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Cited by 59Vaccine Coverage and HesitancySARS-CoV-2 and COVID-19 ResearchCOVID-19 and Mental Health

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

Open access
Lavoie, Kim, Gosselin-Boucher, Vincent, Stojanovic, Jovana, Gupta, Samir, Gagné, Myriam, Joyal-Desmarais, Keven, Séguin, Katherine, Gorin, Sherri Sheinfeld +6 more·2022·BMJ Open
DOI 10.1136/bmjopen-2021-059411PMC PMC8983402

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Abstract

Objective: To examine rates of vaccine hesitancy and their correlates among Canadian adults between April 2020 and March 2021. Design: Five sequential cross-sectional age, sex and province-weighted population-based samples who completed online surveys. Setting: Canada. Participants: A 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 measures: Rates of vaccine hesitancy over the five surveys (time points) and their sociodemographic, clinical and psychological correlates. Results: A 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. Conclusions: Results 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.

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  • Higher density housing with multi-generational households and front-facing essential work confer an increased risk of SARS-CoV-2 exposure and transmission.

    “all of which conferred an increased risk of SARS-CoV-2 exposure and transmission(59,60).”

    From Social inequalities in COVID-19 death by area-level income in 11.2 million people in Ontario, Canada: patterns over time and the mediating role of vaccination. (2026) · cites this paper as [60]

    The Discussion (Profile of Canadians who are vaccine hesitant; page unavailable) says essential and healthcare workers are most likely to be exposed to COVID-19 and expose others. It does not address higher-density housing or multigenerational households, so it supports the work-related part of the claim but not the housing-related part. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Individuals living in lower-income neighbourhoods are more likely to work in front-facing essential services.

    “to work in front-facing essential services”

    From Social inequalities in COVID-19 death by area-level income in 11.2 million people in Ontario, Canada: patterns over time and the mediating role of vaccination. (2026) · cites this paper as [60]

    The Conclusions (page not provided) say that socioeconomically disadvantaged subgroups may be disproportionately represented in essential-service occupations, including healthcare. The paper does not establish the claim specifically for residents of lower-income neighbourhoods or for front-facing roles. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Individuals living in lower-income neighbourhoods are more likely to reside in high density housing with multi-generational households.

    “Individuals living in lower-income neighbourhoods are more likely to reside in high density housing with multi-generational households”

    From Social inequalities in COVID-19 death by area-level income in 11.2 million people in Ontario, Canada: patterns over time and the mediating role of vaccination. (2026) · cites this paper as [60]

    The Results section on sociodemographic predictors and the Discussion section on vaccine-hesitant Canadians address household income in relation to vaccine hesitancy, not housing conditions. Searches for lower-income neighbourhoods, housing density and multigenerational households found no passage addressing the claimed relationship; page numbers were not available in our copy. (LLM, conf=0.75)

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Research works printed but not linked: 47

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Authors
Lavoie, K., Gosselin-Boucher, V., Stojanovic, J., Gupta, S., Gagné, M., Joyal-Desmarais, K., Séguin, K., Gorin, S. S., Ribeiro, P., Voisard, B., Vallis, M., Corace, K., Presseau, J., & Bacon, S.
Affiliations
  • Université du Québec à Montréal (CA)
  • Santé Québec Centre-Sud-de-l’Île-de-Montréal – Universitaire (CA)
  • St. Michael's Hospital (CA)
  • University of Michigan (US)
  • Dalhousie University (CA)
  • University of Ottawa (CA)
Corresponding author
Lavoie, Kim
ORCID
Venue
BMJ Open
Publisher
BMJ
Published
2022-04
Volume
12
Issue
4
Pages
e059411
ISSN
2044-6055 (ISSN-L)
DOI
10.1136/bmjopen-2021-059411
PMC
PMC8983402
OpenAlex
W4225584228
Cited by
59
References
56
Citations by year
2026: 8 · 2025: 15 · 2024: 11 · 2023: 14 · 2022: 11
FWCI
9.78
Type
journal article
Language
en
Open access
Licence
Locations
  • BMJ Open (publishedVersion, cc-by-nc)
  • medRxiv (acceptedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
  • Canadian Institutes of Health Research (MS3‐173099, SMC-151518)
  • Canada Research Chairs (950-232522)
  • Fonds de Recherche du Québec - Santé (2019-SE1-252541, 251618, 34757)
Topics
  • Social Sciences › Health › Vaccine Coverage and Hesitancy
  • Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
  • Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
Keywords
COVID-19 vaccine hesitancy, COVID-19 vaccination, sociodemographic correlates, gender differences, income and education disparities, parents of young children, influenza vaccination, financial concerns, vaccine targeting, Canada
MeSH terms
COVID-19, SARS-CoV-2, COVID-19 Vaccines, Vaccination Hesitancy, Adolescent, Adult, Aged, Aged, 80 and over, Canada, Child, Cross-Sectional Studies, Female, Humans, Influenza Vaccines, Male, Middle Aged, Surveys and Questionnaires, Vaccination, Young Adult

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