Deadly places: The role of geography in Aboriginal and Torres Strait Islander COVID-19 vaccination

Objective: The objective of this study was to investigate the geospatial distribution of COVID-19 vaccination rates for Aboriginal and Torres Strait Islander Peoples across Local Government Areas in Australia. Methods: We described the patterns of COVID-19 vaccination across jurisdictions, identified clusters with different levels of vaccination uptake, and assessed the relationship between contextual factors and vaccination (spatial error model, spatial lag model, and geographic weighted regression). Results: The proportion of the Aboriginal and Torres Strait Islander population that received at least two doses of a COVID-19 vaccine by the last week of June 2022 ranged from 62.9% to 97.5% across Local Government Areas. The proportion of the overall population who is Aboriginal or Torres Strait Islander (beta = 0.280, standard deviation [SD] = 1.92), proportion of the total labour force employed (beta =0.286, SD = 0.98), and proportion of individuals who speak an Aboriginal or Torres Strait Islander language (beta =0.215, SD = 0.15) had, on average, the strongest effects on COVID-19 vaccination rates. Conclusion: Findings underscore the extent to which area-level demographic influence the COVID-19 vaccination for Aboriginal and Torres Strait Islander Australians. Implications for public health: Findings can inform vaccination strategies that prioritise geographic areas with higher vulnerability to promote equity for Aboriginal and Torres Strait Islander Peoples.