Prevalence, Correlates, and Drivers of COVID-19 Vaccine Hesitancy Among Canadians

The objectives of the present study were threefold: (a) examine the prevalence of COVID-19 vaccine hesitancy and rejection; (b) examine demographic, health-, and employment-related correlates of vaccine hesitancy; and (c) examine qualitative drivers of vaccine hesitancy among the Canadian population. Online, cross-sectional surveys were administered to two cohorts of Canadians between December 21, 2020, and March 30, 2021 (T1 n = 5,920, 54.1% female), and September 7, 2021, and December 7, 2021 (T2 n = 7,354, 55.6% female). Mixed methods were used within each cohort: Chi-square analyses investigated correlates of vaccine attitudes, and latent Dirichlet allocation analysis was used to deduce qualitative themes regarding drivers of vaccine hesitancy. At T2, 11% of the sample remained unvaccinated and 34% reported hesitancy towards receiving a booster dose. Correlates of vaccine hesitancy included being younger-middle-aged, having lower educational attainment, living in less densely populated areas, not being or providing care to someone who is medically vulnerable, employment insecurity, and being a non-health-care essential worker. There were significant interactions between several demographic variables. The most common reasons for hesitancy included concerns about long-term and side effects, inadequate testing, low perceived effectiveness and necessity of vaccines, and distrust of medical research, whereas logistical barriers delayed uptake among those who wanted the vaccine. Results illuminate who vaccine uptake promotion campaigns should be targeted towards, as well as the unique drivers of hesitancy towards the COVID-19 vaccine. Vaccine promotion materials should be tailored to be most relevant to identified target subpopulations and directly address concerns.