A national survey has found that at the start of the COVID-19 vaccine rollout, most Canadians planned to get vaccinated, but that intentions were lower among certain demographic groups, including residents of Alberta, Manitoba and Saskatchewan, individuals without a university degree, and racialized Canadians.

The survey results, published online in The Lancet Regional Health–Americas, led by St. Michael’s Unity Health Toronto researchers and supported in part by the COVID-19 Immunity Task Force (CITF), offer insights for policy makers and healthcare providers racing to address vaccine hesitancy in Canada and keep the fourth wave at bay.

Early in the country’s vaccine rollout, researchers asked a nationally representative sample of more than 14,500 Canadians if they intended to get vaccinated when a vaccine became available to them. Researchers identified participants’ differences by age, education, ethnicity, and home province.

Key findings

  • Nine per cent of respondents overall said they did not intend to get vaccinated. Hesitancy was highest in Alberta (16 per cent) and Manitoba and Saskatchewan (14 per cent), with less than 10 per cent of respondents in other provinces saying they did not intend to get a vaccine.
  • Of those with a college education or less, 14 per cent of respondents did not intend to get vaccinated, compared to five per cent of respondents with a bachelor’s degree or higher.
  • A greater percentage of respondents who identified as Indigenous or non-Caucasian said they did not intend to get vaccinated compared to those who did not identify as part of those groups.
  • Men were more hesitant than women overall.

“Given the higher burden of COVID-19 on Indigenous Canadians and racialized groups, we were surprised that they weren’t more likely than others to want the vaccine,” says Dr. Prabhat Jha, study lead and director of the Centre for Global Health Research at St. Michael’s Hospital of Unity Health Toronto. “It means we have work to do providing better information and perhaps better access.”

Other findings:

  • Participants aged 40-59 had the lowest vaccination intention, with about 12 per cent reporting no intention to get vaccinated, compared to seven per cent of 60–69-year-olds.
  • 11 per cent of men had no intention to get vaccinated, compared to eight percent of women.
  • 12 per cent of those identifying themselves as racialized and 15 per cent of those who identified specifically as Indigenous did not intend to get a vaccine, compared to nine per cent of those who identified as neither Indigenous nor a racialized Canadian.
  • 16 per cent of those living in households of five or more people did not intend to get vaccinated, compared to 8 per cent of those living in households of two people.

What is not yet known is how intent translated into action: Did people follow through with their intent to vaccinate or not? The Ab-C study has been conducting periodic surveys since the start of the COVID pandemic in Canada and will be able to answer that question in a few months.

The survey, part of the more expansive Action to Beat Coronavirus (Ab-C) study, was conducted between December 2020 and February 2021, coinciding with the early phase of Canada’s vaccine rollout. The Ab-C study is a collaboration between the Centre for Global Health Research at Unity Health Toronto, the University of Toronto and the Angus Reid Forum.

“This ground breaking survey involved very high levels of participation among respondents. The final results closely matched the Canadian vaccination rates across demographic and health status variables,” comments Dr. Angus Reid, chairman of the Angus Reid Institute.

As of August 27, 2021, 18 per cent of eligible Canadians had not yet received a dose of a COVID-19 vaccine—nearly twice the rate expected based on stated intention. Researchers say the study results should encourage policymakers to target vaccination campaigns to the most reluctant groups, but also to those with “original intent” who have not yet followed through.

“As we try to get as many Canadians vaccinated as possible in this fourth wave, knowing which groups are more hesitant to get vaccines helps identify where efforts should be placed,” says Dr. Catherine Hankins, CITF Co-Chair. “We have seen in several other studies that racialized groups are less likely to be vaccinated. This study confirms that public health, community leaders and healthcare providers must not only improve access to vaccines for these groups, but also develop messaging that connects with people to help alleviate any concerns they may have with COVID vaccination.”

Funding was also provided by an unrestricted grant from Pfizer Global Medical Grants and Unity Health Toronto.

Read the manuscript: COVID-19 vaccination intention during early vaccine rollout in Canada: a nationwide online survey – ScienceDirect

About St. Michael’s

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

About Unity Health Toronto

Unity Health Toronto, comprised of Providence Healthcare, St. Joseph’s Health Centre and St. Michael’s Hospital, works to advance the health of everyone in our urban communities and beyond. Our health network serves patients, residents and clients across the full spectrum of care, spanning primary care, secondary community care, tertiary and quaternary care services to post-acute through rehabilitation, palliative care and long-term care, while investing in world-class research and education. For more information, visit www.unityhealth.to.

About the COVID-19 Immunity Task Force

The Government of Canada established the COVID-19 Immunity Task Force (CITF) in late April 2020. The Task Force is overseen by a Leadership Group of volunteers that includes leading Canadian scientists and experts from universities and healthcare facilities across Canada who are focused on understanding the nature of immunity arising from the novel coronavirus that causes COVID-19. To that end, the CITF is supporting numerous studies to determine the extent of SARS-CoV-2 infection in Canada (in the general population as well as in specific communities and priority populations), understand the nature of immunity following infection, develop improved antibody testing methods, and help monitor the effectiveness and safety of vaccines as they are rolled out across Canada. The Task Force and its Secretariat work closely with a range of partners, including governments, public health agencies, institutions, health organizations, research teams, other task forces, and engages communities and stakeholders. Most recently, the Task Force has been asked to support vaccine surveillance, effectiveness and safety as part of its overall objective to generate data and ideas that inform interventions aimed at slowing—and ultimately stopping—the spread of SARS-CoV-2 in Canada.

Media contacts

Unity Health Toronto
Hayley Mick or Jennifer Stranges

COVID-19 Immunity Task Force
Rebecca Burns
Cell: +1.438.871.8763
Caroline Phaneuf
Cell: +1.514.444.4532