Highlights from the 2023-2024 Seasonal Influenza (Flu) Vaccination Coverage Survey
The Seasonal Influenza Vaccination Coverage Survey is conducted every year to collect information on influenza vaccine uptake in Canada. Survey data are used to estimate the percentage of adults vaccinated against flu and to describe knowledge, attitudes, and beliefs about the flu vaccine and vaccines in general. This year, we have expanded our scope by introducing a new section focusing on the recently approved Respiratory Syncytial Virus (RSV) vaccine. This addition aims to assess public awareness about the disease and intent regarding the RSV vaccine. The COVID-19 vaccination section was retained to continue tracking COVID-19 vaccine uptake and attitudes toward flu and COVID-19 vaccines co-administration. Data collection took place between January 3 and March 5, 2024.
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Highlights
- Influenza vaccination coverage in 2023-2024 (42%) was similar to the previous season (43%).
- While vaccination coverage among seniors (73%) is closer to the coverage goal of 80%, only 44% of the adults aged 18-64 years with chronic medical conditions received the flu shot in Canada.
- The most common reason for getting the flu shot was to prevent infection (23%), whereas the most common reason for not getting the flu shot was the perception that the vaccine was not needed (31%).
- Most adults vaccinated for flu (71%) had received a COVID-19 vaccine at the same time as the flu shot.
- In total, 89% of adults had received at least 1 dose of a COVID-19 vaccine since the beginning of vaccination, while more than one-third (39%) received 1 dose during the 2023-2024 Fall campaign.
- The most common reason for not receiving a COVID-19 vaccine in the 2023-2024 Fall campaign was concerns about the safety or side effects of having so many COVID-19 vaccines (19%).
- Less than a third of adults (30%) would definitely receive a RSV vaccine when it becomes available.
- Despite most people agreeing that the flu shot is safe (87%), 43% 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 vaccination barriers and guide promotion efforts
- identify potential impacts of the COVID-19 pandemic on seasonal influenza vaccine uptake
- measure attitudes toward flu and COVID-19 vaccines co-administration
- assess awareness and vaccination intent regarding the newly approved RSV vaccine
- 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:
- all children 6 to 59 months of age
- people with certain chronic medical conditions
- pregnant people
- people 65 years and older
- people who live in nursing homes or other long-term care facilities
- Indigenous peoples
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 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
Figure 1: Text description
| Flu season | All adults (18 years and older) | People aged 18-64 without chronic medical conditions | People aged 18-64 with chronic medical conditions | Seniors (65 years and older) |
|---|---|---|---|---|
| 2020-2021 | 40 | 29 | 41 | 70 |
| 2021-2022 | 39 | 27 | 38 | 71 |
| 2022-2023 | 43 | 31 | 43 | 44 |
| 2023-2024 | 42 | 28 | 44 | 73 |
In all adults, influenza vaccination coverage in 2023-2024 (42%) was similar to the previous season (43%).
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 2023-2024 flu season:
- Only 44% 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 (43%).
- Vaccination coverage among seniors (73%) is closer to the vaccination goal of 80%.
Timing and place of vaccination
- Most vaccinated adults had received their shot in October (40%) and November 2023 (37%).
- The majority of adults were vaccinated at pharmacies (57%), followed by doctor's offices (15%) and temporary or permanent vaccine clinics (12%).
- The proportion of adults vaccinated in pharmacies increased from 35% in 2018-2019 to 57% in 2023-2024; this increase could be attributed to a growing number of jurisdictions allowing pharmacists to administer the influenza vaccine.
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 (23%).
- The most common reason for not getting the flu shot was the perception that the vaccine was not needed (31%).
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 proportion was much lower compared to the 2020-2021 season during the COVID-19 pandemic (47%).
- The most common difficulty encountered was limited appointment availability (e.g. no vaccine available, hard to book an appointment) (4%).
Flu and COVID-19 vaccines co-administration
- This season, 71% of adults vaccinated for flu received a COVID-19 vaccine at the same time.
- The most common reason for receiving both vaccines at the same time was to save time (47%).
- The most important reason for not receiving both vaccines at the same time was being unable to book an appointment to receive them at the same visit (43%), followed by concerns about causing a higher number of adverse reactions or side effects (15%).
Intent of getting the flu shot next flu season
- 39% of adults stated that they definitely will get the flu shot next flu season.
- The proportion was higher among seniors (40%) and younger adults with chronic medical conditions (36%), compared to those without chronic medical conditions (23%).
COVID-19 vaccines
COVID-19 vaccination coverage
- Most adults in Canada (89%) had received at least 1 dose of a COVID-19 vaccine since the beginning of COVID-19 vaccination.
- 39% of adults received a COVID-19 vaccine during the 2023-2024 Fall campaign.
- Seniors had higher proportion (67%) of receiving a COVID-19 vaccine during the 2023-2024 Fall campaign, compared to younger adults with (39%) or without chronic medical conditions (26%).
Reasons to get, or not get a COVID-19 vaccine
- The most common reason for getting a COVID-19 vaccine during the 2023-2024 Fall campaign was to protect oneself from COVID-19 (41%).
- The most common reason for not getting a COVID-19 vaccine during the 2023-2024 Fall campaign was the concerns about the safety or side effects of having so many COVID-19 vaccines (19%).
RSV vaccine
Awareness of RSV
- 40% of adults have not heard about Respiratory Syncytial Virus (RSV).
- Only 28% of adults know about RSV and what symptoms it causes, while 33% heard about it but do not know what exact symptoms it causes.
RSV vaccine intent
- Overall, about a third of adults (30%) would definitely receive a RSV vaccine when it becomes available.
- Among those who heard about RSV and know what symptoms it causes, 43% would definitely receive the vaccine when it becomes available.
- The proportion of adults would definitely receive a RSV vaccine was higher among seniors (49%) and younger adults with chronic medical conditions (36%), compared to those without chronic medical conditions (20%).
- The most commonly stated reason for not getting a RSV vaccine when it becomes available was the belief in immune system capacity (28%), followed by the concerns about the safety of the RSV vaccine and/or its side effects (15%).
Flu, COVID-19 and RSV vaccines co-administration intent
- If offered option, only 24% of adults would definitely receive the flu, COVID-19 and RSV vaccines during the same visit.
- The most common reason for not willing to receive 3 vaccines at the same time was concerns about causing a higher number of adverse reactions or side effects (35%).
Knowledge, attitudes and beliefs about vaccination
Most adults (90%) reported that they considered vaccines to be important for their health and 91% knew why the flu vaccine is recommended annually. In addition, the majority of the adults (71%) agreed that the opinion of their family doctor, general practitioner, nurse practitioner or pharmacist is an important part of their decision in getting the flu shot.
While most people believed that the flu shot is safe (87%), there was still a high proportion of adults (43%) who mistakenly believed that they might get the flu from the flu vaccine, which is not true for any flu shot.
Moreover, a third of adults (34%) felt that the flu vaccine is ineffective in protecting them against getting the flu. And 40% believed that it is better to get natural immunity (protection) from getting sick with the flu rather than getting vaccinated.
Despite the majority of the adults (70%) agreeing that it is safe to get the flu vaccine and a COVID-19 vaccine at the same time; there were still 23% who thought that the flu vaccine or a COVID-19 vaccine could be less effective if getting them together.
To summarize
Overall, for the 2023-2024 flu season, flu vaccination coverage among all adults aged 18 years and older (42%) was similar to the previous season. The national flu vaccination coverage goal of 80% for those at higher risk remains unmet. Despite a higher flu vaccination coverage among seniors (73%), no significant improvement has been achieved in recent years.
The most frequent reason for getting the flu shot was to prevent infection, whereas the most common reason for not getting the flu shot was the perception that the vaccine was not needed.
An increased number of adults received their flu shot in a pharmacy compared to the pre-pandemic season, highlighting the importance of accessibility and convenience in vaccine uptake.
The co-administration of flu and COVID-19 vaccines was common, with 71% of adults receiving both at the same time, mainly to save time. However, concerns about the safety and side effects of receiving multiple vaccines remain a barrier for some.
Awareness and intent to receive the newly approved RSV vaccine were lower compared to flu and COVID-19 vaccines, indicating a need for increased public education and promotion efforts.
Most adults value vaccines and recognize their importance, yet misconceptions about vaccine safety and effectiveness persist. Ongoing efforts to promote vaccine safety and dispel myths are essential to improve vaccination coverage and protect public health.
Contact us
For more information about the Seasonal Influenza Vaccination Coverage Survey, please contact us at coverage-couvertures@phac-aspc.gc.ca.
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