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Objectives: There have been substantial amounts of misinformation surrounding the importance, safety and effectiveness of the COVID-19 vaccine. The impacts of this misinformation may be augmented as they circulate among ethnic communities, who may concurrently face other barriers related to vaccine uptake and access. To combat some of the key sources of COVID-19 vaccine misinformation among the South Asian communities of the Greater Toronto and Hamilton Area (GTHA), an interdisciplinary team of researchers and marketing experts established the South Asian Youth as Vaccine Agents of Change (SAY-VAC) programme to support and empower South Asian youth to disseminate COVID-19 vaccine information., Design: Cross-sectional and one-group pretest-post-test design., Setting: GTHA., Participants: South Asian youth (18-29 years)., Intervention: The team partnered with grass-roots South Asian organisations to collaborate on shared objectives, curate key concerns, create video products regarding the COVID-19 vaccine that would resonate with the community, disseminate the products using established social media channels and evaluate the effectiveness of this effort., Outcomes: We assessed the change in self-reported knowledge about the COVID-19 vaccine and participant confidence to facilitate a conversation around the COVID-19 vaccine using pre-post surveys, after the implementation of the SAY-VAC programme., Results: In total, 30 South Asian youth (median age=23.2 years) from the GTHA participated in the programme. After completing the SAY-VAC programme, participants reported an increase in their self-reported knowledge regarding the COVID-19 vaccine from 73.3% to 100.0% (p=0.005), and their self-reported confidence to have a conversation about the vaccine with their unvaccinated community members increased from 63.6% to 100.0% (p=0.002). Overall, 51.9% of the participants reported being able to positively affect an unvaccinated/community member's decision to get vaccinated., Conclusions: The SAY-VAC programme highlights the importance of community partnerships in developing and disseminating culturally responsive health communication strategies. A constant assessment of the evidence and utilisation of non-traditional avenues to engage the public are essential., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Early in the COVID-19 pandemic, the South Asian community in the Greater Toronto Area (GTA) was identified as having risk factors for exposure and specific barriers to accessing testing and reliable health information, rendering them particularly vulnerable to SARS-CoV-2 infection. We sought to investigate the burden of SARS-CoV-2 infection among South Asian people in the GTA, and to characterize the demographic characteristics, risk perceptions and trusted sources of health information in this group., Methods: We conducted a cross-sectional analysis from the baseline assessment of participants in a prospective cohort study. Participants from the GTA were enrolled from Apr. 14 to July 28, 2021. Seropositivity for antispike and antinucleocapsid antibodies was determined from dried blood spots, and estimates of seropositivity were age and sex standardized to the South Asian population in Ontario. Demographic characteristics, risk perceptions and sources of COVID-19 information were collected via questionnaire and reported descriptively., Results: Among the 916 South Asian participants enrolled (mean age 41 yr), the age- and sex-standardized seropositivity was 23.6% (95% confidence interval 20.8%-26.4%). Of the 693 respondents to the questionnaire, 228 (32.9%) identified as essential workers, and 125 (19.1%) reported living in a multigenerational household. A total of 288 (49.4%) perceived that they were at high COVID-19 risk owing to their geographic location, and 149 (34.3%) owing to their type of employment. The top 3 most trusted sources of information related to COVID-19 included health care providers and public health, traditional media sources and social media., Interpretation: By the third wave of the COVID-19 pandemic, about one-quarter of a sample of South Asian individuals in Ontario had serologic evidence of prior SARS-CoV-2 infection. Insight into factors that put certain populations at risk can help future pandemic planning and disease control efforts., Competing Interests: Competing interests: Shelly Bolotin is co-investigator on several COVID-19 grants funded by Canadian Institutes of Health Research, the COVID-19 Immunity Task Force, the Canadian Immunization Research Network and the Public Health Agency of Canada. She is director of the Centre for Vaccine Preventable Diseases at the University of Toronto; the centre is supported by the Dalla Lana School of Public Health (DLSPH), which receives funding from government, philanthropic, not-for-profit and private sector organizations. Private sector funding sources include vaccine manufacturers. A set of governance processes are in place at the DLSPH to ensure independent operation of the centre. All funding is received under agreements that are aligned with policies of the University of Toronto and DLSPH that safeguard academic freedom of faculty and students. Decisions on private sector support are made in consultation with the dean, relevant faculty and the Office of Advancement. In addition, the Centre for Vaccine Preventable Diseases receives oversight from the dean of the DLSPH and a Senior Advisory Committee of the University of Toronto. Mark Loeb has received vaccine advisory board consulting fees from Seqirus, Pfizer, Merck, Sanofi and Medicago; grant funding for a vaccine trial from Seqirus; and in-kind vaccine from Sanofi for a trial. He is on the Vaccine Data Safety Monitoring Board for Medicago, National Institutes of Health NIH and CanSino Biologics., (© 2022 CMA Impact Inc. or its licensors.)