Childhood Seasonal Immunization Coverage Survey (CSICS): 2024 results
On this page
Key highlights
- The Childhood Seasonal Immunization Coverage Survey (CSICS) results provide context to vaccination coverage by identifying socio-demographic gaps. Overall, COVID-19 vaccination coverage estimates for 6 months to 17-year-olds was 67%. Among reported ethnicities, COVID-19 vaccination coverage was highest among those identifying as East/Southeast Asian (74%) and lowest among those identifying as Black (56%).
- Children living in urban areas had higher COVID-19 and seasonal influenza vaccination coverage estimates (69% and 33%, respectively) than children living in rural areas (57% and 23%, respectively).
- COVID-19 vaccination coverage was higher among children who reported having received all recommended routine childhood vaccines (70%), compared to those who received some routine vaccines (38%) or did not receive any (11%).
- New in 2024: Approximately 27% of children 6 months to 17 years received a COVID-19 vaccine since September 2023.
- More children who had received a recommendation to get a COVID-19 vaccine from a health care provider reported receiving at least one dose of a COVID-19 vaccine (84%), compared to those who did not receive a recommendation (62%). While a similar notable difference was observed for the seasonal influenza vaccine, where more children who had received a recommendation to get an influenza vaccine from a health care provider reported receiving it (68%), compared to those who did not receive a recommendation (32%).
- The most common reason for COVID-19 vaccine hesitancy was concerns that not enough research on the vaccine has been done in children (64%), while the most common reason for seasonal influenza vaccine hesitancy was concerns about the effectiveness of flu vaccines (40%).
- New in 2024: More than half (58%) of children 6 months to 17 years received a COVID-19 and seasonal influenza vaccine during the same visit.
- The most trusted source of information related to COVID-19 vaccines was health care providers (42%, no change from 2023), followed by scientific publications and journals (17%, no change from 2023), and Public Health Agency of Canada and Health Canada (13%, a decrease from 19% in 2023).
- Most parents/guardians of children younger than 18 years agree that COVID-19 vaccines are safe (66%, a decrease from 70% in 2023) and effective (64%, also a decrease from 68% in 2023). While 82% agree that the influenza vaccine is safe (a slight decrease from 83% in 2023) and 69% agree it is effective (unchanged in 2023).
- Overall, 31% of children 6 months to 17 years and 41% of children with a pre-existing medical condition received the seasonal influenza vaccine during the 2023-2024 influenza season, both decreases from last year 34% and 43%, respectively.
- The above trends were similar to those observed in the 2023 cycle of the survey, unless noted otherwise.
Introduction
The Childhood Seasonal Immunization Coverage Survey (CSICS), (previously known as the Childhood COVID-19 Immunization Coverage Survey) is an annual survey conducted by the Public Health Agency of Canada to measure the proportion of children in Canada who have received a COVID-19 vaccine and/or a seasonal influenza vaccine during the 2023-2024 influenza season (September to March). The survey is given to parents or guardians who have children younger than 18 years of age. In Canada, both the COVID-19 and seasonal influenza vaccines are recommended for children and youth 6 months and older, and especially for populations at risk, such as immunocompromised individuals.
CSICS provides key information about COVID-19 and seasonal influenza (flu) vaccination coverage among children and parents/guardians, parental knowledge, attitudes and beliefs (KABs) regarding these vaccines, intention to vaccinate, hesitancy and barriers to vaccination, COVID-19 diagnosis and recommendations from healthcare providers, along with select demographic information. In addition, the 2024 CSICS also asks about receiving the COVID-19 and seasonal influenza vaccines at the same time.
COVID-19 and seasonal influenza vaccination coverage estimates were collected for children 6 months to 17 years of age.
Detailed results tables and the methodological report are published on the Library and Archives Canada website. The following summary presents survey findings from the third cycle of data collection, which started on April 18th, 2024, and ended on July 15th, 2024. All differences noted are significant at the 95% confidence interval.
Results
COVID-19 vaccination coverage among childrenFootnote 1
The 2024 Childhood Seasonal Immunization Coverage Survey (CSICS) found that among children 6 months to 17 years of age:
- 67% had received at least one dose of a COVID-19 vaccine approved for use in Canada (unchanged from 2023) (Table 1).
- Of these, 6% had received only one dose, 29% received two doses, 20% received three doses, and 8% received four doses and 3% received five or more doses. 34% of children 6 months to 4 years received at least one dose of a COVID-19 vaccine, an increase from 31% in 2023, 68% of children 5 to 11 years received at least one dose of a COVID-19 vaccine, a decrease from 71% in 2023, while 89% of children 12 to 17 years received at least one dose of a COVID-19 vaccine, similar to 2023.
- There were no statistical differences in vaccination coverage among males and females in 2024, nor were there any differences in vaccination coverage by sex between the 2023 and 2024 survey cycles.
- Vaccine recommendation from a health care provider: Overall, 25% of children 6 months to 17 years were recommended by a health care provider to receive a COVID-19 vaccine, a decrease from 30% in 2023. More children 6 months to 17 years who had received a recommendation to get a COVID-19 vaccine from a health care provider reported receiving at least one dose of a COVID-19 vaccine (84%), compared to those who did not consult a health care provider (69%) or those who indicated a health care provider recommended against it (37%).
- Provincial/territorial vaccination coverage estimates for at least one dose of a COVID-19 vaccine among children 6 months to 17 years ranged from 78% in Northwest Territories to 63% in Alberta. There were no changes in coverage from 2023, except in Alberta (an increase from 60%).
- Ethnicity and Indigenous identity: Vaccination coverage among children 6 months to 17 years of age across various ethnicities ranged from 56% to 74%. Similar to trends seen in 2023, coverage was highest among those identifying as East/Southeast Asian (74%), followed by Latin American (71%), white European descent (69%), South Asian (66%), Middle Eastern and North African (63%), Indigenous (62%) and Black (African, Afro-Caribbean, and African) descent (56%). 64% of those identifying as First Nations, 59% identifying as Métis and 77% identifying as Inuit received at least one dose of a COVID-19 vaccine.Footnote 2
- Rural/urban: Similar to trend seen in 2023, more children 6 months to 17 years of age living in an urban area received at least one dose of a COVID-19 vaccine (69%) compared to those living in a rural area (57%).
- Routine immunization coverage: Similar to trend seen in 2023, parents/guardians who reported their 6 months to 17-year-old child got all recommended routine childhood vaccinations were more likely to report their child received at least one dose of a COVID-19 vaccine (70%), compared to those who received some routine vaccinations (38%) and those who did not receive any routine vaccinations (10%).
- Medical conditions/disability: Among children 6 months to 17 years of age, more children who had a pre-existing medical condition reported receiving at least one dose of a COVID-19 vaccine (74%) compared to those that did not have a medical condition (66%). Similarly, there were significant differences in vaccination coverage among children that had a disability (78%) compared to children who did not have a disability (66%). A similar trend was seen in 2023.
- COVID-19 vaccination during the 2023-2024 fall campaign: New to this cycle, parents were asked whether their child received a COVID-19 vaccine since September 2023, aligning with Canada's fall vaccination campaign. Approximately 27% of children 6 months to 17 years of age received a COVID-19 vaccine since September 2023. More children 6 months to 4 years received their COVID-19 vaccine since September 2023 (49%), compared to children 5 to 11 years (27%) and 12 to 17 years (21%). There were no statistical differences in vaccination coverage by child's sex.
- COVID-19 and seasonal influenza vaccination during the same visit: New to this cycle, parents were asked whether their child received a COVID-19 and seasonal influenza vaccine during the same visit. More than half (58%) of children 6 months to 17 years received a COVID-19 and seasonal influenza vaccine at the same visit. The most common reason reported was to save time (70%). While the most common reason for not getting the vaccine at the same time was not being offered the option/able to book an appointment to receive them both at the same time (43%).
| Demographic | At least 1 dose | 1 dose | 2 doses | 3 doses | 4 doses | 5 or more doses |
|---|---|---|---|---|---|---|
| All children | 67% | 6% | 29% | 20% | 8% | 3% |
| Females | 68% | 6% | 29% | 20% | 9% | 3% |
| Males | 66% | 6% | 29% | 20% | 8% | 3% |
| 6 months to 4 years | 34% | 8% | 15% | 9% | 3% | <1% |
| 5 to 11 years | 68% | 8% | 29% | 20% | 9% | 3% |
| 12 to 17 years | 89% | 4% | 39% | 29% | 12% | 5% |
- Intent to keep COVID-19 doses up to date: New to this cycle, parents/guardians of children younger than 18 years of age were asked about their level of intent to keep their child's vaccine doses up to date (i.e., in the future, receiving them as they are recommended by public health). Overall, fewer parents (40%) reported they will keep their child's COVID-19 doses up to date compared to those who will not (54%) (Figure 1). There were no statistical differences by child's sex nor by child's age group for those intending to keep COVID-19 vaccine doses up to date.
- Parents/guardians' level of intention to keep their child's COVID-19 doses up to date, ranged across the provinces and territories; 25% of parents/guardians in Nunavut indicated they definitely will keep their child's doses up to date, while only 12% in Quebec indicated they definitely will.
Figure 1 : Descriptive text
| Level of intention to vaccinate against COVID-19 | Overall (%) | Parents of males (%) | Parents of females (%) | Parents of 0–4 years (%) | Parents of 5–11 years (%) | Parents of 12–17 years (%) |
|---|---|---|---|---|---|---|
| Definitely will | 17 | 17 | 18 | 19 | 17 | 17 |
| Probably will | 23 | 22 | 23 | 22 | 23 | 24 |
| Probably won'tFootnote a | 26 | 25 | 26 | 23 | 25 | 28 |
| Definitely won'tFootnote a | 28 | 29 | 27 | 31 | 29 | 25 |
| Don't know | 6 | 6 | 6 | 6 | 6 | 6 |
|
||||||
Parental reasons for COVID-19 vaccination or obstacles that prevented vaccination
- Reasons for vaccination: According to parents/guardians of children 6 months to 17 years of age the most common reasons for getting their child a COVID-19 vaccine was to protect themselves and/or household members against COVID-19 infection (65%), followed by public health recommendations (64%), and preventing the spread of COVID-19 in the community (60%), these were also the most commonly reported reasons in 2023.
- Reasons for non-vaccination: The most common reasons for not vaccinating their child against COVID-19 were perceptions of low vaccine safety/concerns about side effects (48%), not considering it necessary for their child (46%) and believing that their child is already adequately protected by natural immunity (31%). This was followed by the lack of trust in the government and/or pharmaceutical companies (30%) and lack of vaccine effectiveness in protecting against the virus (30%).
- Obstacles to COVID-19 vaccination: Seventy-four percent (74%) of parents/guardians of 6 months to 17-year-old children indicated they did not face any obstacles. Among those who reported facing an obstacle (26%), 9% reported their child fears needles, 8% reported that it was difficult to get an appointment and 4% indicated that at least one parent opposed the vaccine.
COVID-19 vaccine hesitancyFootnote 3
Parents/guardians of children younger than 18 years of age were asked if they were hesitant to get a COVID-19 vaccine for their child, regardless of whether the child got a COVID-19 vaccine or not. Overall, 43% of parents/guardians of children below 18 years of age indicated they were hesitant to vaccinate their child against COVID-19, similar to 2023 (44%), regardless of child's vaccination status.
- Hesitancy ranged in the provinces/territories from 26% in Nunavut to 49% in Alberta;
- There were no differences among parents/guardians of males (43%) compared to parents/guardians of females (42%). Vaccine hesitancy was higher in parents/guardians of 0- to 4-year-olds (49%) compared to parents/guardians of 5- to 11-year-olds (43%) or 12- to 17-year-olds (38%). A similar trend was seen in 2023.
The most common reasons for COVID-19 vaccine hesitancy were concerns that not enough research on the vaccine has been done in children (64%), followed by concerns about the safety of COVID-19 vaccines and/or side effects (39%) and concerns about the effectiveness (32%). These were also the top three reasons for hesitancy in 2023.
COVID-19 vaccine refusalFootnote 4Footnote 5
In this cycle, parents/guardians were asked whether they intentionally decided to not vaccinate their children aged 6 months to 17 years against COVID-19, if their child had not received a vaccine or did not disclose vaccination status. Results are not comparable to 2023 due to a change in the wording of the question (changed from "Why did you refuse a COVID-19 vaccine for your child" to "Did you intentionally decide not to get a COVID-19 vaccine for your child"). 79% of parents/guardians indicated they refused to vaccinate their child against COVID-19, with the following:
- There were no significant differences between parents/guardians of males (79%) or females (79%).
- Parents/guardians of children 6 months to 4 years were less likely to indicate they refused to vaccinate their child (71%) compared to parents/guardians of children 5 to 11 years (86%) or children 12 to 17 years (89%).
- Provincial/territorial differences in parents/guardians refusing to vaccinate their child ranged from 58% in Newfoundland and Labrador to 88% in Saskatchewan.
Source of information
- Similar to 2023, the most trusted source of information related to COVID-19 vaccines reported by parents/guardians of children younger than 18 years of age was health care providers (42%, no change from 2023), followed by scientific publications or journals (17%, no change from 2023) and Public Health Agency of Canada/Health Canada (13%, a decrease from 19% in 2023).
Seasonal influenza vaccination coverage among children
- Overall, 31% of children 6 months to 17 years received the influenza vaccine during the 2023-2024 influenza season (Figure 2), a decrease from 34% in the previous influenza season.
- Slightly lower influenza vaccination coverage estimates were noted between this cycle and the previous cycle by sex and age group. Both males and females (31%) received their influenza vaccine compared to 34% for males and 35% for females in the previous influenza season.
- A decrease in children 6 months to 4 years (38%) received their influenza vaccine in the 2023-2024 influenza season compared to 41% in the 2022-2023 influenza season; similarly decreases in coverage for children 5 to 11 years (31%) and 12 to 17 years (27%) were reported compared to the previous season (35% and 28%, respectively).
- Provincial/territorial vaccination coverage estimates among children 6 months to 17 years ranged from 16% in Quebec to 41% in Nova Scotia and British Columbia.
- In 2023-2024, almost all provinces and territories reported decreases in influenza vaccines for all children 6 months and older. There were no changes in New Brunswick, Quebec, Saskatchewan and Yukon compared to the 2022-2023 influenza season.
- Rural/urban: Similar to the trend seen in the previous season, more children 6 months to 17 years of age, living in an urban area received the influenza vaccine in the 2023-2024 influenza season (33%, a decrease from 36% in the previous season) compared to those living in a rural area (23%, unchanged from 25% in the previous season).
- Ethnicity and Indigenous identity: Influenza vaccination coverage among children 6 months to 17 years of age decreased from the previous influenza season across various ethnicities. Influenza vaccination coverage was highest among East/Southeast Asian (43%), followed by South Asian descent (38%), Latin American (33%), white European descent (32%), Indigenous people (30%), Black (African, Afro-Caribbean, and African) descent (27%), and Middle Eastern and North African (26%). Compared to the previous influenza season, vaccination coverage in Indigenous children increased among Inuit children (40%, compared to 25% in the previous season), remained unchanged among both Métis and First Nation children (31%). These differences, among Indigenous children must be interpreted with caution as they may be due to small sample sizes.
- Medical conditions/disability: Similar to the trend seen in the previous season, more children 6 months to 17 years of age who had a pre-existing medical condition received their influenza vaccine in the 2023-2024 influenza season (41%; 43% in the previous season) compared to those who did not have a medical condition (30%; a decrease from 34% in the previous season). Similarly, slightly more children that had a disability (37%; unchanged from the previous season) compared to those who did not have a disability (31%, a decrease from 34% in the 2022-2023 season) received their influenza vaccine.
Figure 2: Descriptive text
| Demographic | Overall (%) | Males (%) | Females (%) | 6 months–4 years (%) | 5–11 years (%) | 12–17 years (%) |
|---|---|---|---|---|---|---|
| 2021-2022 seasonal influenza season | 30 | 30 | 30 | 40 | 29 | 24 |
| 2022-2023Footnote a seasonal influenza season | 34 | 34 | 35 | 41 | 35 | 28 |
| 2023-2024Footnote a seasonal influenza season | 31 | 31 | 31 | 38 | 31 | 27 |
|
||||||
- Frequency: Prior to the 2023-2024 influenza season, 23% of children received the influenza vaccine every influenza season, a decrease from 25% in the previous season, 15% received it most influenza seasons, 20% received it some influenza seasons and 42% never received it (an increase from 41% in the previous season).
- Reasons for influenza vaccination: Similar to trends in the previous influenza season, the most common reasons for a child getting the influenza vaccine in the 2023-2024 influenza season was to protect themselves and/or household members from influenza (71%), followed by preventing the spread of influenza in their community (58%), and that the child receives the influenza vaccine every year (56%). These were the most commonly reported reasons for influenza vaccination in the previous season as well.
- Obstacles to influenza vaccination: The majority (80%) of parents/guardians of unvaccinated 6 months to 17-year-olds indicated they did not face any obstacles, an increase from 77% in the previous influenza season. Among parents/guardians that faced an obstacle to vaccinating their child against influenza, the most common obstacle they faced was difficulty in booking time off work/school for an appointment (8%, a decrease from 36% in the previous season), followed by their child fears needles (8%, a decrease from 25% in the previous influenza season). While 2% of parents reported that at least one parent opposed it (a decrease from 26% in the previous season), 1% of parents reported that their child or themselves had an adverse reaction to a previous vaccine (a decrease from 9%) and 3% reported some other reason.
- Influenza vaccine hesitancyFootnote 3: About 29% of parents/guardians were hesitant to vaccinate their child against influenza, unchanged from the previous influenza season. Consistent with the previous influenza season, no differences were reported between males (29%) and females (28%). More parents/guardians of older children (30%, 5- to 11-year-olds; 29%, 12- to 17-year-olds) reported influenza vaccine hesitancy compared to parents/guardians of children 6 months to 4 years (27%). The most common reasons for vaccine hesitancy were that parents were concerned about the effectiveness of the flu vaccine (40%, unchanged from last cycle), 20% were concerned about the safety of the flu vaccine, a decrease from 27% and lack of trust in the government or pharmaceutical companies (17%).
- RefusalFootnote 4Footnote 5: Overall, 58% of parents/guardians refused to vaccinate their child against influenza. The most common reasons for parents refusing to vaccinate their child against influenza was believing it was not necessary (56%, a decrease from 70% in the previous cycle), 26% did not get around to getting their child a flu vaccine, while 17% had concerns about the safety/side effects of the flu vaccine, a decrease from 31%.
- Intent to receive the influenza vaccine next season (Figure 3): Overall, 49% of parents/guardians indicated they definitely will or probably will get their child the influenza vaccine during the 2024-2025 influenza season (unchanged from the previous cycle). Similar to trends in the last cycle, the younger the child, the higher was parental intention to vaccinate their child; 54% of parents of children younger than 5 years of age indicated that they intend to vaccinate their child in the next influenza season, a slight decrease from last cycle (58%), compared to parents of 5 to 11 and 12 to 17-year-olds (48% and 44%, respectively).
- Influenza vaccine recommendation from a health care provider: Overall, 23% of parents reported that it was recommended for their child to receive the influenza vaccine, a slight increase from 22% in 2023. Recommendations were more often made to parents/guardians of children younger than 5 years (33%) compared to parents/guardians of 5 to 11 (22%) or 12 to 17 years (17%). Similar to trends seen in the past influenza season, more children who had received a recommendation to get an influenza vaccine from a health care provider reported receiving it (68%, a decrease from 70% in 2023), compared to those who did not consult a health care provider (24%) or those who indicated a health care provider recommended against a vaccine (8%).
Figure 3: Descriptive text
| Level of intention to vaccinate against seasonal influenza | Overall (%) | Parents of males (%) | Parents of females (%) | Parents of 6 months–4 years (%) | Parents of 5–11 years (%) | Parents of 12–17 years (%) |
|---|---|---|---|---|---|---|
| Definitely willFootnote a | 24 | 24 | 24 | 29 | 23 | 20 |
| Probably will | 25 | 24 | 26 | 25 | 25 | 25 |
| Probably won'tFootnote a | 25 | 25 | 24 | 20 | 26 | 27 |
| Definitely won't | 21 | 22 | 21 | 22 | 21 | 22 |
| Don't knowFootnote a | 5 | 6 | 5 | 4 | 5 | 7 |
|
||||||
COVID-19 vaccination coverage among parents/guardians
- Overall, no major changes were noticed compared to 2023.
- COVID-19 vaccination coverage: Overall, 91% of parents/guardians received at least one dose of a COVID-19 vaccine.
- Intent to vaccinate: Among parents/guardians who were not vaccinated, less than 1% indicated they definitely will or probably will get the vaccine in the future, while 95% reported they definitely won't.
- Vaccine hesitancyFootnote 3: Approximately, 41% of all parents/guardians (regardless of their vaccination status) were hesitant about the COVID-19 vaccine, an increase from 37% in 2023.
- RefusalFootnote 4Footnote 5: Among parents/guardians that did not get vaccinated, 96% of parents/guardians refused to get a COVID-19 vaccine.
Seasonal influenza vaccination coverage among parents/guardians
- Seasonal influenza vaccination coverage: About 37% of parents/guardians received their influenza vaccine during the 2023–2024 influenza season, a decrease from 41% in the 2022-2023 season.
- Provincial and territorial influenza vaccination coverage ranged from 26% in Quebec to 49% in Yukon.
- Vaccine hesitancyFootnote 3 and refusalFootnote 4Footnote 5: Approximately, 27% of parents were hesitant to receive the influenza vaccine, unchanged from last cycle; and 67% refused to get the influenza vaccine during the 2023-2024 influenza season.
- Intent to vaccinate: About 26% of parents of children younger than 18 years reported they definitely will get the influenza vaccine in the 2024-2025 influenza season (a decrease from 28% in the previous season), while 24% reported they definitely won't, an increase from 20% in the previous influenza season.
Knowledge, attitudes and beliefs
To better understand factors influencing decisions on COVID-19 and influenza vaccinations, additional questions were asked of parents/guardians. These questions were designed to determine their knowledge, attitudes and beliefs around vaccines (Table 2) and to understand if there is any relation to their child's vaccination status. Parents were asked their level of agreement with a series of statements about childhood vaccines.
- Most parents/guardians of children younger than 18 years agree that COVID-19 vaccines are safe (66%, a decrease from 70% in 2023) and effective (64%, also a decrease from 68% in 2023). While 82% agree that the influenza vaccine is safe and 69% agree it is effective (both slight decreases from 83% and 70% in 2023, respectively).
- 40% agree that close family and friends want them to get their child vaccinated against COVID-19, a decrease from 45% in 2023.
- 51% agreed that their child needs to be vaccinated against COVID-19 even if they had a COVID-19 infection before, a decrease from 54% in 2023.
- Most parents/guardians of children younger than 18 years agreed they have access to enough trustworthy information to make an informed decision about COVID-19 vaccines (83%, a decrease from 85% in 2023).
| Statement | Parental level of agreement (%)Footnote a | ||
|---|---|---|---|
| Strongly or somewhat agree | Strongly or somewhat disagree | Don't know | |
| In general, vaccines are safe | 88 | 11 | 1 |
| In general, vaccines are effective | 90 | 9 | 1 |
| In general, COVID-19 vaccines are safe | 66 | 29 | 6 |
| In general, COVID-19 vaccines are effective | 64 | 31 | 5 |
| My child needs to be vaccinated against COVID-19 even after infection | 51 | 44 | 5 |
| I have access to enough trustworthy information about COVID-19 vaccines to make an informed decision | 83 | 15 | 2 |
| Close family and friends want me to get my child vaccinated against COVID-19 | 40 | 44 | 16 |
| In general, the flu vaccine is safe | 82 | 13 | 4 |
| In general, the flu vaccine is effective | 69 | 26 | 5 |
|
|||
Summary
COVID-19 vaccination coverage
To summarize, 67% of children 6 months to 17 years of age have been vaccinated with at least one dose of a COVID-19 vaccine. The results revealed significant age differences in COVID-19 vaccination coverage; among those that received at least one dose of a COVID-19 vaccine, children 6 months to 4 years have the lowest coverage (34%) compared to 5- to 11-year-olds (68%) and 12- to 17-year-olds (89%).
Overall, 25% of children 6 months to 17 years were recommended by a health care provider to receive a COVID-19 vaccine. Vaccination coverage was higher in those that were recommended to get a COVID-19 vaccine (84%) compared to those who did not consult a health care provider (69%) or those who indicated a health care provider recommended against a vaccine (37%).
The most common reason for parents/guardians to get their child vaccinated was to protect themselves and/or household members against COVID-19 infection (65%). Overall, 17% reported they definitely will keep their child's COVID-19 doses up to date, and in the future 23% indicated they probably will. The most common reason for not vaccinating child against COVID-19 was perceptions of low vaccine safety/concerns about side effects (48%).
Parental hesitancy to vaccinate their child or to vaccinate themselves was similar to 2023 (43% and 41%, respectively). The main reason for hesitancy reported by parents/guardians was concern that not enough research on the vaccine has been done in children (64%). Overall, 79% of parents/guardians refused to vaccinate their children. Among parents/guardians that had not received a COVID-19 vaccine (9%), 96% refused to get the vaccine for themselves.
Similar trends to last cycle, parents/guardians who reported their children got all recommended routine childhood vaccinations were more likely to report their child received at least one dose of a COVID-19 vaccine (70%), compared to those who received some routine vaccinations (38%) and who did not receive any routine vaccinations (11%).
Seasonal influenza vaccination coverage
Overall, 31% of children 6 months to 17 years have received their influenza vaccine during the 2023-2024 influenza season. The most common reason to get their child the influenza vaccine was to protect themselves and/or household members from influenza (71%).
Parents were also asked about intentions to vaccinate their child in the next influenza season; 49% of parents intend to vaccinate their child against influenza in the 2024-2025 influenza season.
There were no major differences between parental/guardian hesitancy to vaccinate their child against influenza (29%) than they were to vaccinate themselves (27%). 58% of parents/guardians refused to get their child the influenza vaccine, while 67% of parents/guardians refused to get the influenza vaccine for themselves. The most commonly reported reason for influenza vaccine hesitancy was that parents were concerned about the effectiveness of the influenza vaccine (40%); while the most common reason for refusing to vaccinate was that they did not consider it necessary for their child (56%).
Socio-demographic characteristics
Among reported ethnicities, COVID-19 and influenza vaccination coverage were highest among children identifying as East/Southeast Asian (74%, 43%, respectively), Latin American (71%, 33%, respectively), and South Asian (66%, 38%, respectively) descent. COVID-19 vaccine and influenza vaccination coverage were lower among children identifying as Middle Eastern and North African (63%, 26%, respectively) and Black (56%, 27%, respectively). Children living in urban areas had higher COVID-19 and influenza vaccination coverage estimates (69% and 33%, respectively) compared to children living in rural areas (57% and 23%, respectively). More children with a pre-existing medical condition or a disability received the COVID-19 and influenza vaccines compared to those who do not have a medical condition or disability.
Knowledge, attitudes and beliefs
The majority of parents agree that vaccines in general, COVID-19 and influenza vaccines are safe and effective. Most parents/guardians agreed they have access to enough trustworthy information to make an informed decision about COVID-19 vaccines (83%). However, 44% of parents disagree that their child needs to be vaccinated against COVID-19 even after infection.
The most trusted source of information reported was health care providers (42%), followed by scientific publications or journals (17%) and Public Health Agency of Canada/Health Canada (13%).
Considerations and limitations
Due to the collection methodology and the nature of the survey, CSICS estimates of COVID-19 vaccination coverage in children below 18 years of age may be higher than results reported by the Canadian COVID-19 Vaccination Coverage Surveillance System (CCVCSS). Children living in the North were oversampled to gain more information on Indigenous people, although specific efforts to oversample children residing on-reserve and across the Inuit Nunangat regions were not carried out. Institutionalised children and youth are also not included. Furthermore, caution must be taken when making comparisons between the 2022, 2023 and 2024 cycles of CCICS/CSICS in terms of COVID-19 vaccination coverage; in the 2022 cycle of CCICS, children below 5 years were not included in coverage estimates as they were not eligible at the time of data collection, while in the 2023 and 2024 cycles they were included.
For more information about the Childhood Seasonal Immunization Coverage Survey (CSICS), please contact us at ccics-ecvec@phac-aspc.gc.ca.
Related links
- Vaccines for COVID-19: How to get vaccinated
- Approved COVID-19 vaccines
- Vaccines for children: COVID-19
- Statement on Seasonal Influenza Vaccine for 2024-2025
- Vaccination Coverage in Canada
- Childhood COVID-19 Immunization Coverage Survey (CCICS): 2022 results
- Childhood COVID-19 Immunization Coverage Survey (CCICS): 2023 results
Endnotes:
- Footnote 1
-
Please note, that during the 2022 survey cycle, children younger than 5 years were not eligible for COVID-19 vaccination, whereas in 2023 and 2024 they were. Therefore, coverage comparisons between 2022 and 2023 were among children 5 to 17 years of age, while comparison between the 2023 and 2024 are among children 6 months to 17 years of age.
- Footnote 2
-
Estimates among Indigenous children shown in the detailed tables, particularly by age group, must be interpreted with caution as they may be due to small sample sizes.
- Footnote 3
-
In this case, vaccine hesitancy refers to a delay in acceptance or refusal of vaccines despite availability.
- Footnote 4
-
In this case, vaccine refusal refers to intentionally deciding to not take a vaccine.
- Footnote 5
-
The wording of the question on vaccine refusal changed in 2024 from "Why did you refuse… " to "Did you intentionally decide not to get… ". Results are not comparable to 2023.
Page details
- Date modified: