Prevalence and factors related to COVID-19 vaccine hesitancy and unwillingness in Canada: A systematic review and meta-analysis

J Med Virol. 2023 Jan;95(1):e28156. doi: 10.1002/jmv.28156. Epub 2022 Oct 3.

Abstract

This systematic review and meta-analysis examined the prevalence and factors associated with vaccine hesitancy and vaccine unwillingness in Canada. Eleven databases were searched in March 2022. The pooled prevalence of coronavirus disease 2019 (COVID-19) vaccine hesitancy and unwillingness was estimated. Subgroup analyses and meta-regressions were performed. Out of 667 studies screened, 86 full-text articles were reviewed, and 30 were included in the systematic review. Twenty-four articles were included in the meta-analysis; 12 for the pooled prevalence of vaccine hesitancy (42.3% [95% CI, 33.7%-51.0%]) and 12 for vaccine unwillingness (20.1% [95% CI, 15.2%-24.9%]). Vaccine hesitancy was higher in females (18.3% [95% CI, 12.4%-24.2%]) than males (13.9% [95% CI, 9.0%-18.8%]), and in rural (16.3% [95% CI, 12.9%-19.7%]) versus urban areas (14.1% [95%CI, 9.9%-18.3%]). Vaccine unwillingness was higher in females (19.9% [95% CI, 11.0%-24.8%]) compared with males (13.6% [95% CI, 8.0%-19.2%]), non-White individuals (21.7% [95% CI, 16.2%-27.3%]) than White individuals (14.8% [95% CI, 11.0%-18.5%]), and secondary or less (24.2% [95% CI, 18.8%-29.6%]) versus postsecondary education (15.9% [95% CI, 11.6%-20.2%]). Factors related to racial disparities, gender, education level, and age are discussed.

Keywords: COVID-19 vaccine; systematic review; vaccine hesitancy; vaccine willingness.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • COVID-19 Vaccines*
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Canada / epidemiology
  • Databases, Factual
  • Female
  • Humans
  • Male
  • Prevalence

Substances

  • COVID-19 Vaccines

Grants and funding