Highlights from the 2022–2023 Seasonal Influenza (Flu) Vaccination Coverage Survey

On this page

• Highlights
• Purpose of this survey
• Background
• Key results
  • Influenza vaccine
  • COVID-19 vaccines
  • Knowledge, attitudes and beliefs
• To summarize
• Contact us
• Related links

Highlights

• Influenza vaccination coverage increased from 39% in 2021-2022 to 43% in 2022-2023 and is now back to the pre-pandemic level.
• Only 43% of the adults aged 18-64 years with chronic medical conditions received the flu shot in Canada.
• Vaccination coverage among seniors (74%) is closer to the coverage goal of 80%, however no significant improvement has been observed in recent years.
• The most common reason for getting the flu shot was to prevent infection (47%), whereas the most common reason for not getting the flu shot was not getting around to it (21%).
• An increased number of adults received their flu shot in a Pharmacy (52%) or in a temporary vaccine clinic (12%) compared to the pre-pandemic 2019/20 season, highlighting the importance of these settings as point of vaccination.
• About one third of the adults (30%) had received a COVID-19 vaccine at the same time when receiving the flu shot.
• A majority of adults (66%) stated that getting a COVID-19 vaccine at the same time as the flu shot would not affect their likelihood of getting the flu shot.
• In total, 68% of adults had received at least 1 additional dose of a COVID-19 vaccine, while 16% were reluctant to get one.
• The most common reason for being reluctant to receive an additional dose was concerns about the side effects of having an additional dose.
• The most important reason for getting a COVID-19 additional dose despite the initial reluctance was the perception that the benefits are more important than risks.
• Despite most people agreeing that the flu shot is safe, 40% of adults mistakenly believed that they could get the flu from the flu vaccine.

Purpose of this survey

The survey results provide necessary information about how well adults are protected against flu and COVID-19 in Canada, as well as what they know and think about these vaccines. Besides measuring the vaccination coverage, the survey results are used to:

• measure progress towards achieving Canada's national vaccination coverage goals
• determine reasons for non-vaccination and guide promotion efforts
• identify potential impacts of the COVID-19 pandemic on seasonal influenza vaccine uptake
• measure attitudes toward flu and COVID-19 vaccination
• report Canada's vaccination coverage to the World Health Organization (WHO)

Background

In Canada, the flu season normally runs from November to April. Anyone can get the flu, which can sometimes lead to severe complications or death. Among those eligible for flu vaccination, some people are at higher risk for complications or hospitalization due to the flu, including:

• pregnant people
• people with certain chronic medical conditions
• people 65 years and older
• children 6 months to less than 5 years of age
• people who live in nursing homes or other long-term care facilities
• Indigenous people

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 is particularly recommended to get the flu shot every year. Getting the flu shot early before the flu season helps protect from infection before the virus begins to spread widely.

Key results

Influenza vaccine

Flu vaccination coverage

In all adults, influenza vaccination coverage increased from 39% in 2021-2022 to 43% in 2022-2023 and is now back to the pre-pandemic level.

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.

Figure 1 - Text description

Seasonal flu vaccination coverage (percent vaccinated)

Flu season	All adults (18+)	People aged 18-64 without chronic medical conditions	People aged 18-64 with chronic medical conditions	Seniors (65+)
2019-2020	42	30	44	70
2020-2021	40	29	41	70
2021-2022	39	27	38	71
2022-2023	43	31	43	74

In the 2022-2023 flu season:

• Only 43% of the adults aged 18-64 years with chronic medical conditions received the flu shot in Canada. This proportion is similar to the previous seasons.
• Vaccination coverage among seniors (74%) is closer to the target of 80%; however, no significant improvement has been observed over the past 4 years.

Timing and place of vaccination

• Most adults were vaccinated in October (38%) or November 2022 (36%).
• The majority of adults were vaccinated at pharmacies (52%), followed by doctor's offices (17%) or temporary vaccine clinics (12%).
• The proportion of people vaccinated at a pharmacy was higher than the pre-pandemic 2019/20 season (40%); and the proportion of adults vaccinated in a temporary vaccine clinic has almost tripled (4% in 2019/20).

Reasons to get, or not get the flu shot

• The most common reason for getting the flu shot was to prevent infection or avoid getting sick (47%).
• The most common reason for not getting the flu shot was not getting around to it (e.g. too busy, lack of time) (21%).

Barriers to get the flu shot

• In total, only 15% of the adults stated that they had encountered difficulties in scheduling an appointment for getting the flu shot this year.
• The most common difficulty encountered was limited appointment availability (e.g. no flu shot available, hard to book an appointment) (6%), followed by the vaccine not being offered at a convenient or close location (4%).

Impact of having the flu on getting the flu shot

• During the data collection period between January and February 2023, the majority of adults in Canada stated that they did not have the flu this season (78%). Only 12% had the flu and 9% had some symptoms but were not sure if it was flu or something else.
• The proportion of adults who had the flu was higher among those who did not get vaccinated against flu this season (14%) compared to those vaccinated against flu (10%).
• Among those who had the flu, the majority (66%) stated that having the flu this season would not affect their likelihood of getting the flu shot next year. About one third (30%) were more likely and 5% were less likely to get the flu shot next year.

Flu and COVID-19 vaccines co-administration

• This season, 30% of the adults had received a COVID-19 vaccine at the same time when receiving the flu shot.
• While the majority of the adults (66%) stated that getting a COVID-19 vaccine at the same time as the flu shot would not affect their likelihood of getting the flu shot, 16% were more likely to get the flu shot and 18% were less likely to get the flu shot.
• The most important reason for being more likely to receive the flu shot was to save time (53%).
• The most important reason for being less likely to receive the flu shot was the concerns about causing a higher number of adverse reactions or side effects (42%).

Impact of COVID-19 on getting the flu shot

• Overall, the majority of the adults (70%) stated that the COVID-19 pandemic had no impact on their likelihood of getting the flu shot this year.
• Only 11% of the adults were less likely to get the seasonal flu shot because of the COVID-19 pandemic; this proportion was higher among younger adults with or without chronic medical conditions (12% and 13%, respectively) compared to seniors (6%).

COVID-19 vaccines

COVID-19 vaccination coverage

• Most adults in Canada (92%) had received at least 1 dose of a COVID-19 vaccine and 91% had received 2 doses or more.
• Only 8% of the adult population never received a COVID-19 vaccine. The proportion unvaccinated was higher among younger adults with or without chronic medical conditions (8% and 9%, respectively) compared to seniors (3%).

COVID-19 additional dose uptake

Additional dose is defined as any dose(s) received after the completion of a 1-dose or 2-dose vaccine primary series. They are mostly booster doses but may include additional doses given for other reasons (e.g. for travel purposes, being immunocompromised).

• Overall, 68% of adults had received at least 1 additional dose of a COVID-19 vaccine.
• About one third of the adults (29%) had received 1 additional dose, 26% had received 2 additional doses and 13% had received 3 additional doses or more.

COVID-19 additional dose reluctance

• Among individuals who ever had received an additional dose, 16% have been reluctant to get one. The proportion is higher among young adults with or without chronic medical conditions (17% and 20%, respectively) compared to seniors (9%).
• The most commonly stated reason for being reluctant to get a COVID-19 additional dose was concerns about the side effects of having an additional dose (52%).
• The most common reason for getting a COVID-19 additional dose despite the initial reluctance was the perception that the benefits are more important than risks (29%), followed by the recommendation of a healthcare professional (20%).

COVID-19 additional dose intent

• Among individuals who never received an additional dose of a COVID-19 vaccine, 48% were very unlikely and 18% were somewhat unlikely to get one in the future. A higher proportion of younger adults without any chronic medical conditions (50%) were unlikely to receive an additional dose compared to seniors (37%).
• Almost half of the adults (47%) stated that they were likely to keep the COVID-19 doses up to date. The proportion was much higher among seniors (70%) compared to younger adults with or without chronic medical conditions (51% and 36%, respectively).
• The main reason adults were willing to receive a COVID-19 additional dose was to protect oneself from getting infected.
• The main reason for not being willing to get a COVID-19 additional dose was concerns about the side effects of having too many COVID-19 vaccines.

Knowledge, attitudes and beliefs

Most adults (92%) reported that they considered vaccines to be important for their health and 93% knew enough about vaccines to make informed decisions about getting vaccinated.

The majority of the adults (67%) agreed that the opinion of their family doctor, general practitioner or nurse practitioner is an important part of their decision in getting the flu shot.

While most people believed that the flu shot is safe (90%), there were still a high proportion of adults (40%) who mistakenly believed that they might get the flu from the flu vaccine, which is not true for any flu shot. Moreover, 39% felt that the flu vaccine does not protect them against getting the flu.

In addition, more than half of the adults believed that it is good for children (64%) or adults (58%) to get natural immunity against the flu by being exposed to the virus.

Despite the majority of the adults (67%) agreeing that it is safe to get the flu vaccine and a COVID-19 vaccine at the same time; more than a quarter of the adult population (26%) thought that the flu vaccine or a COVID-19 vaccine could be less effective if getting them together.

To summarize

Overall, for the 2022-2023 flu season, flu vaccination coverage among all adults aged 18 years and older (43%) was slightly higher than the previous season and is now back to the pre-pandemic level. The national flu vaccination coverage goal of 80% for those at higher risk remains unmet. Despite a higher flu vaccination coverage among seniors (74%), no significant improvement has been achieved in recent years.

The most important reason for getting the flu shot was to prevent infection, whereas the most common reason for not getting the flu shot was not getting around to it.

An increased number of adults received their flu shot in a Pharmacy or in a temporary vaccine clinic compared to the pre-pandemic season, highlighting the importance of these settings as point of vaccination.

This year, about one third of the adults in Canada had received a COVID-19 vaccine at the same time when receiving the flu shot. A majority of adults reported that getting a COVID-19 vaccine at the same time as the flu shot would not affect their likelihood of getting the flu shot.

In total, 68% of adults had received at least 1 additional dose of a COVID-19 vaccine, while 16% were reluctant to get one. The most common reason for being reluctant was concerns about the side effects of having an additional dose, and the most important reason for getting a COVID-19 additional dose despite the initial reluctance was the perception that the benefits are more important than risks.

Despite most people agreeing that the flu shot is safe, there were still a high proportion of adults who mistakenly believed that they could get the flu from the flu vaccine. Ongoing efforts to promote flu vaccine safety and to dispel the myth that flu vaccines can cause the flu is needed to further increase flu vaccine uptake.

A full report of the survey results is available.

Contact us

For more information about the Seasonal Influenza Vaccination Coverage Survey, please contact us at coverage-couvertures@phac-aspc.gc.ca.

Related links

• Everyone 6 months and older should get the flu shot
• Where to get the flu shot
• Adults need vaccines too
• Use of influenza vaccine in the presence of COVID-19
• Vaccination and pregnancy
• Download or order free flu awareness materials