COVID-19 vaccine adverse events in indigenous communities in Northwest Territories, Canada

The development and distribution of COVID-19 vaccines were crucial during the pandemic; however, adverse events can affect public perception and vaccine utilization. This project explored COVID-19 vaccine adverse events among Indigenous communities in Northwest Territories, Canada, where overcrowding, limited healthcare access, and historical disparities increase disease risk. This cross-sectional study surveyed Indigenous adults (18+) in Northwest Territories using interviewer-administered questionnaires. Phase one (Apr–Nov 2021) in ten communities examined adverse events after the first COVID-19 vaccine dose. Phase two (Aug 2022–Jan 2023) in eleven communities assessed adverse events after doses two to five. In phase one ( n = 93) and phase two ( n = 190), most participants were women (62.4% and 67.9%), with mean ages of 41.6 years (±12.1) and 43.7 ± 14.2 years (±14.2), respectively. Adverse events were most frequent after the first dose (97.9%) and declined with subsequent doses ( p < .001). Injection site pain/swelling was most common. Severe symptoms after dose one included chills (64.3%), muscle pain (56.9%), and fatigue (51.3%). Fatigue was more frequent in women than men (50.9% vs. 23.5%, p = .04). Younger adults reported higher rates of pain ( p = .003), chills ( p = .01), headache ( p = .02), and fever (p = .003) than adults over 50. Adverse events decreased with each additional dose and were generally mild to moderate after the first dose. Communicating the mild nature of side effects and the protection vaccines offer against severe illness may help increase uptake. Higher rates among younger individuals and women highlight the need for targeted public health messaging and supportive strategies. • Adverse events were most common after the first dose for 97.85% of participants • The prevalence of adverse events decreased with each subsequent dose • Women reported fatigue more often than men after the first vaccine dose. • Younger adults experienced more muscle pain, chills, and fever than older. • Most adverse events were mild to moderate, supporting vaccine safety.