Vaccine uptake in Canadian adults: Highlights from the 2020-2021 Seasonal Influenza Vaccination Coverage Survey

The Seasonal Influenza Vaccination Coverage Survey collects information every year about the uptake of the flu shot in Canada. Each flu season, it estimates how many people get vaccinated as well as knowledge, attitudes, and beliefs about the flu shot. Every two years, the survey also collects information about other recommended vaccines for adults: pertussis (whooping cough), tetanus, pneumococcal and shingles. The 2020-2021 Seasonal Influenza Vaccination Coverage Survey took place between January 6 and February 11, 2021. With the current pandemic context, questions about the COVID-19 vaccine were also added to the survey this year.

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Purpose of this survey

Results from the survey provide information about how well Canadian adults are protected against vaccine preventable diseases as well as what they know and think about vaccines.

Survey results are used to:

Key results

Influenza vaccine

The flu season in Canada normally runs from November to April. Anyone can get the flu, which can sometimes lead to severe complications or death. Some people are at higher risk of complications due to the flu, including:

The influenza vaccine, also known as the flu shot, is the best way to prevent the disease. Every Canadian 6 months of age and older should get the flu shot every year.

Figure 1. Seasonal flu vaccination coverage, 2018-2019 to 2020-2021 flu seasons
Figure 1
Figure 1 - Text description
Seasonal flu vaccination coverage
Flu season Percent vaccinated (%)
for all adults
(18+)
for age 18-64
without chronic medical conditions
for age 18-64
with chronic medical conditions
for seniors
(65+)
2018-2019 41.8 30.8 42.8 69.9
2019-2020 41.8 30 43.6 70.3
2020-2021 40.4 29.2 40.5 70.4

Overall, influenza vaccination coverage among all adults (40%) was similar to the previous season (42%).

Canada's goal is to have 80% of those at higher risk of complications from the flu vaccinated. This includes seniors (65 years of age and older) and adults aged 18-64 years with chronic medical conditions.

In the 2020/21 flu season:

Timing and place of vaccination

Reasons to get, or not get the flu shot

Impact of COVID-19 on getting the flu shot

Other vaccines

Tetanus and pertussis (whooping cough) vaccines

In Canada, adults can be vaccinated against tetanus (lockjaw) with either the tetanus-diphtheria (Td) or the tetanus-diphtheria-pertussis (Tdap) vaccines. All adults should receive 1 dose of Tdap in adulthood to be protected from pertussis and tetanus, and all pregnant individuals should receive 1 dose of Tdap to protect their babies until they can be vaccinated themselves. In addition, all adults should receive a booster dose of tetanus vaccine (Td) every 10 years to be protected from tetanus.

Pneumococcal vaccine

The bacterium Streptococcus pneumoniae, also known as pneumococci, is a common cause of pneumonia and can also cause blood infections referred to as invasive pneumococcal disease (IPD). People with some underlying medical conditions and seniors (65 years of age and older) are at higher risk of IPD and should receive the pneumococcal vaccine if not previously vaccinated.

Among seniors

Among adults

Shingles vaccine

Shingles is a painful skin rash with blisters, usually on part of one side of the body. It is triggered by the same virus that causes varicella (chicken pox). Any person who has had varicella can get shingles, but most people who get the disease are older than 50 or have a weakened immune system. One dose of the shingles vaccine is recommended for adults 50 years of age and older.

COVID-19 vaccines

At the time of the data collection between January 6 and February 11, 2021, two COVID-19 vaccines (Pfizer-BioNTech and Moderna) were authorized for use in Canada. At that time:

Knowledge, attitudes and beliefs

Most adults (90%) reported that they knew enough about vaccines to make a decision about getting vaccinated and considered vaccines to be important for their health (92%).

While most of the respondents believed that the flu shot is safe (91%), there were still 40% of respondents who believed they might get the flu from the flu vaccine—which is not true for any flu shot in Canada. Moreover, 34% felt that the flu vaccine does not protect them against getting the flu.

About three quarters of respondents (74%) agreed that the opinion of their family doctor, general practitioner or nurse practitioner is an important part of their decision to get the flu shot.

To summarize

Overall, coverage among all adults aged 18 years and older for the 2020/21 flu season has not changed significantly from previous years. Although the national flu vaccination coverage goal of 80% for those at higher risk remain unmet, flu shot uptake among seniors is close to this goal (70%), although little improvement has been achieved in recent years.

While almost half of the Canadian adults surveyed stated that they had encountered difficulties in scheduling an appointment for getting the flu shot this year due to the preventive measures to reduce the spread of COVID-19 (47%), it did not seem to have a significant impact on flu vaccination coverage.

The most common reason for getting the flu shot was to prevent infection or avoid getting sick, whereas the most common reason for non-vaccination was the perception of being healthy/never getting the flu.

While a greater proportion of seniors reported having received a pneumococcal vaccine in adulthood compared to younger adults, the number still fell short of the national goal of 80%.

The most commonly stated reason for not getting other adult vaccines (tetanus, pertussis, pneumococcal and shingles) was the perception that the vaccines are not necessary.

A full report of the survey results is available. For more information about the Seasonal Influenza Coverage Survey, please contact us at coverage-couvertures@phac-aspc.gc.ca.

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