This is a summary, written by members of the CITF Secretariat, of:

Jantzen R, Maltais M, Broet P. Socio-Demographic Factors Associated With COVID-19 Vaccine Hesitancy Among Middle-Aged Adults During the Quebec’s Vaccination Campaign. Front. Public Health, 18 March 2022 doi:

The results and/or conclusions contained in the research do not necessarily reflect the views of all CITF members.

Published in Frontiers in Public Health, the CARTaGENE research team, based at the Research Center at the Centre Hospitalier Universitaire Sainte-Justine and part of the CITF-funded CanPATH study, found that vaccination hesitancy among adults in Quebec was correlated with education levels, age and other socio-demographic determinants. The results by the team led by Drs. Rodolphe Jantzen, Mathieu Maltais, and Philippe Broet, were based on a well-characterized population-based cohort and offered a unique opportunity to identify the factors associated with COVID-19 vaccination hesitancy during the spring 2021 vaccination campaign.

Vaccine hesitancy generally refers to a delay in acceptance or refusal of vaccination despite the availability of vaccination services. Based on an online survey conducted between March and June 2021 comparing the vaccinated and unvaccinated participants, the authors investigated vaccine hesitancy among those who were unvaccinated.

As of June 2021, 3,553 of 6,105 (58.2%) participants of the survey had at least one dose of the COVID-19 vaccine whereas 2,552 (41.8%) participants remained unvaccinated. The mean age for the unvaccinated participants was 60 years whereas the mean age among the vaccinated participants was 67 years. Among the unvaccinated, 221 (8.7%) did not want to be vaccinated (91) or were uncertain (130).

Key findings:

Characteristics associated with higher vaccine hesitancy were as follows:

  • lower level of education (less than a university degree)
  • working full-time or being self-employed, and
  • living outside of Montreal
  • born outside of Canada
  • a lower annual household income before the pandemic (less than $100,000),
  • experienced a financial impact because of the pandemic, and were from visible minority groups
  • those without post-secondary education and who experienced a loss of income during the pandemic

Those factors associated with lower vaccination hesitancy (or greater vaccine confidence) included:

  • being over 60 – along with associated and age-related factors (such as living in a retirement home, being retired)
  • having a pre-existing medical condition, and good mental/emotional health
  • higher levels of education (university or graduate degree).
  • did not experience a loss of income.

The authors highlight that economic wealth status before the pandemic by itself is not sufficient to explain vaccine hesitancy but should be interpreted in the light of other factors such as education, age and socio-cultural background.

CARTaGENE is a population-based cohort comprised of more than 43,000 Quebec residents between ages 40 and 69 years. It is a part of the Canadian Partnership for Tomorrow’s Health (CanPath) study, which is Canada’s largest population health research platform.