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Flu vaccination rates in Canada
Statistics Canada Catalogue no. 82-624-X
by Linda Gionet
- Higher percentage of people receiving the flu vaccine
- Flu vaccination rates increased in all provinces and territories except Ontario
- Flu vaccination rates decreased among seniors while they increased among younger Canadians
- Flu vaccination rates among seniors differed across the provinces
- Flu vaccination rates among people under 65 with one or more selected chronic conditions remained below the national target
- Data source, method and definitions
- References and notes
- Related material for this article
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- Almost one-third of Canadians aged 12 and over got a flu vaccination in 2013–2014.
- Nova Scotia had the greatest increase in the percentage of people getting a flu vaccination between 2003 and 2013–2014, while Ontario was the one province where the rate decreased.
- 2013–2014 saw a higher flu vaccination rate among younger Canadians aged 12 to 44 (19%), compared with the 2003 rate (16%).
- Among seniors aged 65 and older, the percentage who received a flu vaccination increased between 2003 and 2013–2014 in New Brunswick; while it decreased in Ontario, Saskatchewan and British Columbia.
- Among those with chronic conditions (under 65 years old), the flu vaccination rate increased between 2003 and 2013–2014 in the Atlantic and Prairie provinces, while it decreased in Ontario.
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Millions of Canadians become infected with seasonal influenza (flu) each year.Note 1 Although most people recover from this type of respiratory infection within ten days, some people are at risk of more serious complications such as pneumonia. There is an average of about 12,200 flu-related hospitalizationsNote 2, Note 3, Note 4 and 3,500 deaths from the flu each year.Note 5 When flu and pneumonia were combined, they represented the eighth leading cause of death in Canada in 2011.Note 6
The National Advisory Committee on Immunizations (NACI) recommends that Canadians six months of age and older get vaccinated against the flu every year. Note 7, Note 8 The flu vaccine serves to protect the recipient, and also helps prevent the spread of the virus to others.
In this article, national, provincial and territorial flu vaccination rates are presented for those aged 12 and over who received a flu vaccination within the 12 months prior to responding to the survey. Flu vaccination rates are also provided for two groups at high risk of complications from the flu: seniors aged 65 and over and those under 65 with selected chronic conditions.
Data for this article are from the 2003 to 2014 Canadian Community Health Survey-Annual Component (CCHS-Annual).
In 2013–2014, nearly a third of Canadians received a flu vaccination within the 12 months prior to responding to the survey. The age-standardized rate was 30% in 2003, increased to 36% in 2005 and then decreased to 31% in 2013–2014 (Chart 1). As with previous studies, respondents of the 2013–2014 CCHS who got a flu vaccination were more likely to have a regular medical doctor, and tended to be: female, older, less educated, and in fair or poor health.Note 9, Note 10, Note 11
The majority of people who were not vaccinated in the 12 months prior to responding to the survey felt it was unnecessary (56%) while 26% “didn’t get around to it” in 2013–2014 (data not shown).
Between 2003 and 2013–2014, there were a number of key developments that may have had an impact on flu vaccination rates. One example is the H1N1 pandemic during the 2009–2010 flu season, resulting in a nation-wide promotional campaign and an extensive vaccination program. According to the 2010 CCHS, 41% of Canadians got the H1N1 vaccine (excluding the territories).Note 12 The 2009–2010 flu season was unique in that the H1N1 vaccine was separate from the regular flu vaccine. As such, it may have influenced the flu vaccination rates during that time.
Another change that may have had an impact on flu vaccination rates was that, following the H1N1 pandemic, five provinces and one territory joined Ontario, Yukon and Nunavut in providing flu vaccines free of charge to more people (universal coverage).Note 13, Note 14 Another key development is the increasing availability of flu vaccines at pharmacies in select provinces.Note 15, Note 16
Flu vaccination rates increased in all provinces and territories except Ontario between 2003 and 2013–2014. Nova Scotia had the highest provincial flu vaccination rate (45%), while Quebec had the lowest (24%) in 2013–2014 (Chart 2).
In Quebec, the flu vaccination rate was 24% in 2013–2014, similar to the rate in 2003. Within the province, however, there were notable increases during that time period in two health regions: la Gaspésie–Îles-de-la-Madeleine in eastern Quebec and Montérégie near Montreal.Note 17
Ontario was the one province where the flu vaccination rate was lower in 2013–2014 at 34%, down from 38% in 2003. Within the province, the greatest declines were in the health regions of the Middlesex-London health unit (southwest Ontario) and in the Eastern Ontario health unit.
The largest increases in flu vaccination rates between 2003 and 2013–2014 occurred in Nova Scotia and New Brunswick. In Nova Scotia, specifically, females aged 12 to 44 had double the increase in their vaccination rate (from 18% to 37%) compared with their male counterparts (data not shown).
Seniors (aged 65 and over) are a group identified by the NACI as being at risk of health complications from the flu.Note 7 In response, the NACI set a national target where 80% of seniors should be vaccinated.Note 18 In the past 12 years, the closest that seniors in Canada have come to reaching this target was 71% in 2005 (data not shown).
In 2013–2014, 64% of seniors got a flu vaccination; down from 67% in 2003. Meanwhile, the rate increased among younger Canadians (12 to 44 years) from 16% to 19% during the same time period (Table 1).
|12 to 44||16||19Note *|
|12 to 17||18||23Note *|
|18 to 34||13||17Note *|
|35 to 44||18||22Note *|
|45 to 64||32||32|
|45 to 54||26||25|
|55 to 64||39||39|
|65 and over||67||64Note *|
Between 2003 and 2013–2014, changes in provincial flu vaccination rates among seniors did not mirror those among all Canadians 12 years and over. In all four Atlantic provinces, for instance, flu vaccination rates increased among the general population (Chart 2), while the rate among seniors only increased in New Brunswick during that time period (Chart 3).
Moreover, the increases in flu vaccination rates among the general population in the three Prairie provinces and British Columbia were not reflected in the senior population. In fact, vaccination rates among seniors decreased between 2003 and 2013–2014 in Saskatchewan and British Columbia and remained unchanged in Manitoba and Alberta.
Flu vaccination rates among people under 65 with one or more selected chronic conditions remained below the national target
Another group at risk of complications from the flu are those under 65 with one or more selected chronic conditions, including: heart disease, effects of stroke, asthma, diabetes, cancer, emphysema, bronchitis, chronic obstructive pulmonary disease and a high level of obesity (class 3).Note 7, Note 19
As with the senior population, the NACI also established a goal to vaccinate 80% of Canadians under 65 with selected chronic conditions.Note 18 Although, overall, Canadians with selected chronic conditions in 2013–2014 had a higher vaccination rate (32%) than those with no chronic conditions (22%), they were still well below the NACI target (Table 2).
There were notable regional differences in vaccination rates among those with one or more selected chronic conditions (Table 2). The largest decrease was in Ontario where the proportion of those vaccinated dropped from 43% in 2003 to 34% in 2013–2014.
In contrast, increases over time in the vaccination rate among this at-risk group occurred in the Atlantic and Prairie provinces. The largest increase was 12 percentage points in the Atlantic provinces, where 43% were vaccinated in 2013–2014, up from 31% in 2003.
|Canada and regions||One or more selected chronic conditions||No selected chronic conditions|
|Atlantic provincesNote 4||31||43Note *||16||28Note *|
|Ontario||43||34Note *||28||25Note *|
|Prairie provincesNote 4||27||31Note *||16||25Note *|
|British Columbia||31||35||19||24Note *|
Sources: Statistics Canada, 2003 and 2013–2014 Canadian Community Health Surveys.
Almost one-third of Canadians aged 12 and over got a flu vaccination in 2013–2014. With the exception of Ontario, the percentage of people who got a flu vaccination was higher in 2013–2014 than in 2003 for all provinces and territories.
While the flu vaccination rate among seniors was double that of the general population, it still did not reach the target of 80% for this high-risk group. In fact, the flu vaccination rate among Canadian seniors decreased between 2003 and 2013–2014. People in another high risk group – those under 65 with select chronic conditions– had a flu vaccination rate that was lower than the target of 80%.
Further research is needed to better understand the differences in provincial and territorial rates, including the impact of promotional campaigns, free coverage for flu vaccines as well as increasing access to vaccines at pharmacies.
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The Canadian Community Health Survey-Annual Component (CCHS-Annual) is a cross-sectional survey that collects information related to health status, health care utilization and health determinants for the Canadian population. The CCHS-Annual covers the population 12 years of age and over living in the ten provinces and the three territories.
Excluded from the survey's coverage are: persons living on reserves and other Aboriginal settlements in the provinces; full-time members of the Canadian Forces; the institutionalized population and persons living in the Quebec health regions of Région du Nunavik and Région des Terres-Cries-de-la-Baie-James. Altogether, these exclusions represent less than 3% of the target population.
Estimates for this study were based on data from the 2003, 2005, 2007–2008, 2009–2010, 2011–2012 and 2013–2014 CCHS-Annual. About 130,000 respondents were interviewed for each of the listed CCHS-Annual time periods.
Weighted frequencies and cross-tabulations were used to estimate the percentage of people who received a flu vaccination as well as their reasons for not receiving it.
Age-standardized rates: were used in this paper to account for the differing age structures of the Canadian population both over time and by geography (e.g., by province). When comparing flu vaccination rates over time by province and territory, rates were adjusted to the age structure of the Canadian population who responded to the 2013–2014 CCHS-Annual.
Health Region: A region created by provincial ministries to administer and monitor health services.Note 20
Obesity (class 3): Obesity is identified by using the body mass index (BMI), a ratio that consists of an individual’s weight relative to their height.Note 21, Note 22 People classified under BMI’s obesity (class 3) category are at high risk of health problems.
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Linda Gionet is an analyst with the Health Statistics Division.
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