COVID-19 vaccine hesitancy and refusal and associated factors in an adult population in Saskatchewan, Canada: Evidence from predictive modelling

PLoS One. 2021 Nov 12;16(11):e0259513. doi: 10.1371/journal.pone.0259513. eCollection 2021.

Abstract

Background: A high population level of vaccination is required to control the COVID-19 pandemic, but not all Canadians are convinced of the value and safety of vaccination. Understanding more about these individuals can aid in developing strategies to increase their acceptance of a COVID-19 vaccine. The objectives of this study were to describe COVID-19 vaccine acceptance, hesitancy and refusal rates and associated factors in Saskatchewan, Canada.

Methods: This is a cross-sequential study that consisted of pooled responses from weighted samples of 9,252 Saskatchewan adults (≥18 years) across nine rounds of data collection between May 4, 2020 and April 3, 2021. The outcome variable was vaccine intention: vaccine acceptance, hesitancy, and refusal. The independent variables were layered into socio-demographic factors, risk of exposure to coronavirus, mitigating behaviours, and perceptions of COVID-19. Data were analyzed using multinomial logistic regression and a classification and regression tree.

Results: Seventy-six percent of the respondents indicated that they had been or were willing to be vaccinated, 13% had not yet decided, and the remaining 11% said they would not be vaccinated. Factors that increased the likelihood of vaccine refusal and hesitancy were lower education level, financial instability, Indigenous status, and not being concerned about spreading the coronavirus. Perceiving COVID-19 to be more of a threat to one's community and believing that one had a higher risk of illness or death from COVID-19 decreased the likelihood of both vaccine refusal and hesitancy. Women and newcomers to Canada were more likely to be unsure about getting vaccinated. Respondents who did not plan to be vaccinated were less likely to wear face masks and practice physical distancing.

Conclusion: While many Canadians have voluntarily and eagerly become vaccinated already, reaching sufficient coverage of the population is likely to require targeted efforts to convince those who are resistant or unsure. Identifying and overcoming any barriers to vaccination that exist within the socio-demographic groups we found were least likely to be vaccinated is a crucial component.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • COVID-19 / epidemiology*
  • COVID-19 / psychology
  • COVID-19 / virology
  • COVID-19 Vaccines*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pandemics / prevention & control
  • SARS-CoV-2 / immunology
  • SARS-CoV-2 / pathogenicity
  • Saskatchewan / epidemiology
  • Vaccination / psychology*
  • Vaccination Refusal / psychology*

Substances

  • COVID-19 Vaccines

Grants and funding

Social Contours and COVID-19 received funding from 2020 Rapid Response COVID-19 Research Award, College of Medicine, University of Saskatchewan (Fund ID: 423181). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.