COVID-19 Vaccine Confidence in Ontario and Strategies to Support Capability, Opportunity,


Category: Epidemiology, Public Health & Implementation

Published: October 8, 2021

Key Message

Overall confidence in COVID-19 vaccines amongst Ontarians has remained within the range of 72% to 76%. It is important to understand which individuals and groups have lower vaccine confidence, and why, as this knowledge can support a tailored and informed response. 

Survey data from 28,660 Ontarians reveal that individuals with lower confidence in COVID-19 vaccines tend to have a lower household income, are more likely to be unable to work from home, and self-identify as racialized (a race other than white European). Lower vaccine confidence is associated with a complex set of factors including health inequities, systemic barriers to accessing health care, and mistrust in government and health care institutions. 

Community-level strategies, outreach, and interventions can address the drivers of lower vaccine confidence.  These strategies include engagement with local leaders, and partnerships with trusted individuals and organizations to build confidence and drive increased vaccine uptake. 



All Ontarians over the age of 12 years have been eligible for COVID-19 vaccines as of May 23, 2021. As of October 5, 2021, 11,299,600  (86.7%) eligible individuals in Ontario have received their first dose, and 10,649,353 (81.7%) have received two doses of a COVID-19 vaccine.1  

While mandatory vaccination or reporting of vaccination status is required in a growing number of settings, vaccination ultimately remains an individual choice. The decision to get vaccinated is multifactorial, and influenced by a combination of capability, opportunity, and motivation (key determinants of behaviour).2,3 Vaccine uptake in Ontario has been lower among racialized communities, especially in areas with the highest proportions of refugees, recent immigrants, and recent OHIP registrants — communities that have also been the most impacted by SARS-CoV-2 infections.4–6 Effective and efficient tailored community outreach programs that aim to increase population-level vaccine coverage can be informed by an understanding of the populations with the highest rate of vaccine hesitancy.

The Fields Institute for Research in Mathematical Sciences developed and administered an internet-based survey to better understand Ontarians’ views, knowledge, and engagement with COVID-19 public health measures, as well as their plans to get a COVID-19 vaccine. Household income, ethnic background, and the number of individuals in the household working outside of the home were self-reported by respondents. The survey was launched on December 9, 2020 and concluded at days end June 30, 2021. During this period, 28,660 Ontarians between the ages of 15 to 98 completed the survey of English-language, multiple-choice questions. The survey was administered by RIWI, an Ontario-based third-party provider that surveys online consumers about sentiment, knowledge, and attitudes. This Brief presents some of the findings from the survey data applicable to vaccination. This Brief also includes some key strategies to enhance messaging to those communities among whom the survey has identified lower rates of vaccine confidence.


What does the survey data reveal about the proportion of Ontarians choosing to get a COVID-19 vaccine, and has this proportion changed over time?

Are there specific groups among whom vaccine hesitancy is higher?

Using the information gathered from the survey data, what specific strategies can community leaders use to help increase COVID-19 vaccine uptake in these groups? 


COVID-19 Vaccine Confidence in Ontario

Between December 2020 and June 2021, 28,660 Ontarians completed a survey. Demographics of the respondents are presented in Table 1. Over 75% of respondents were vaccine confident, with 26% reporting they would “probably get vaccinated,” and 49% reporting they would “definitely get vaccinated.” Among those reporting they were unlikely to get a vaccine against COVID-19, 11% reported they would “definitely not get vaccinated,” and 13% reported they would “probably not get vaccinated.” 

Table 1: Demographics of Survey Respondents’ Self-Reported Race/Ethnicity, Age (Grouped Following Submission), Household Income, and Gender
Figure 1. Overall Vaccine Confidence (“Definitely” or “Probably Will” Get Vaccinated) For Survey Respondents by 2-Week Period from December 9, 2020 to June 30, 2021

Overall, vaccine confidence in Ontario has remained relatively stable in the period since COVID-19 vaccines were approved for use in Canada. Vaccine confidence has ranged from 72% and 79% between December 2020 and June 2021. Vaccine confidence was highest in early April 2021, corresponding to the peak of Wave 3, when the province was reporting between 3,000 – 4,000 daily new cases of COVID-19 and there were over 700 individuals with COVID-19 related critical illness in Ontario critical care units.1 Conversely, vaccine confidence was lowest during periods of uncertainty related to COVID-19 vaccines, either due to supply issues (January 2021) or concerns over safety (May 2021). Overall, 76% of respondents surveyed were vaccine confident, and despite ongoing public messaging about the importance of vaccination, there appears to be a vaccine confidence ceiling. 

Figure 2. Distribution of Responses for Reported Intention to Get Vaccinated for All Respondents and Stratified by Self-Reported Age, Gender, and Race/Ethnicity 
Demographic and Regional Associations with COVID-19 Vaccine Confidence

Aggregated survey results demonstrate that those who self-identify as a visible minority, who have a lower self-reported household income, and who live in a household with a greater number of people working outside of the home, reported higher, lower levels of vaccine confidence.

Figure 3. Distribution of Survey Responses for Reported Intention to Get Vaccinated Stratified by Self-Reported Household Income, Number of People Working outside of Home, and Region 

Table 2 presents the results of multivariable logistic regression analyses conducted to determine the independent association between survey respondents’ self-reported demographics (race/ethnicity, household income, and number of people in the household working outside the home) and the odds of being vaccine confident (definitely or probably going to get vaccinated). A statistically significant decrease in the odds of being vaccine confident was found among those with lower household income, with increasing numbers of people in the household unable to work from home, and self-identifying as a race other than white European.

Table 2. Odds of Being Vaccine Confident Based on Self-Reported Household Income, Number in Household Working Outside of Home, and Self-Reported Race/Ethnicity


The results of a survey of 28,660 individuals in Ontario demonstrate fairly consistent levels of confidence in COVID-19 vaccines over time (72%-76%). However, there is a statistically significant difference in vaccine confidence between specific groups. Individuals identifying as non-white European, from lower income households, and with a higher number of individuals working outside the home had a statistically significant lower odds of being vaccine confident. 

Ontario data show a higher risk for SARS-CoV-2 exposure and infection among racialized and low-income communities.7York, Peel and Toronto have seen the highest rates of cases per capita.7 Workplace outbreaks have contributed to a significant number of cases.8 Concerningly, the results of this survey demonstrate that vaccine hesitancy is highest among these same groups for whom there has been a disproportionate burden of COVID-19 outcomes, and in whom vaccination will prevent more infections and severe outcomes.9

While other Canadian surveys have shown higher rates of overall confidence in COVID-19 vaccines,10 we believe that the larger sample size and the granularity of choice (allowing respondents to indicate how confident they were in their choice to either get vaccinated or not get vaccinated), provides an accurate picture of the attitudes of Ontario’s residents over the period of data…


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