Seasonal Influenza Vaccination Coverage Survey, 2022-2023

Final Report

Submitted to the Public Health Agency of Canada
Contract Number: CW2267103

Prepared By: Leger

Ce rapport est également disponible en français.
Contract value: $220,435.20
Award date: January 4, 2023
Delivery date: March 24, 2023

Registration number: POR 107-22
For more information on this report, please contact cpab_por-rop_dgcap@hc-sc.gc.ca

Leger
507 Place d'Armes, Suite 700
Montréal, Quebec
H2Y 2W8
Telephone: 514-982-2464
Fax.: 514-987-1960

Seasonal Influenza Vaccination Coverage Survey, 2022-2023

Final Report

Prepared for the Public Health Agency of Canada
Supplier Name: Leger Marketing Inc.
March 2023

This public opinion research report presents the methodology of a telephone survey conducted by Leger Marketing Inc. on behalf of the Public Health Agency of Canada. The research was conducted with 3,558 Canadians between January 5 and February 20, 2023.

Cette publication est aussi disponible en français sous le titre : Enquête sur la couverture vaccinale contre la grippe saisonnière, 2022-2023.

This publication may be reproduced for non-commercial purposes only. Prior written permission must be obtained from Health Canada. For more information on this report, please contact Health Canada at cpab_por-rop_dgcap@hc-sc.gc.ca or at:

Health Canada, CPAB
200 Eglantine Driveway, Tunney's Pasture
Jeanne Mance Building, AL 1915C
Ottawa, Ontario K1A 0K9

Catalogue Number:
H14-315/2023E-PDF

International Standard Book Number (ISBN):
978-0-660-47942-2

Related publications (registration number: POR 107-22):

Catalogue Number: H14-315/2023F-PDF (Final Report, French)
978-0-660-47943-9

©His Majesty the King in Right of Canada, as represented by the Minister of Health, 2023.

Table of Contents

1. Summary

Leger is pleased to submit this methodological report to the Public Health Agency of Canada (PHAC) of a quantitative survey assessing seasonal influenza vaccination coverage among the Canadian population.

This report was prepared by Leger following the awarding of a contract to PHAC (contract number CW2267103), awarded January 4, 2023. This contract has a value of $220,435.20 (including HST).

1.1 Background and Objectives

Influenza usually occurs in the northern hemisphere between November and April. In Canada, an average of 12,200 hospitalizations and 3,500 deaths related to influenza occur each year. The risk of hospitalization is greatest in very young children and elderly persons. The best way to prevent influenza is by getting the influenza vaccine.

The National Advisory Committee on Immunization (NACI) recommends that every year, individuals six months and older receive an influenza vaccine. This is especially true for populations at high risk for influenza-related complications such as those with chronic medical conditions (CMCs), older adults (aged 65 years and older), and young children (aged six to 59 months). Canadian provinces and territories launch their influenza vaccination programs before influenza begins spreading in the community, usually beginning in October and continuing on past December. Vaccination continues to be offered throughout the influenza season, as long as influenza viruses are circulating.

There are two main types of influenza viruses that cause outbreaks and epidemics: influenza A and B. Influenza A and B viruses are further broken down into subtypes and lineages, respectively. Across influenza seasons, different subtypes and/or lineages are in circulation, so experts must create a new influenza vaccine each year. Further, the effectiveness of the vaccine can wear off over time. This is why it is important to get a new influenza vaccine every year. Monitoring influenza vaccine coverage across the country helps PHAC assess how well the general population in Canada are protected from the virus.

In order to survey people on their attitudes and beliefs toward COVID-19 vaccines, as well as their intent or acceptance of co-administration of the COVID-19 and flu vaccine, the section of COVID-19 vaccine-related questions introduced last year will again be used in the Seasonal Influenza Vaccination Coverage Survey 2022-2023 questionnaire.

Slightly higher than the World Health Organization (WHO) coverage goals of 75%, the Canadian national influenza vaccination coverage goals for seniors aged 65 and older and adults aged 18–64 years with CMCs were set at 80% in 2017 to be reached by 2025. Measuring vaccine coverage against the national goals on a routine basis plays an important role in protecting the health of Canadians for a number of reasons. First, it allows for the monitoring and evaluation of vaccination programs across years, and across different seasons for influenza. Second, it identifies factors influencing influenza vaccine uptake and sub-populations with low vaccine coverage, to support developing targeted programs for improving vaccine coverage in un- and under-vaccinated populations. Finally, it allows for the fulfillment of various reporting activities, such as performance measurement indicators, monitoring progress towards national vaccination coverage goals, and obligations to international health partners such as the Pan American Health Organization.

The primary objective of the research is to provide national vaccination coverage estimates for the seasonal influenza vaccine. Specifically, the survey will be used to:

1.2 Application of Results

The results of this study will help the Public Health Agency of Canada (PHAC) to identify at-risk populations with lower immunization coverage, recognize factors leading to vaccine uptake or refusal, measure the performance of vaccination programs, and design future vaccination programs in Canada. The survey results also allow PHAC to monitor and evaluate vaccination programs during the flu seasons.

1.3 Methodology—Quantitative Research

The quantitative research consisted of telephone interviews, which were conducted using a computer-assisted telephone interviewing system (CATI technology).

Data collection for this survey took place between January 5 and February 20, 2023. The national response rate for the survey was 10.14%. The comprehensive distribution of calls is presented in Appendix A. A pre-test of 41 interviews, in both official languages, was conducted between January 5 and 6, 2023. More specifically, 18 interviews were conducted in French and 23 in English. No changes were made to the questionnaire or the programming following the pre-test, data collection began as planned. The pre-test responses were included in the overall results. The interviews lasted an average of seventeen minutes and twenty seconds. The interviews were recorded to assess the level of understanding of each question among respondents.

To obtain reliable data for each of the subgroups, we surveyed a total sample of 3,558 Canadian adults in all regions of the country. Only one adult respondent was interviewed per household. The national margin of error for this survey is +/- 1.64%, 19 times out of 20.

The main target population in this study was Canadian adults aged 18 and older who were making vaccine-related decisions for themselves. As was the case in previous years, the final analysis of the study focused on 3 different target groups:

A proportion of the interviews was conducted with a sample of cell-phone numbers (cell-phone-only household members), in order to provide an adequate and reliable sample of the youth cohort (18 to 34). While the cell-phone sample did not exclusively target the youth cohort, this age group was over-indexed in that target sample. The other interviews were conducted with landline users. According to 2021 national census data from Statistics Canada, Leger weighted the results of this survey by age, gender, region, language (mother tongue) and education level. Results were also weighted by households with a landline phone and household with cellphones only, according to the latest Canadian Radio-Television and Telecommunications commission (CRTC) data available.

Leger meets the strictest quantitative research guidelines. The questionnaire was prepared in accordance with the Standards for the Conduct of Government of Canada Public Opinion Research—Series B—Fieldwork and Data Tabulation for Telephone Surveys. Details on the methodology, Leger's quality control mechanisms, the questionnaire, and the weighting procedures are provided in the appendix.

1.4 Notes on the Interpretation of the Findings

The opinions and observations expressed in this document do not reflect those of the Public Health Agency of Canada. This report was compiled by Leger based on research conducted specifically for this project. This research is probabilistic; the results can be applied to the general population of Canada. The research was designed with this objective in mind.

1.5 Declaration of Political Neutrality and Contact Information

I hereby certify, as chief agent of Leger, that the deliverables are in full compliance with the neutrality requirements of the Policy on Communications and Federal Identity and the Directive on the Management of Communications—Appendix C (Appendix C: Mandatory Procedures for Public Opinion Research).

Specifically, the deliverables do not include information on electoral voting intentions, political party preferences, party positions, or the assessment of the performance of a political party or its leaders.

Signed by:

Christian Bourque
Executive Vice President and Associate
Leger
507 Place d'Armes, Suite 700
Montréal, Quebec
H2Y 2W8
cbourque@leger360.com

Appendix A—Detailed Research Methodology

A.1 Quantitative Methodology

A.1.1 Methods

For tracking and comparability purposes, the methodology used for this survey was the same as that of previous waves of surveys. Leger used the same methods as those used in the 2021–2022 survey with respect to sampling methodology, data collection methods and some elements of the questionnaire.

The quantitative research consisted of telephone interviews, which were conducted using a computer-assisted telephone interviewing system (CATI technology). This approach is the most suitable for assessing seasonal influenza vaccination coverage among different subgroups of the Canadian population, while ensuring a high level of representativeness.

Leger meets the strictest quantitative research guidelines. The survey questionnaire was prepared in accordance with the Standards for the Conduct of Government of Canada Public Opinion Research—Series B—Fieldwork and Data Tabulation for Telephone Surveys.

Respondents were assured of the voluntary and confidential nature of the approach, and the anonymity of their responses. As with all research conducted by Leger, any information that could identify respondents was removed from the data, in accordance with Canada's Privacy Act.

Research interviews were conducted from the Montréal and Winnipeg virtual call centres. The Montreal call centre has three separate divisions of interviewers: one made up exclusively of English-speaking interviewers, another exclusively of French-speaking interviewers, and the last of bilingual interviewers. These divisions ensure that all telephone surveys can easily be conducted in either official language. Interviews in English were also conducted from the Winnipeg call centre.

A.1.2 Data Collection

Data collection for this survey was conducted between January 5 and February 20, 2023. The national response rate for the survey was 10.14%. The comprehensive distribution of calls is presented below. A pre-test of 41 interviews, in both official languages, was conducted between January 5 and 6, 2023. More specifically, 18 interviews were conducted in French and 23 in English. The interviews lasted an average of seventeen minutes and twenty seconds.

To obtain reliable data for each of the subgroups, we surveyed a total sample of 3,558 Canadian adults who had access to either a landline or a cellphone in all regions of the country. Only one adult respondent was interviewed per household. Canadians without a landline or cellphone were excluded from the study. This research is probabilistic; the results can be applied to the general population of Canada. The national margin of error for this survey is +/- 1.64%, 19 times out of 20.

Representative sample of approximately 3,500 Canadians

A sample of Canadian adults was selected randomly using a stratified regional sampling approach. Flexible regional quotas were applied to ensure that a sufficient number of interviews were conducted in each region of Canada.

The following table details the regional quotas for the 3,500 Canadian adults and the effective distribution of the 3,558 respondents:

Table 1. Flexible regional quotas

Region

Quotas

Number of completed interviews

Atlantic (New Brunswick, Nova Scotia, Prince Edward Island, Newfoundland and Labrador)

210 – 250

250

Quebec

770 – 830

820

Ontario

1,300 – 1,400

1,394

Manitoba and Saskatchewan

220 – 260

239

Alberta

400 – 440

385

British Columbia

440 – 480

425

Nunavut

15

15

Northwest Territories

15

15

Yukon Territories

15

15

Total

3,500

3,558

A.1.3 Sampling Procedures

Landline telephone numbers were generated, and only cell phone numbers were purchased[1] using a stratified regional sampling approach. Telephone interviews were conducted using Leger's computer-assisted telephone interviewing system (CATI technology). This system manages the sampling electronically, by selecting and randomly dialing the phone number to call. To ensure perfect coverage of a population, the sample included residential telephone numbers located in all of Canada's provinces and territories, as well as the cell phone numbers of Canadians who do not have a residential landline (i.e., pre-validated cell numbers only). Flexible quotas were established to ensure a sufficient number of interviews in each region of Canada. In addition to these regional quotas, data was collected to ensure proper distribution of respondents by gender (men and women) and language (English and French), using flexible quotas.

Canada-wide sampling: Households with a landline

We defined a Canada-wide sample of telephone numbers. All numbers were randomly selected to generate this basic sample. Each telephone number in this sampling frame was associated with a Canadian province. Subsequently, we used this Canada-wide sample to randomly select numbers by province or region, in proportion with the provincial or regional quotas established for the project.

Canada-wide sampling: households with a cell phone number only

For the portion of the sample composed of "cell phone only households," candidates were randomly selected for each province or region taking into account provincial or regional quotas. The precise target of 1,680 respondents from cellphone only households was set and reached to match as closely as possible the proportion of Canadian cellphone only households estimated by the CRTC (48%). Statistical weighting corrected the demographic differences between the sample and the actual proportion in the population.

A.1.4 Maximizing Response Rate

A low response rate compromises the reliability and validity of a survey. Based on their experience in surveying various populations, Leger has established the following methods to maximize response rates:

A.1.5 Call Distribution

The overall response rate for this study was 10.14%. The participation rate is calculated using the following formula: Participation rate / response rate = R ÷ (U + IS + R). The table below provides details of the calculation.

Table 2. Call determination and response rate

Base Sample

75,240

Invalid number

23,523

No service

22,906

Non-residential

143

Fax / modem / pager

468

Double

6

Unresolved (U)

40,058

No answer

15,049

Answering machine

24,204

Line busy

805

EFFECTIVE SAMPLE*

15,217

In-scope non-responding units (IS)

6,414

Refusal

5,957

Language Barrier

457

Responding units (R)

5,245

Quota attained

-

Unqualified

436

Incomplete

391

Appointment

860

COMPLETED INTERVIEWS

3,558

Participation rate

10.14%

A.1.6 Non-response Biases and Additional Socio-Demographic Analysis

An effective response rate of 10.14% is around the average for a national telephone survey of 3,558 respondents conducted over a period of approximately five weeks. This rate is consistent with similar surveys. A response rate of more than 10% is considered typical and within industry standards for a telephone survey with the general population.

Weighting

According to Statistics Canada's 2021 national census data, Leger weighted the results of this survey by age, gender, region, language (mother tongue) and education level. In addition, the weighting of respondents in the cell phone-only sample was also controlled to match the 48% of Canadian households with cellphones only and to correct the difference between the sample and the actual proportion in the population, as per our estimate of CRTC's data.

A baseline comparison of weighted and unweighted samples was also conducted to identify potential non-response biases that could be introduced by lower response rates in some demographic subgroups (see tables in the next section). As is usually the case for a telephone survey targeting mainly households with a landline, it was more difficult to reach young respondents. To compensate for this, Leger conducted 1,680 interviews with individuals whose homes do not have landlines (called on their cell phones) in order to maximize the number of youth in the final sample.

A.1.7 Weighted and Unweighted Samples

The table below shows the geographical distribution of respondents, before and after weighting. There is very little geographical distribution imbalance in the unweighted sample. The weighting process mainly adjusted the weights of British Columbia, which was slightly underrepresented in the sample, and of Nunavut, Northwest Territories and Yukon, which were slightly overrepresented in the sample.

Table 3. Unweighted and weighted sample distribution by province

Province or territory

Unweighted

Weighted

Newfoundland and Labrador

50

51

Prince Edward Island

21

15

Nova Scotia

112

96

New Brunswick

67

77

Quebec

820

819

Ontario

1,394

1,374

Manitoba

133

124

Saskatchewan

106

104

Alberta

385

394

British Columbia

425

494

Nunavut

15

3

Northwest Territories

15

4

Yukon

15

4

The tables below illustrate the demographic distribution of respondents by gender, age, language (mother tongue), and education level.

First, with respect to gender, we can see that the weighting adjusted the proportion of female respondents to male respondents, with women still over-represented in telephone surveys.

Table 4. Unweighted and gender-weighted sample distribution

GENDER

Unweighted

Weighted

Male

1,534

1,708

Female

1,997

1,823

Other

13

13

Don't know

4

4

Refusal

10

9

With respect to age distribution, the final weighting of the results corrected some imbalances regarding age groups. Respondents under 45 years old were underrepresented in the final sample, and respondents aged 45 years and older were overrepresented. The weighting corrected that discrepancy.

Table 5. Unweighted and age-weighted sample distribution

AGE

Unweighted

Weighted

From 18 to 24 years old

202

359

From 25 to 34 years old

377

590

From 35 to 44 years old

485

587

From 45 to 54 years old

592

558

From 55 to 64 years old

684

624

From 65 to 74 years old

734

505

75 years and older

484

335

Some imbalances in language distribution were corrected through weighting, as shown below. The French-speaking respondents were slightly overrepresented and, as such, the respective weights of these respondents were therefore reduced.

Table 6. Unweighted and weighted sample distribution by mother tongue

LANGUAGE (MOTHER TONGUE)

Unweighted

Weighted

French

789

700

English

2,203

2,251

Other

558

596

Don't know

4

7

Refusal

4

4

Regarding education level, weighting adjusted the weights of respondents who have a college and less education level who were underrepresented in the sample, while those with a university degree were overrepresented.

Table 7. Unweighted and education-weighted sample distribution

EDUCATION LEVEL

Unweighted

Weighted

High school or less

883

1,142

College

926

1,236

University

1,687

1,098

The following table details the demographic distribution of respondents based on their phone equipment: whether they only had a cellphone or not. Those who only had a cellphone were slightly underrepresented in the sample.

Table 8. Unweighted and education-weighted sample distribution

PHONE EQUIPMENT

Unweighted

Weighted

Cellphone only

1,680

1,841

Not cellphone only

1,878

1,717

The weighting applied corrected the original imbalance for data analysis purposes; no further manipulation was required.

As with all research conducted by Leger, contact information was kept completely confidential, and any information that could identify respondents was removed from the data, in accordance with Canada's Privacy Act.

A.1.8 Weighting Factors

Certain subgroups tend to be underrepresented or overrepresented in a sample compared to the general population. The weighting of a sample makes it possible to correct for differences in the representation of the various subgroups of that sample compared to what is usually observed in the overall study population. Weighting factors are therefore the weight given to each respondent that corresponds to a subgroup of the sample.

The following tables illustrate the proportion allocated to each target in the sample.

Table 9. Weighting by gender and ageTable 9. Weighting by gender and age

GENDER*AGE

Proportion (%)

Male AND aged 18 to 24 years

5.215

Male AND aged 25 to 34 years

8.326

Male AND aged 35 to 44 years

8.105

Male AND aged 45 to 54 years

7.693

Male AND aged 55 to 64 years

8.578

Male AND aged 65 and older

10.842

Female AND aged 18 to 24 years

4.880

Female AND aged 25 to 34 years

8.253

Female AND aged 35 to 44 years

8.381

Female AND aged 45 to 54 years

7.999

Female AND aged 55 to 64 years

8.957

Female AND aged 65 and older

12.771

Total

100%

 

Table 10. Weighting by gender and region

GENDER*REGION

Proportion (%)

Newfoundland AND Male

0.696

Newfoundland AND Female

0.739

Prince Edward Island AND Male

0.204

Prince Edward Island AND Female

0.218

Nova Scotia AND Male

1.299

Nova Scotia AND Female

1.402

New Brunswick AND Male

1.050

New Brunswick AND Female

1.104

Quebec AND Male

11.273

Quebec AND Female

11.741

Ontario AND Male

18.704

Ontario AND Female

19.905

Manitoba AND Male

1.718

Manitoba AND Female

1.777

Saskatchewan AND Male

1.434

Saskatchewan AND Female

1.479

Alberta AND Male

5.486

Alberta AND Female

5.600

British Columbia AND Male

6.752

British Columbia AND Female

7.130

Yukon Territory AND Male

0.053

Yukon Territory AND Female

0.055

Northwest Territories AND Male

0.053

Northwest Territories AND Female

0.052

Nunavut AND Male

0.039

Nunavut AND Female

0.038

Total

100%

 

Table 11. Weighting by region and language

REGION*LANGUAGE

Proportion (%)

Quebec AND French

17.223

Quebec AND English

5.791

Rest of Canada AND French

2.450

Rest of Canada AND English

74.536

Total

100%

 

Table 12. Households with a cell phone number only

HOUSEHOLDS WITH A CELL PHONE NUMBER ONLY

Proportion (%)

Yes

48

No

52

Total

100%

 

Table 13. Weighting by education level

HIGHEST EDUCATION LEVEL COMPLETED

Proportion (%)

No University

69.152

University

30.848

Total

100%

Appendix B — Questionnaire

Seasonal Influenza Vaccination Coverage Survey, 2022-2023

LEGEND FOR ATTRIBUTE COLUMN
X= Exclusive choice
F= Fixed Choice (not part of the rotation or permutation)
O= Open-ended

Section info
Page info
[ASK ALL]
QINF#

Good morning (afternoon, evening), my name is XX and I'm calling from LEGER research.

We are currently conducting a study on flu vaccine. This survey is led by the Public Health Agency of Canada. Your answers will help improve services that impact Canadians like you. We would therefore greatly appreciate your cooperation.

Your participation is voluntary and completely confidential. Your answers will remain anonymous and cannot affect in any way your dealings with the government of Canada.

Can I ask you a few questions? It will take less than 15 minutes.

IF ASKED: Your opinion counts. Leger research is a renowned company throughout Canada. Today's study is about a topic related to public health in Canada. There are no wrong answers. When may I contact you again? When would be a good time to contact you? Whom should I ask to speak with when I call back? Is there another person in your household with whom we could talk?

NOTE: If a respondent requests to speak with a study leader at the Public Health Agency of Canada, please provide the following contact email address.

Contact: coverage-couvertures@phac-aspc.gc.ca.

Note to the interviewer: If a respondent asks you about the legitimacy of this project or if the respondent wants to make a complaint or a comment about this project, you must invite him/her to visit the MRIA Website: www.surveyverification.ca(English) or www.verificationsondage.ca(French), and you must give him the MRIA Project Registration Number: 20171229-641F

Section info
[ASK ALL]
QSCTDEMO1
INTERVIEWER SCRIPT:

To begin, I have a few questions about you.

Simple mention question
[ASK IF ECHA=CELL]
ADTADM_010

Do you currently have a residential land-line telephone service at home?
INTERVIEWER INSTRUCTIONS: (DO NOT READ LIST. ONLY ONE MENTION)

Numeric question
[ASK ALL]
[NUMeric : Min=18, Max=150]
[NOTES: Under 18 = terminate]
[VALIDATION: AGE]

ADTDEM_010

How old were you as of September 1, 2022?
INTERVIEWER INSTRUCTIONS: (RECORD THE NUMBER.)

Calculated variable
[NOTES: CALCULATION FROM ADTDEM_010]
ADTDEM_011

QUESTION PROVX
Simple mention question
[ASK ALL]
ADTDEM_020

What is the language you first learned at home in your childhood and that you still understand?
INTERVIEWER INSTRUCTIONS: (DO NOT READ LIST. ONLY ONE MENTION)

Simple mention question
[ASK ALL]
ADTDEM_030

What is your gender?
INTERVIEWER INSTRUCTIONS:

Clarification, if asked: Gender is the way a person internally feels and/or publicly expresses in their daily life. A person's gender may differ from the sex they were assigned at birth (male or female). (DO NOT READ LIST. ONLY ONE MENTION)

Simple mention question
[ASK ALL]
ADTKAB_010

As far as you know, are you up to date on your vaccines (other than flu and COVID-19 vaccines)?
INTERVIEWER INSTRUCTIONS: DELETED

If asked: COVID-19 vaccination should not be included in being up to date on your vaccines. READ. ONLY ONE MENTION

INTERVIEWER SCRIPT:

The next few questions will ask you how much you agree or disagree with a series of statements. The options are: strongly disagree, somewhat disagree, somewhat agree, or strongly agree.

Simple mention question
[ASK ALL]
ADTKAB_020

"In general, I consider vaccines to be important for my health." :
INTERVIEWER INSTRUCTIONS:
Clarification, if asked: "The options are: strongly disagree, somewhat disagree, somewhat agree, or strongly agree".

DO NOT READ, UNLESS ASKED BY RESPONDENT.

ONLY ONE MENTION.

Simple mention question
[ASK ALL]
ADTKAB_030

"I know enough about vaccines to make an informed decision about getting vaccinated." :
INTERVIEWER INSTRUCTIONS:
Clarification, if asked: "The options are: strongly disagree, somewhat disagree, somewhat agree, or strongly agree".

DO NOT READ, UNLESS ASKED BY RESPONDENT.

ONLY ONE MENTION.

ADULT – Flu vaccination

INTERVIEWER SCRIPT: Now, I will ask you some questions about the flu vaccine, and your vaccination status.

Simple mention question
[ASK ALL]
ADTFLU_010

Before September 1st, 2022, have you ever received the seasonal flu vaccine (also known as the flu shot)?
INTERVIEWER INSTRUCTIONS:
Note: The flu vaccine can be received by a shot (needle) or nasal spray.

(DO NOT READ LIST. ONLY ONE MENTION)

Simple mention question
[ASK ALL]
ADTFLU_020

From September 1st 2022 to now, have you received the seasonal flu vaccine (also known as the flu shot)?
INTERVIEWER INSTRUCTIONS:
(DO NOT READ LIST. ONLY ONE MENTION)

Simple mention question
[ASK IF ADTFLU_020=0]
ADTFLU_030

How likely is it that you will get the seasonal flu vaccine between now and June 2023? Would you say you:
INTERVIEWER INSTRUCTIONS: (READ LIST. ONLY ONE MENTION)

  1. Will definitely get one 1
  2. Will probably get one 2
  3. Will probably not get one 3
  4. Will definitely not get one 4
  5. (DO NOT READ) Valid skip/ Not applicable 7
  6. (DO NOT READ) Don't know 8
  7. (DO NOT READ) Refusal 9

Simple mention question
[ASK IF ADTFLU_020=0]
ADTFLU_040

What was the most important reason why you did not receive the flu vaccine this time? Would you say it is because…?
INTERVIEWER INSTRUCTIONS:
If the respondents say, 'all of the above', or select several reasons, prompt them to pick, among those, the most important reason
If the respondent says, "Other specify" (96) – capture verbatim response. Do not back-code. (READ LIST. ONLY ONE MENTION)

Simple mention question
[ASK IF ADTFLU_040=2]
ADTFLU_041

What was the most important reason why you did not need the flu vaccine this time? Would you say it is because…?
INTERVIEWER INSTRUCTIONS:
If the respondents say, 'all of the above', or select several reasons, prompt them to pick, among those, the most important reason
If the respondent says, "Other specify" (96) – capture verbatim response. Do not back-code. (READ LIST. ONLY ONE MENTION)

Simple mention question
[ASK IF ADTFLU_020=1]
ADTFLU_060

In which month did you receive the flu vaccine this time?
INTERVIEWER INSTRUCTIONS: READ. ONLY ONE MENTION

Simple mention question
[ASK IF ADTFLU_020=1]
ADTFLU_070

Where did you receive the flu vaccine this time?
INTERVIEWER INSTRUCTIONS: (READ IF NEEDED - ONE ANSWER ALLOWED)

Simple mention question
[ASK IF ADTFLU_020=1]
ADTFLU_080

Did you receive a COVID-19 vaccine at the same time when you received your flu shot?
INTERVIEWER INSTRUCTIONS: (READ IF NEEDED - ONE ANSWER ALLOWED)

Multiple mentions question
[ASK if ADTFLU_020=1]
[MENTIONS MULTIPLES : Max=12]
ADTFLU_090

What are the reasons why you decided to receive the flu vaccine this time?
INTERVIEWER INSTRUCTIONS:
If the respondent says "Other specify" (96) – capture verbatim response. Do not back-code. DO NOT READ - MULTIPLE ANSWERS ALLOWED

Please select all that apply.

Simple mention question
[ASK ALL]
ADTFLU_100

Would getting a COVID-19 vaccine at the same time as your flu shot affect your likelihood of getting the flu shot?

Single mention question
[ASK IF ADTFLU_100 = 01 (more likely)]
ADTFLU_101

What is the main reason why you would be more likely to receive the flu shot if you receive a COVID-19 vaccine at the same time? Would you say it is …?
INTERVIEWER INSTRUCTIONS:
If the respondents say, 'all of the above', or select several reasons, prompt them to pick, among those, the most important reason

(READ LIST. ONLY ONE MENTION)

Single mention question
[ASK IF ADTFLU_100 = 02 (less likely)]
ADTFLU_102

What is the main reason why you would be less likely to receive the flu shot if you receive a COVID-19 vaccine at the same time? Would you say it is because…?
INTERVIEWER INSTRUCTIONS:
If the respondents say, 'all of the above', or select several reasons, prompt them to pick, among those, the most important reason

(READ LIST. ONLY ONE MENTION)

Simple mention question
[ASK ALL]
ADTCOV_010

How has the COVID-19 pandemic affected your likelihood of getting the seasonal flu shot this time?

Multiple mentions question
[ASK if ADTFLU_020=1]
ADTCOV_020

Did you encounter any of the following difficulties in scheduling an appointment for getting the flu shot this time?
MULTIPLE ANSWERS ALLOWED

Please select all that apply.

INTERVIEWER SCRIPT: The next few questions will ask you how much you agree or disagree with a series of statements. The options are: strongly disagree, somewhat disagree, somewhat agree, or strongly agree.

Simple mention question
[ASK ALL]
ADTKAB_040

"The flu vaccine does not protect you against getting the flu.":
INTERVIEWER INSTRUCTIONS:
Clarification, if asked: "The options are: strongly disagree, somewhat disagree, somewhat agree, or strongly agree".

DO NOT READ, UNLESS ASKED BY RESPONDENT.

ONLY ONE MENTION.

Simple mention question
[ASK ALL]
ADTKAB_050

"Sometimes, you can get the flu from the flu vaccine.":
INTERVIEWER INSTRUCTIONS:
Clarification, if asked: « The options are: strongly disagree, somewhat disagree, somewhat agree, or strongly agree".

DO NOT READ, UNLESS ASKED BY RESPONDENT.

ONLY ONE MENTION.

Single mention question
[ASK ALL]
ADTKAB_060

"It's a good thing for children to get natural immunity (protection) against flu by being exposed to the virus."

Single mention question
[ASK ALL]
ADTKAB_070

"It's a good thing for adults to get natural immunity (protection) against flu by being exposed to the virus."

Responses:

Simple mention question
[ASK ALL]
ADTKAB_080

"The opinion of my family doctor, general practitioner, nurse practitioner or pharmacist is an important part of my decision when it comes to getting the flu vaccine.":
INTERVIEWER INSTRUCTIONS:
Clarification, if asked: "The options are: strongly disagree, somewhat disagree, somewhat agree, or strongly agree".

DO NOT READ, UNLESS ASKED BY RESPONDENT.

ONLY ONE MENTION.

Simple mention question
[ASK ALL]
ADTKAB_090

"The flu vaccine is safe.":
INTERVIEWER INSTRUCTIONS:
Clarification, if asked: "The options are: strongly disagree, somewhat disagree, somewhat agree, or strongly agree".

DO NOT READ, UNLESS ASKED BY RESPONDENT.

ONLY ONE MENTION.

Simple mention question
[ASK ALL]
ADTKAB_100

"I understand why the flu vaccine is recommended annually." :
INTERVIEWER INSTRUCTIONS:
Clarification, if asked: "The options are: strongly disagree, somewhat disagree, somewhat agree, or strongly agree".

DO NOT READ, UNLESS ASKED BY RESPONDENT.

ONLY ONE MENTION.

Simple mention question
[ASK ALL]
ADTKAB_110

"It is safe to get the flu vaccine and a COVID-19 vaccine at the same time." :
INTERVIEWER INSTRUCTIONS:
Clarification, if asked: "The options are: strongly disagree, somewhat disagree, somewhat agree, or strongly agree".

DO NOT READ, UNLESS ASKED BY RESPONDENT.

ONLY ONE MENTION.

Simple mention question
[ASK ALL]
ADTKAB_120

"The flu vaccine or a COVID-19 vaccine could be less effective if getting them at the same time." :
INTERVIEWER INSTRUCTIONS:
Clarification, if asked: "The options are: strongly disagree, somewhat disagree, somewhat agree, or strongly agree".

DO NOT READ, UNLESS ASKED BY RESPONDENT.

ONLY ONE MENTION.

Section info

HEALTH STATUS

INTERVIEWER SCRIPT:

In this next section, I will ask you a few general questions about your health.

Simple mention question
[ASK ALL]
ADTHLT_010

On a scale of one to five, with one being poor and five being excellent, how would you rate your health?
INTERVIEWER INSTRUCTIONS: READ. ONLY ONE MENTION

Multiple mentions question
[ASK ALL]
[MENTIONS MULTIPLES: Max=12]
[LIST ORDER : IN ORDER]
ADTCMC_010

Are you currently suffering from or being treated for any of the following conditions? Indicate only conditions that have been diagnosed.
INTERVIEWER INSTRUCTIONS: (READ LIST - MULTIPLE ANSWERS ALLOWED)

Please select all that apply.

Single mention question
[ASK ALL]
ADTHLT_020

Do you have a regular family doctor, general practitioner, nurse practitioner or pharmacist?
INTERVIEWER INSTRUCTIONS: READ LIST. ONLY ONE MENTION

Single mention question
[ASK IF ADTHLT_020=1]
ADTHLT_030

Since September 1, 2022, have you seen your family doctor, general practitioner, nurse practitioner or pharmacist?
INTERVIEWER INSTRUCTIONS: READ LIST. ONLY ONE MENTION

Simple mention question
[ASK IF ADTHLT_030=1]
ADTHLT_040

Did your family doctor, general practitioner, nurse practitioner or pharmacist recommend that you get the flu vaccine?
INTERVIEWER INSTRUCTIONS:
READ. ONLY ONE MENTION

Single mention question
[ASK ALL]
ADTHLT_050

This flu season, have you had the flu?
INTERVIEWER INSTRUCTIONS:
If asked: "This flu season" means September 1, 2022 to now
If asked: flu refers to influenza, which is different from a stomach flu (i.e. gastrointestinal illness) READ LIST. ONLY ONE MENTION

Single mention question
[ASK IF ADTHLT_050=1]
ADTHLT_051

Would you say that you had a severe, moderate or mild case of the flu?
INTERVIEWER INSTRUCTIONS:
Clarifications, if asked: A severe case might include hospitalization or pneumonia. A moderate case might include sinus or ear infections. A mild case might include sudden onset of high fever, chills, sore throat, cough or muscle pain.

DO NOT READ LIST. ONLY ONE MENTION

Single mention question
[ASK IF ADTHLT_050=1]
ADTHLT_060

Does having the flu this season affect your likelihood of getting the flu shot next year?

Single mention question
[ASK ALL]
ADTHLT_070

Not including this flu season, have you ever had the flu?
INTERVIEWER INSTRUCTIONS:
If asked: "This flu season" means September 1, 2022 to now
If asked: flu refers to influenza, which is different from a stomach flu (i.e. gastrointestinal illness).

READ LIST. ONLY ONE MENTION

Single mention question
[ASK IF ADTHLT_070=1]
ADTHLT_071

Thinking about the worst flu you ever had, not including this flu season, would you say you had a severe, moderate or mild case of the flu?
INTERVIEWER INSTRUCTIONS:
Clarifications, if asked: A severe case might include hospitalization or pneumonia. A moderate case might include sinus or ear infections. A mild case might include sudden onset of high fever, chills, sore throat, cough or muscle pain.

DO NOT READ LIST. ONLY ONE MENTION

ADULT – COVID-19 vaccination

INTERVIEWER SCRIPT: In the context of the COVID-19 pandemic, I will now ask you some questions about the COVID-19 vaccination

ADTCOV_030
[ASK ALL]

How many doses of a COVID-19 vaccine have you received?

ADTCOV_040
[ASK IF ADTCOV_030=3,4 or 5]
INTERVIEWER INSTRUCTIONS:
Please provide the definition on booster dose to the respondent:
A booster dose may be offered to people 6 months after completing their primary series for continued protection against COVID-19 infections.

Have you received a COVID-19 vaccine booster dose?

Responses:

ADTCOV_050
[ASK IF ADTCOV_040=01, 02 or 03]

Have you ever been reluctant or hesitated to get a COVID-19 booster dose?

Responses:

ADTCOV_051
[ASK IF ADTCOV_050=1]

For which reasons were you reluctant to get a COVID-19 booster dose?
INTERVIEWER INSTRUCTIONS: (READ LIST - MULTIPLE ANSWERS ALLOWED)

Please select all that apply.

Responses:

ADTCOV_052
[ASK IF ADTCOV_050=1]

What made you decide to get a COVID-19 booster dose despite your initial reluctance?
INTERVIEWER INSTRUCTIONS: (READ LIST - MULTIPLE ANSWERS ALLOWED)

Please select all that apply.

Responses:

ADTCOV_060
[ASK IF ADTCOV_040=00 or ADTCOV 030 = 01 or 02]

How likely are you to get a booster dose of a COVID-19 vaccine?

(READ LIST. ONLY ONE MENTION)

Responses:

ADTCOV_070
[ASK IF ADTCOV_030=01, 02, 03, 04 or 05]

How likely are you to keep your COVID-19 doses up to date (e.g. continue to receive them as you become eligible for another booster dose)?

(READ LIST. ONLY ONE MENTION)

Responses:

Single mention question
[ASK IF ADTCOV_060 or ADTCOV_070 = Very likely or somewhat likely or ADTCOV_04=01, 02 or 03]
ADTCOV_080

What is the main reason why you would receive COVID-19 booster doses? Would you say it is because…?
INTERVIEWER INSTRUCTIONS:
If the respondents say, 'all of the above', or select several reasons, prompt them to pick, among those, the most important reason

(READ LIST. ONLY ONE MENTION)

Single mention question
[ASK IF ADTCOV_060 or ADTCOV_070 = somewhat unlikely or very unlikely]
ADTCOV_090

What is the main reason why you do not intend to get a COVID-19 booster dose? Would you say it is because…?
INTERVIEWER INSTRUCTIONS:
If the respondents say, 'all of the above', or select several reasons, prompt them to pick, among those, the most important reason

(READ LIST. ONLY ONE MENTION)

INTERVIEWER SCRIPT: The next few questions will ask you how much you agree or disagree with a series of statements. The options are: strongly disagree, somewhat disagree, somewhat agree or strongly agree.

Single mention question
[ASK ALL]
ADTCOV_100

"It's a good thing for children to get natural immunity (protection) against COVID-19 by being exposed to coronavirus."

Responses:

Single mention question
[ASK ALL]
ADTCOV_110

"It's a good thing for adults to get natural immunity (protection) against COVID-19 by being exposed to coronavirus."

Responses:

ANCIENNE AUDTCOV_110 SUPPRIMÉE

ADTCOV_120

"It is important to stay up to date with COVID-19 vaccinations including booster doses."

Responses:

Section info

QSCTDEMO

INTERVIEWER SCRIPT:

The next questions are for statistical purposes only. It will allow us to group your answers with those of other similar respondents.

Single mention question
Scola
[ASK ALL]
[ORDRE DE LA LISTE : En ordre]
ADTDEM_040

First, what is the highest level of formal education that you have completed?
INTERVIEWER INSTRUCTIONS: (DO NOT READ LIST. ONLY ONE ANSWER)

Single mention question
Reven
[ASK ALL]
[LIST ORDER : IN ORDER]
ADTDEM_050

Which of the following categories best describes your total household income for the year 2022? That is, the total income of all persons in your household combined, before taxes.
INTERVIEWER INSTRUCTIONS: (READ LIST UP TO CATEGORY THAT RESPONDENT SELECTS. ONE MENTION POSSIBLE.)

Simple mention question
[ASK ALL]
ADTDEM_060

Were you born in Canada?
INTERVIEWER INSTRUCTIONS: (DO NOT READ LIST. ONLY ONE MENTION)

Simple mention -open
[ASK IF ADTDEM_060=0]
ADTDEM_070

In which country were you born?
INTERVIEWER INSTRUCTIONS: (DO NOT READ LIST. ONLY ONE MENTION)

Numerical question
[ASK IF ADTDEM_060=0]
[NUMERIC: BORNES Min=1, Max=100]
ADTDEM_080

How many years have you been living in Canada?
INTERVIEWER INSTRUCTIONS: (RECORD NUMBER OF YEARS.)


INTERVIEWER SCRIPT:

This concludes the questions we have for you. Your answers will help improve services that impact Canadians like you.

We greatly appreciate your cooperation and thank you for your participation.


[1] Leger has been purchasing its samples from ASDE Survey Sampler, a reputable and reliable supplier, for over 15 years.