{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T08:15:41Z","timestamp":1788509741853,"version":"build-2803163510"},"reference-count":32,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"unspecified","delay-in-days":11,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001804","name":"Canada Research Chairs","doi-asserted-by":"publisher","award":["CRC-2019-381"],"award-info":[{"award-number":["CRC-2019-381"]}],"id":[{"id":"10.13039\/501100001804","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Canadian Institutes for Health Research Operating","award":["EG2-179430"],"award-info":[{"award-number":["EG2-179430"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,7,29]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Population-based retrospective matched cohort study using linked administrative healthcare, laboratory and vaccination data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Manitoba, Canada, from 1 March 2020 to 31 March 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Manitoba residents aged \u226516 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measure<\/jats:title>\n                    <jats:p>Receipt of \u22652 COVID-19 vaccine doses. Poisson regression models incorporating person-time were used to estimate adjusted rate ratios (aRRs) and 95% CIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with matched comparators, vaccine uptake was lower in the Syphilis Only (aRR 0.83, 95%\u2009CI 0.80 to 0.86), Syphilis Plus (aRR 0.77, 95%\u2009CI 0.74 to 0.79), Chlamydia\/Gonorrhoea Only (aRR 0.91, 95%\u2009CI 0.90 to 0.92), Chlamydia\/Gonorrhoea Plus (aRR 0.74, 95%\u2009CI 0.72 to 0.77), Methamphetamine Only (aRR 0.71, 95%\u2009CI 0.68 to 0.73)\u2009and Methamphetamine plus STBBI cohorts (aRR 0.64, 95%\u2009CI 0.62 to 0.67). Uptake in the HIV Only cohort was similar to that among matched comparators (aRR 0.97, 95%\u2009CI 0.93 to 1.00). Lower uptake was concentrated among individuals living in lower-income areas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-122964","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T13:45:34Z","timestamp":1786542334000},"page":"e122964","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["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\u20132022)"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0982-1302","authenticated-orcid":false,"given":"Souradet Y","family":"Shaw","sequence":"first","affiliation":[{"name":"College of Community and Global Health, University of Manitoba, Winnipeg, Manitoba, Canada"},{"name":"Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyson","family":"Mahar","sequence":"additional","affiliation":[{"name":"School of Nursing, Queen\u2019s University, Kingston, Ontario, Canada"},{"name":"Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Bailey","sequence":"additional","affiliation":[{"name":"Nine Circles Community Health Centre, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Payne","sequence":"additional","affiliation":[{"name":"Nine Circles Community Health Centre, Winnipeg, Manitoba, Canada"},{"name":"Manitoba HIV Program, Winnipeg, Manitoba, 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