Anand, Bowdish, Punthakee, Schulze, Williams), McMaster University; Population Health Research Institute (Anand, Bangdiwala, de Souza, Desai, F. Khan, Z. Khan, Limbachia, Punthakee), Hamilton, Ont.; Department of Biochemistry, Microbiology and Immunology (Arnold, Langlois, Nakka, Pelchat), University of Ottawa, Ottawa, Ont.; Department of Health Research Methods, Evidence and Impact (Bangdiwala, de Souza, Kandasamy, Loeb, Manoharan), McMaster University, Hamilton, Ont.; Public Health Ontario (Bolotin); Dalla Lana School of Public Health (Bolotin, Loh), University of Toronto, Toronto, Ont.; Department of Pediatrics (Chanchlani, Wahi), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Lear), Simon Fraser University, Vancouver, BC; Department of Pathology and Molecular Medicine (Loeb), McMaster University, Hamilton, Ont
| | - Farah Khan
- Department of Medicine (Anand, Bowdish, Punthakee, Schulze, Williams), McMaster University; Population Health Research Institute (Anand, Bangdiwala, de Souza, Desai, F. Khan, Z. Khan, Limbachia, Punthakee), Hamilton, Ont.; Department of Biochemistry, Microbiology and Immunology (Arnold, Langlois, Nakka, Pelchat), University of Ottawa, Ottawa, Ont.; Department of Health Research Methods, Evidence and Impact (Bangdiwala, de Souza, Kandasamy, Loeb, Manoharan), McMaster University, Hamilton, Ont.; Public Health Ontario (Bolotin); Dalla Lana School of Public Health (Bolotin, Loh), University of Toronto, Toronto, Ont.; Department of Pediatrics (Chanchlani, Wahi), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Lear), Simon Fraser University, Vancouver, BC; Department of Pathology and Molecular Medicine (Loeb), McMaster University, Hamilton, Ont
| | - Zainab Khan
- Department of Medicine (Anand, Bowdish, Punthakee, Schulze, Williams), McMaster University; Population Health Research Institute (Anand, Bangdiwala, de Souza, Desai, F. Khan, Z. Khan, Limbachia, Punthakee), Hamilton, Ont.; Department of Biochemistry, Microbiology and Immunology (Arnold, Langlois, Nakka, Pelchat), University of Ottawa, Ottawa, Ont.; Department of Health Research Methods, Evidence and Impact (Bangdiwala, de Souza, Kandasamy, Loeb, Manoharan), McMaster University, Hamilton, Ont.; Public Health Ontario (Bolotin); Dalla Lana School of Public Health (Bolotin, Loh), University of Toronto, Toronto, Ont.; Department of Pediatrics (Chanchlani, Wahi), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Lear), Simon Fraser University, Vancouver, BC; Department of Pathology and Molecular Medicine (Loeb), McMaster University, Hamilton, Ont
| | - Marc-André Langlois
- Department of Medicine (Anand, Bowdish, Punthakee, Schulze, Williams), McMaster University; Population Health Research Institute (Anand, Bangdiwala, de Souza, Desai, F. Khan, Z. Khan, Limbachia, Punthakee), Hamilton, Ont.; Department of Biochemistry, Microbiology and Immunology (Arnold, Langlois, Nakka, Pelchat), University of Ottawa, Ottawa, Ont.; Department of Health Research Methods, Evidence and Impact (Bangdiwala, de Souza, Kandasamy, Loeb, Manoharan), McMaster University, Hamilton, Ont.; Public Health Ontario (Bolotin); Dalla Lana School of Public Health (Bolotin, Loh), University of Toronto, Toronto, Ont.; Department of Pediatrics (Chanchlani, Wahi), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Lear), Simon Fraser University, Vancouver, BC; Department of Pathology and Molecular Medicine (Loeb), McMaster University, Hamilton, Ont
| | - Jayneel Limbachia
- Department of Medicine (Anand, Bowdish, Punthakee, Schulze, Williams), McMaster University; Population Health Research Institute (Anand, Bangdiwala, de Souza, Desai, F. Khan, Z. Khan, Limbachia, Punthakee), Hamilton, Ont.; Department of Biochemistry, Microbiology and Immunology (Arnold, Langlois, Nakka, Pelchat), University of Ottawa, Ottawa, Ont.; Department of Health Research Methods, Evidence and Impact (Bangdiwala, de Souza, Kandasamy, Loeb, Manoharan), McMaster University, Hamilton, Ont.; Public Health Ontario (Bolotin); Dalla Lana School of Public Health (Bolotin, Loh), University of Toronto, Toronto, Ont.; Department of Pediatrics (Chanchlani, Wahi), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Lear), Simon Fraser University, Vancouver, BC; Department of Pathology and Molecular Medicine (Loeb), McMaster University, Hamilton, Ont
| | - Scott A Lear
- Department of Medicine (Anand, Bowdish, Punthakee, Schulze, Williams), McMaster University; Population Health Research Institute (Anand, Bangdiwala, de Souza, Desai, F. Khan, Z. Khan, Limbachia, Punthakee), Hamilton, Ont.; Department of Biochemistry, Microbiology and Immunology (Arnold, Langlois, Nakka, Pelchat), University of Ottawa, Ottawa, Ont.; Department of Health Research Methods, Evidence and Impact (Bangdiwala, de Souza, Kandasamy, Loeb, Manoharan), McMaster University, Hamilton, Ont.; Public Health Ontario (Bolotin); Dalla Lana School of Public Health (Bolotin, Loh), University of Toronto, Toronto, Ont.; Department of Pediatrics (Chanchlani, Wahi), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Lear), Simon Fraser University, Vancouver, BC; Department of Pathology and Molecular Medicine (Loeb), McMaster University, Hamilton, Ont
| | - Mark Loeb
- Department of Medicine (Anand, Bowdish, Punthakee, Schulze, Williams), McMaster University; Population Health Research Institute (Anand, Bangdiwala, de Souza, Desai, F. Khan, Z. Khan, Limbachia, Punthakee), Hamilton, Ont.; Department of Biochemistry, Microbiology and Immunology (Arnold, Langlois, Nakka, Pelchat), University of Ottawa, Ottawa, Ont.; Department of Health Research Methods, Evidence and Impact (Bangdiwala, de Souza, Kandasamy, Loeb, Manoharan), McMaster University, Hamilton, Ont.; Public Health Ontario (Bolotin); Dalla Lana School of Public Health (Bolotin, Loh), University of Toronto, Toronto, Ont.; Department of Pediatrics (Chanchlani, Wahi), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Lear), Simon Fraser University, Vancouver, BC; Department of Pathology and Molecular Medicine (Loeb), McMaster University, Hamilton, Ont
| | - Lawrence Loh
- Department of Medicine (Anand, Bowdish, Punthakee, Schulze, Williams), McMaster University; Population Health Research Institute (Anand, Bangdiwala, de Souza, Desai, F. Khan, Z. Khan, Limbachia, Punthakee), Hamilton, Ont.; Department of Biochemistry, Microbiology and Immunology (Arnold, Langlois, Nakka, Pelchat), University of Ottawa, Ottawa, Ont.; Department of Health Research Methods, Evidence and Impact (Bangdiwala, de Souza, Kandasamy, Loeb, Manoharan), McMaster University, Hamilton, Ont.; Public Health Ontario (Bolotin); Dalla Lana School of Public Health (Bolotin, Loh), University of Toronto, Toronto, Ont.; Department of Pediatrics (Chanchlani, Wahi), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Lear), Simon Fraser University, Vancouver, BC; Department of Pathology and Molecular Medicine (Loeb), McMaster University, Hamilton, Ont
| | - Baanu Manoharan
- Department of Medicine (Anand, Bowdish, Punthakee, Schulze, Williams), McMaster University; Population Health Research Institute (Anand, Bangdiwala, de Souza, Desai, F. Khan, Z. Khan, Limbachia, Punthakee), Hamilton, Ont.; Department of Biochemistry, Microbiology and Immunology (Arnold, Langlois, Nakka, Pelchat), University of Ottawa, Ottawa, Ont.; Department of Health Research Methods, Evidence and Impact (Bangdiwala, de Souza, Kandasamy, Loeb, Manoharan), McMaster University, Hamilton, Ont.; Public Health Ontario (Bolotin); Dalla Lana School of Public Health (Bolotin, Loh), University of Toronto, Toronto, Ont.; Department of Pediatrics (Chanchlani, Wahi), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Lear), Simon Fraser University, Vancouver, BC; Department of Pathology and Molecular Medicine (Loeb), McMaster University, Hamilton, Ont
| | - Kiran Nakka
- Department of Medicine (Anand, Bowdish, Punthakee, Schulze, Williams), McMaster University; Population Health Research Institute (Anand, Bangdiwala, de Souza, Desai, F. Khan, Z. Khan, Limbachia, Punthakee), Hamilton, Ont.; Department of Biochemistry, Microbiology and Immunology (Arnold, Langlois, Nakka, Pelchat), University of Ottawa, Ottawa, Ont.; Department of Health Research Methods, Evidence and Impact (Bangdiwala, de Souza, Kandasamy, Loeb, Manoharan), McMaster University, Hamilton, Ont.; Public Health Ontario (Bolotin); Dalla Lana School of Public Health (Bolotin, Loh), University of Toronto, Toronto, Ont.; Department of Pediatrics (Chanchlani, Wahi), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Lear), Simon Fraser University, Vancouver, BC; Department of Pathology and Molecular Medicine (Loeb), McMaster University, Hamilton, Ont
| | - Martin Pelchat
- Department of Medicine (Anand, Bowdish, Punthakee, Schulze, Williams), McMaster University; Population Health Research Institute (Anand, Bangdiwala, de Souza, Desai, F. Khan, Z. Khan, Limbachia, Punthakee), Hamilton, Ont.; Department of Biochemistry, Microbiology and Immunology (Arnold, Langlois, Nakka, Pelchat), University of Ottawa, Ottawa, Ont.; Department of Health Research Methods, Evidence and Impact (Bangdiwala, de Souza, Kandasamy, Loeb, Manoharan), McMaster University, Hamilton, Ont.; Public Health Ontario (Bolotin); Dalla Lana School of Public Health (Bolotin, Loh), University of Toronto, Toronto, Ont.; Department of Pediatrics (Chanchlani, Wahi), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Lear), Simon Fraser University, Vancouver, BC; Department of Pathology and Molecular Medicine (Loeb), McMaster University, Hamilton, Ont
| | - Zubin Punthakee
- Department of Medicine (Anand, Bowdish, Punthakee, Schulze, Williams), McMaster University; Population Health Research Institute (Anand, Bangdiwala, de Souza, Desai, F. Khan, Z. Khan, Limbachia, Punthakee), Hamilton, Ont.; Department of Biochemistry, Microbiology and Immunology (Arnold, Langlois, Nakka, Pelchat), University of Ottawa, Ottawa, Ont.; Department of Health Research Methods, Evidence and Impact (Bangdiwala, de Souza, Kandasamy, Loeb, Manoharan), McMaster University, Hamilton, Ont.; Public Health Ontario (Bolotin); Dalla Lana School of Public Health (Bolotin, Loh), University of Toronto, Toronto, Ont.; Department of Pediatrics (Chanchlani, Wahi), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Lear), Simon Fraser University, Vancouver, BC; Department of Pathology and Molecular Medicine (Loeb), McMaster University, Hamilton, Ont
| | - Karleen M Schulze
- Department of Medicine (Anand, Bowdish, Punthakee, Schulze, Williams), McMaster University; Population Health Research Institute (Anand, Bangdiwala, de Souza, Desai, F. Khan, Z. Khan, Limbachia, Punthakee), Hamilton, Ont.; Department of Biochemistry, Microbiology and Immunology (Arnold, Langlois, Nakka, Pelchat), University of Ottawa, Ottawa, Ont.; Department of Health Research Methods, Evidence and Impact (Bangdiwala, de Souza, Kandasamy, Loeb, Manoharan), McMaster University, Hamilton, Ont.; Public Health Ontario (Bolotin); Dalla Lana School of Public Health (Bolotin, Loh), University of Toronto, Toronto, Ont.; Department of Pediatrics (Chanchlani, Wahi), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Lear), Simon Fraser University, Vancouver, BC; Department of Pathology and Molecular Medicine (Loeb), McMaster University, Hamilton, Ont
| | - Natalie Williams
- Department of Medicine (Anand, Bowdish, Punthakee, Schulze, Williams), McMaster University; Population Health Research Institute (Anand, Bangdiwala, de Souza, Desai, F. Khan, Z. Khan, Limbachia, Punthakee), Hamilton, Ont.; Department of Biochemistry, Microbiology and Immunology (Arnold, Langlois, Nakka, Pelchat), University of Ottawa, Ottawa, Ont.; Department of Health Research Methods, Evidence and Impact (Bangdiwala, de Souza, Kandasamy, Loeb, Manoharan), McMaster University, Hamilton, Ont.; Public Health Ontario (Bolotin); Dalla Lana School of Public Health (Bolotin, Loh), University of Toronto, Toronto, Ont.; Department of Pediatrics (Chanchlani, Wahi), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Lear), Simon Fraser University, Vancouver, BC; Department of Pathology and Molecular Medicine (Loeb), McMaster University, Hamilton, Ont
| | - Gita Wahi
- Department of Medicine (Anand, Bowdish, Punthakee, Schulze, Williams), McMaster University; Population Health Research Institute (Anand, Bangdiwala, de Souza, Desai, F. Khan, Z. Khan, Limbachia, Punthakee), Hamilton, Ont.; Department of Biochemistry, Microbiology and Immunology (Arnold, Langlois, Nakka, Pelchat), University of Ottawa, Ottawa, Ont.; Department of Health Research Methods, Evidence and Impact (Bangdiwala, de Souza, Kandasamy, Loeb, Manoharan), McMaster University, Hamilton, Ont.; Public Health Ontario (Bolotin); Dalla Lana School of Public Health (Bolotin, Loh), University of Toronto, Toronto, Ont.; Department of Pediatrics (Chanchlani, Wahi), McMaster University, Hamilton, Ont.; Faculty of Health Sciences (Lear), Simon Fraser University, Vancouver, BC; Department of Pathology and Molecular Medicine (Loeb), McMaster University, Hamilton, Ont
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