Understanding national trends in COVID-19 vaccine hesitancy in Canada: results from five sequential cross-sectional representative surveys spanning April 2020–March 2021
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Abstract
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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SciScore for 10.1101/2021.11.10.21266174: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics not detected. Sex as a biological variable not detected. Randomization Two thirds of the panel were recruited randomly by telephone, with the remainder recruited via publicity and social media. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Further research is needed to determine the extent to which this reflects a lack of motivation or desire to get vaccinated, or a perceived inability …
SciScore for 10.1101/2021.11.10.21266174: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics not detected. Sex as a biological variable not detected. Randomization Two thirds of the panel were recruited randomly by telephone, with the remainder recruited via publicity and social media. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Further research is needed to determine the extent to which this reflects a lack of motivation or desire to get vaccinated, or a perceived inability to get vaccinated due to practical barriers or limitations (e.g., lack of access to paid leave to get vaccinated). Limitations and strengths: This study should be interpreted in light of some methodological limitations. First, although we included large, national samples of Canadians with representation across age, sex, and province, the absolute number of participants in certain provinces (e.g., Atlantic) was lower, making inter-provincial comparisons difficult. Second, the survey was only available in English and French, which may have led to an underrepresentation of certain non-native English or French speaking groups. Further, our surveys included fewer people of color, which may reflect participation on online panels, so results might not generalize as well to non-Whites. Third, since the surveys were voluntary and participants were drawn from a polling firm’s subject pool, participation may have been subject to some degree of selection bias. Fourth, though this study presents data depicting vaccine intentions over time, it was drawn from three separate cohorts of online panels, so data reflect trends in vaccine intentions over time but not in the same individuals. Finally, data were self-reported, which may have been subject to social desirability bias.64 However, the fact that the surveys were anonymous likely mitigated t...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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