tetano
Editor, Senior Moderator
BMJ Open
. 2026 Aug 12;16(8):e122964.
doi: 10.1136/bmjopen-2026-122964.
COVID-19 vaccination among people affected by sexually transmitted and bloodborne infections, methamphetamine use and their intersection in Manitoba, Canada: a retrospective matched cohort analysis using population-based administrative healthcare data (2020-2022)
Souradet Y Shaw[SUP] 1 2 [/SUP], Alyson Mahar[SUP] 3 4 [/SUP], Kim Bailey[SUP] 5 [/SUP], Michael Payne[SUP] 5 6 [/SUP], Jason Kindrachuk[SUP] 2 [/SUP], Christine Kelly[SUP] 7 [/SUP], Kevin J Friesen[SUP] 4 [/SUP], Charles N Bernstein[SUP] 8 [/SUP], Joss N Reimer[SUP] 9 [/SUP], Marissa L Becker[SUP] 7 2 [/SUP], Leigh Michelle McClarty[SUP] 7 [/SUP], Derek Stein[SUP] 2 10 [/SUP], Nathan C Nickel[SUP] 7 4 [/SUP]
Affiliations
Objectives: To examine COVID-19 vaccine uptake among people diagnosed with sexually transmitted and bloodborne infections (STBBIs), people with healthcare-documented methamphetamine use and those experiencing both exposures in Manitoba, Canada.
Design: Population-based retrospective matched cohort study using linked administrative healthcare, laboratory and vaccination data.
Setting: Manitoba, Canada, from 1 March 2020 to 31 March 2022.
Participants: Manitoba residents aged ≥16 years with laboratory-confirmed chlamydia or gonorrhoea, syphilis or HIV and/or healthcare-documented methamphetamine use during the 4 years before 1 March 2020 were classified into eight mutually exclusive exposure cohorts. Individuals were matched with comparators without the corresponding exposure based on age, sex, geographical region and area-level income quintile.
Primary outcome measure: Receipt of ≥2 COVID-19 vaccine doses. Poisson regression models incorporating person-time were used to estimate adjusted rate ratios (aRRs) and 95% CIs.
Results: Compared with matched comparators, vaccine uptake was lower in the Syphilis Only (aRR 0.83, 95% CI 0.80 to 0.86), Syphilis Plus (aRR 0.77, 95% CI 0.74 to 0.79), Chlamydia/Gonorrhoea Only (aRR 0.91, 95% CI 0.90 to 0.92), Chlamydia/Gonorrhoea Plus (aRR 0.74, 95% CI 0.72 to 0.77), Methamphetamine Only (aRR 0.71, 95% CI 0.68 to 0.73) and Methamphetamine plus STBBI cohorts (aRR 0.64, 95% CI 0.62 to 0.67). Uptake in the HIV Only cohort was similar to that among matched comparators (aRR 0.97, 95% CI 0.93 to 1.00). Lower uptake was concentrated among individuals living in lower-income areas.
Conclusions: COVID-19 vaccine uptake was lower among several populations affected by STBBIs, methamphetamine use or both, with the greatest disparity among people experiencing intersecting STBBI and methamphetamine-related exposures. Integrating vaccination with HIV, STBBI, harm-reduction and addiction services may improve vaccine equity during future public health emergencies.
Keywords: COVID-19; EPIDEMIOLOGY; HIV & AIDS; Syphilis; Vaccination.
. 2026 Aug 12;16(8):e122964.
doi: 10.1136/bmjopen-2026-122964.
COVID-19 vaccination among people affected by sexually transmitted and bloodborne infections, methamphetamine use and their intersection in Manitoba, Canada: a retrospective matched cohort analysis using population-based administrative healthcare data (2020-2022)
Souradet Y Shaw[SUP] 1 2 [/SUP], Alyson Mahar[SUP] 3 4 [/SUP], Kim Bailey[SUP] 5 [/SUP], Michael Payne[SUP] 5 6 [/SUP], Jason Kindrachuk[SUP] 2 [/SUP], Christine Kelly[SUP] 7 [/SUP], Kevin J Friesen[SUP] 4 [/SUP], Charles N Bernstein[SUP] 8 [/SUP], Joss N Reimer[SUP] 9 [/SUP], Marissa L Becker[SUP] 7 2 [/SUP], Leigh Michelle McClarty[SUP] 7 [/SUP], Derek Stein[SUP] 2 10 [/SUP], Nathan C Nickel[SUP] 7 4 [/SUP]
Affiliations
- PMID: 42586735
- DOI: 10.1136/bmjopen-2026-122964
Objectives: To examine COVID-19 vaccine uptake among people diagnosed with sexually transmitted and bloodborne infections (STBBIs), people with healthcare-documented methamphetamine use and those experiencing both exposures in Manitoba, Canada.
Design: Population-based retrospective matched cohort study using linked administrative healthcare, laboratory and vaccination data.
Setting: Manitoba, Canada, from 1 March 2020 to 31 March 2022.
Participants: Manitoba residents aged ≥16 years with laboratory-confirmed chlamydia or gonorrhoea, syphilis or HIV and/or healthcare-documented methamphetamine use during the 4 years before 1 March 2020 were classified into eight mutually exclusive exposure cohorts. Individuals were matched with comparators without the corresponding exposure based on age, sex, geographical region and area-level income quintile.
Primary outcome measure: Receipt of ≥2 COVID-19 vaccine doses. Poisson regression models incorporating person-time were used to estimate adjusted rate ratios (aRRs) and 95% CIs.
Results: Compared with matched comparators, vaccine uptake was lower in the Syphilis Only (aRR 0.83, 95% CI 0.80 to 0.86), Syphilis Plus (aRR 0.77, 95% CI 0.74 to 0.79), Chlamydia/Gonorrhoea Only (aRR 0.91, 95% CI 0.90 to 0.92), Chlamydia/Gonorrhoea Plus (aRR 0.74, 95% CI 0.72 to 0.77), Methamphetamine Only (aRR 0.71, 95% CI 0.68 to 0.73) and Methamphetamine plus STBBI cohorts (aRR 0.64, 95% CI 0.62 to 0.67). Uptake in the HIV Only cohort was similar to that among matched comparators (aRR 0.97, 95% CI 0.93 to 1.00). Lower uptake was concentrated among individuals living in lower-income areas.
Conclusions: COVID-19 vaccine uptake was lower among several populations affected by STBBIs, methamphetamine use or both, with the greatest disparity among people experiencing intersecting STBBI and methamphetamine-related exposures. Integrating vaccination with HIV, STBBI, harm-reduction and addiction services may improve vaccine equity during future public health emergencies.
Keywords: COVID-19; EPIDEMIOLOGY; HIV & AIDS; Syphilis; Vaccination.