Understanding Low Vaccine Uptake in African, Caribbean, and Black Populations Relative to Public Health in High-Income Countries: A Scoping Review Protocol

BackgroundVaccination has significantly contributed to reducing once common and even deadly infectious diseases, yet vaccine hesitancy threatens the emergence of vaccine-preventable diseases. The COVID-19 pandemic has caused the need for the largest mass vaccination campaign ever undertaken to date; however, African, Caribbean, and Black (ACB) populations have shown both a disproportionately high degree of negative impacts from the pandemic and the lowest willingness to become vaccinated. Low vaccination rates in this vulnerable population are a pinnacle concern in public health, as low vaccination rates in ACB communities may both be the result of health inequities, as well as further exacerbate them. PurposeTo explore low vaccine uptake in African, Caribbean, and Black (ACB) populations relative to public health in high-income countries. Objectives 1) To identify concepts and boundaries of existing evidence sources on low vaccine uptake in ACB populations; 2) To map out the evidence on the concepts and boundaries and to identify gaps in the research; and 3) To determine existing interventions to improve low vaccine uptake in the study population. MethodologyThis scoping review follows the Joanna Briggs Institute (JBI) framework for scoping reviews, supplemented by the Preferred Reporting Items for Systematic Reviews extension (PRISMA-ScR). Any deviations from the JBI recommendations are stated. Theoretical underpinnings of the intersectionality approach will be used to help interpret the complexities of health inequities in the ACB population, including those related to the social determinants of health (SDOH). Search strategies were developed by an information specialist (VC) and peer- reviewed using the PRESS guideline. The search was conducted in: MEDLINE(R) ALL (OvidSP), Embase (OvidSP), CINAHL (EBSCOHost), APA PsycInfo (OvidSP), Cochrane Central Register of Controlled Trials (OvidSP), Cochrane Database of Systematic Reviews (OvidSP), Allied & Complimentary Medicine Database (Ovid SP), and Web of Science. Eligibility criteria are based on the Population, Concept, Context (PCC) framework. The inclusion criteria for this study included evidence -sources with a primary focus on African, Caribbean, and Black populations, and other related terms; high-income countries as defined by the World Bank where ACB populations are considered a minority; all service providers; English and French languages; all types of evidence sources; related to low vaccine uptake and alternative terms; all vaccines; and publications from 2020- current (July 19th, 2022). The screening, selection, and extraction of the evidence sources were completed by the AVA research team. Analysis was done through the process of Thematic Mapping, and summarization and presentation of the findings were done through a narrative description organized using the socioeconomic model (SEM) as a framework. Ethics and disseminationThis study used published evidence sources with no human or animal participants; thus, ethical approval and consent to participate are not applicable. DisseminationThis will occur through peer-reviewed open-access journals and conferences that target stakeholders in public health, vaccination campaigns and overcoming inequities in healthcare.