Understanding national trends in COVID-19 vaccine hesitancy in Canada: results from five sequential cross-sectional representative surveys spanning April 2020–March 2021

Abstract

ObjectiveTo examine rates of vaccine hesitancy and their correlates among Canadian adults between April 2020 and March 2021.DesignFive sequential cross-sectional age, sex and province-weighted population-based samples who completed online surveys.SettingCanada.ParticipantsA total of 15 019 Canadians aged 18 years and over were recruited through a recognised polling firm (Leger Opinion). Respondents were 51.5% female with a mean age of 48.1 (SD 17.2) years (range 18–95 years) and predominantly white (80.8%).Primary and secondary outcome measuresRates of vaccine hesitancy over the five surveys (time points) and their sociodemographic, clinical and psychological correlates.ResultsA total of 42.2% of respondents reported some degree of vaccine hesitancy, which was lowest during surveys 1 (April 2020) and 5 (March 2021) and highest during survey 3 (November 2020). Fully adjusted multivariate logistic regression analyses revealed that women, those aged 50 and younger, non-white, those with high school education or less, and those with annual household incomes below the poverty line in Canada were significantly more likely to report vaccine hesitancy, as were essential and healthcare workers, parents of children under the age of 18 and those who do not get regular influenza vaccines. Endorsing prevention behaviours as important for reducing virus transmission and high COVID-19 health concerns were associated with 77% and 54% reduction in vaccine hesitancy, respectively. Having high personal financial concerns was associated with 1.33 times increased odds of vaccine hesitancy.ConclusionsResults highlight the importance of targeting vaccine efforts to specific groups by emphasising the outsized health benefits compared with risks of vaccination. Future research should monitor changes in vaccine intentions and behaviour to better understand underlying factors.

Prevalence and factors related to COVID‐19 vaccine hesitancy and unwillingness in Canada: A systematic review and meta‐analysis

“…Most studies used samples of adults ( N = 26). Sixteen studies addressed vaccine hesitancy (i. e., doubts concerning the reception of a COVID‐19 vaccine) 6 , 7 , 8 , 16 , 17 , 29 , 33 , 34 , 37 , 39 , 44 , 45 , 46 , 47 , 48 , 50 and 14 studies explored vaccine unwillingness (i.e., the likelihood of refusing a COVID‐19 vaccine). 28 , 30 , 32 , 35 , 36 , 38 , 40 , 41 , 42 , 43 , 46 , 49 , 51 , 52 The characteristics of the studies are presented in Table 1 .…”

“…Twelve papers reported the prevalence of COVID‐19 vaccine hesitancy among Canadians. 6 , 7 , 8 , 16 , 17 , 33 , 37 , 39 , 45 , 47 , 48 , 50 The pooled prevalence of COVID‐19 vaccine hesitancy was 42.3% (95% CI, 33.7%−51.0%, Figure 2 ). The heterogeneity level in the analysis was high ( I 2 = 99.03%.…”

“…The covariates in the meta‐regression model were not statistically associated with the pooled prevalence of COVID‐19 vaccine hesitancy (Table 2 ). Six papers 6 , 7 , 16 , 17 , 39 , 45 and three papers 6 , 16 , 33 reported the prevalence of COVID‐19 vaccine hesitancy in females and males, and White and non‐White individuals, respectively. The prevalence of COVID‐19 vaccine hesitancy was significantly higher in females (34.9% [95% CI, 20.1%−49.8%]) than males (31.9% [95% CI, 16.0%−47.8%]), Log OR = 0.21 (95% CI, 0.03, 0.38), z = 2.34, p = 0.019 (Figure 5 ).…”

“…15 In addition, studies of issues related to vaccine willingness, hesitancy, and acceptance among Canadian populations have also led to mixed results requiring synthesis of findings. 7 , 8 , 16 , 17 …”

Characterizing intentions to receive the COVID-19 vaccine among the general population in British Columbia based on their future intentions towards the seasonal influenza vaccine

“…Another Canadian-wide survey, which examined COVID-19 vaccine intention at the beginning of COVID-19 vaccine rollout, reported that only 9% of respondents indicated that would not receive a COVID-19 vaccine [21] , indicating intention to receive a COVID-19 vaccine may have continued to increase as COVID-19 vaccine rollout commenced. In contrast, vaccine hesitancy toward a COVID-19 vaccine, measured during the same period in another Canadian population, was lowest at the beginning of the pandemic, and increased throughout the summer and fall of 2020, before experiencing a sharp decline in vaccine hesitancy in November 2020 [22] . In BC, as COVID-19 vaccine programs continue, reported vaccine receipt has outpaced initial estimated vaccine intention, with >90% of eligible adolescents (12+ years of age) and adults having received at least 1 dose of COVID-19 vaccine, prior to the pediatric (5–11yearsold) COVID-19 vaccine approval announcement in November 2021 [23] .…”