Understanding COVID-19 vaccine hesitancy in Canada

Claire Corsten; Zoua M Vang; Ian Gold; Maya J Goldenberg; Fernanda Pérez-Gay Juarez; Daniel Weinstock; Maxwell J Smith; Oren Krajden; Elizaveta Solomonova

doi:10.1016/j.vaccine.2023.10.058

Understanding COVID-19 vaccine hesitancy in Canada

Vaccine. 2023 Oct 27:S0264-410X(23)01260-4. doi: 10.1016/j.vaccine.2023.10.058. Online ahead of print.

Authors

Claire Corsten¹, Zoua M Vang², Ian Gold³, Maya J Goldenberg⁴, Fernanda Pérez-Gay Juarez³, Daniel Weinstock⁵, Maxwell J Smith⁶, Oren Krajden⁷, Elizaveta Solomonova⁸

Affiliations

¹ Department of Sociology, McGill University, Montreal, Quebec, Canada.
² Department of Sociology, McGill University, Montreal, Quebec, Canada. Electronic address: zoua.vang@mcgill.ca.
³ Department of Philosophy, McGill University, Montreal, Quebec, Canada.
⁴ Department of Philosophy, University of Guelph, Guelph, Ontario, Canada.
⁵ Faculty of Law, McGill University, Montreal, Quebec, Canada.
⁶ School of Health Studies, Faculty of Health Sciences, Western University, London, Ontario, Canada.
⁷ University of British Columbia, Vancouver, British Columbia, Canada.
⁸ Department of Psychiatry, McGill University, Montreal, Quebec, Canada.

PMID: 39492073
DOI: 10.1016/j.vaccine.2023.10.058

Abstract

While Canada has had relatively high vaccination rates against COVID-19, specifically during earlier waves of the pandemic, vaccine hesitancy has continued to serve as a significant barrier to adequate protection against the virus and, more recently, booster vaccine uptake. This paper explores the processes underlying Canadians' perceptions of COVID-19 vaccines and their decisions to take or refuse them, as well as how public policy and health messaging about vaccination has influenced vaccination attitudes and behaviors. Our focus group interviews with 18 vaccinated and unvaccinated adult Canadians conducted during October 2021 reveal that, in some respects, COVID-19 vaccine hesitancy conforms to prior knowledge about some of the factors that affect vaccine attitudes (e.g., the influence of known medical providers) but deviates from current theoretical frameworks regarding general vaccine hesitancy. Specifically, these frameworks emphasize a lack of scientific knowledge and literacy ("knowledge deficit" accounts) or individuals' inability to incorporate rational risk perceptions into initial emotional responses to vaccines ("emotionality/irrationality" accounts). In contrast to the knowledge deficit account, we find that expressions of COVID-19 vaccine hesitancy were most frequently associated with an information surplus or inability to prioritize information from multiple and often contradictory sources. Furthermore, top-down pro-vaccination messaging often triggered significant pushback against what participants perceived as moral shaming of the unvaccinated. Our findings demonstrate the necessity for a new framework to understand and address vaccine hesitancy. A better theoretical account of vaccine hesitancy has important implications for future vaccination efforts, specifically within the context of new variants and low booster vaccination rates in Canada.

Keywords: COVID-19; Canada; Pandemic; Public health; Vaccine hesitancy.