HABIT Wave 2

Vaccination

Among those who got vaccinated in Fall 2023, most got both seasonal vaccines

Overall, 39% of respondents got a COVID-19 vaccine between September and December 2023, and 41% got a flu vaccine. 51% of respondents got neither a COVID-19 nor flu vaccine. Older respondents (55+) were much more likely to have gotten at least one vaccine (65%) compared to respondents aged 54 and under (37%).

The top reason for not getting a seasonal vaccine was feeling that it was unnecessary

Among respondents who did not get a COVID-19 or flu vaccine between September and December 2023, the top three reasons were: Feeling that it was not needed; Not wanting to experience side effects; and, Thinking that flu/COVID-19 vaccines do not work. A greater proportion of respondents reported not getting the flu vaccine because it was not needed, while a higher number reported not getting the COVID-19 vaccine due to protection from natural immunity or past doses. Respondents were also more likely to have safety concerns about the COVID-19 vaccine than the flu vaccine.

Among those who had not yet gotten a flu or COVID-19 vaccine, 1 in 4 said they will get one

Among respondents who indicated that they had not yet gotten a flu (59% of the sample) or COVID-19 (61% of the sample) vaccine between September and December 2023, 24% indicated they will probably or definitely get a flu vaccine this season, and 27% will probably or definitely get a COVID-19 vaccine. Younger respondents (18-35) were more likely more likely to be unsure (13%) about whether they would get a flu vaccine than those aged 35+ (~5%). Older respondents (55+) were more likely to say they will probably or definitely get a COVID-19 vaccine (36%) by June 2024.

Respondents indicate high interest in co-administration of COVID-19 and flu vaccines

Regardless of vaccination status, when asked what they would choose if offered the option to get the COVID-19 and flu vaccine at the same time, the highest portion (44%) indicated they would choose to get both vaccines at the same time. 15% said they would get both vaccines, but at different times, and 25% indicated that they would not get either vaccine. Older respondents (55+) were more likely to say they would get both vaccines at the same time (57%), while respondents aged 18-34 were more likely to say they would opt to get both vaccines at different times (24%).

Two-thirds of those who got a vaccine in Fall 2023 were offered both

Overall, 68% of respondents who got either a flu vaccine, a COVID-19 vaccine, or both vaccines in Fall 2023 were offered the option to get both vaccines at the same time. 45% indicated that they got both vaccines at the same time and 23% chose not to get both vaccines together. Respondents from Quebec who got a flu and/or COVID-19 vaccine between September and December 2023 were more likely to have been offered the option to get both vaccines at the same time (83%) compared to the national average (68%). Residents of Ontario were less likely to have been offered both vaccines at the same time (60%).

Two-thirds of respondents have heard of RSV

In December 2023, 27% of respondents indicated that they knew what RSV was, and 41% had heard of RSV but did not know much about it. One-third (33%) had not heard of RSV. While the HABIT Wave 1 and Wave 2 samples are not directly comparable, familiarity with RSV was higher in Wave 2. This suggests a potential increase in familiarity in the population, likely due to the second wave being collected during the height of respiratory infection season, higher news coverage of RSV and of the RSV vaccine.

Half of pregnant respondents say they would get an RSV vaccine

Across both waves of HABIT, approximately half of respondents who were pregnant, recently pregnant, or planning to become pregnant indicated that they would get a vaccine for RSV to protect their infant*.

Intentions to get an RSV vaccine in seniors did not translate to uptake in Fall 2023

In both waves of HABIT, over half of respondents aged 60+ indicated that they would get an RSV vaccine. However, only 7% of respondents aged 60+ indicated that they had received an RSV vaccine by December 2023. Familiarity with RSV among those aged 60+ was relatively high, with 80% having at least heard of RSV. This suggests that despite high willingness to be vaccinated against RSV, seniors may be facing barriers to uptake. Note: RSV vaccines were not available for free in most jurisdictions at the time of data collection.​

Seniors are less likely to get an RSV vaccine if they have to pay for it

Intentions to get an RSV vaccine decreased from 57% to 25% when respondents aged 60+ were asked if they would get the vaccine if they had to pay $200 for it. Seniors from Quebec (n=122) were much more likely to say they would get an RSV vaccine if they had to pay for it (63%) compared to residents of other provinces.

Half to two-thirds hold pro-vaccination attitudes

67% of respondents agreed that they would get vaccinated to protect the health of those around them. 58% would get vaccinated if recommended by a health professional. 53% agreed that it is important to stay up-to date with COVID-19 vaccinations. Those with pro-vaccine attitudes were much more likely to have gotten COVID-19 and flu vaccines in Fall 2023. For example, 56% of those who agreed that they would get vaccinated to protect the health of those around them got a flu vaccine, compared to 9% of those who disagreed with the statement.

A fifth of respondents think the risks of vaccination outweigh the benefits

22% strongly or somewhat agree that there are more risks than benefits to vaccination. 15% agree that they are worried about the safety of getting both the COVID-19 and flu vaccines at the same time, and 14% are worried about the effectiveness of co-administration. These safety and effectiveness concerns were highly associated with vaccine uptake in Fall 2023. For example, 18% of those who agree that there are more risks than benefits to vaccination got a flu vaccine, compared to 60% of those who disagree with the statement.

A quarter of respondents think that a healthy lifestyle can replace vaccination

Some respondents endorsed statements related to taking natural approaches instead of vaccinating. 26% strongly or somewhat agree that a healthy lifestyle can replace vaccination, and 40% agree that it is a good thing for adults to get natural immunity (protection) by being exposed to viruses. Agreement with these statements on natural immunity was negatively associated with vaccine uptake in Fall 2023. For example, 19% of those who agree that healthy lifestyle can replace vaccination got a flu vaccine, compared to 59% of those who disagree with the statement.

Respondents are split on mandatory vaccination

37% strongly or somewhat agree that health practices such as vaccination should not be mandatory, while 39% disagree. 33% agree that they prefer not to discuss their vaccination choices with others. 25% agree that the only reason to vaccinate children is to attend school and daycare. Respondents who agreed with these statements were less likely to have received seasonal vaccines this year.

Primary care providers and the GoC are top information sources on vaccines

The most common source for information on vaccines was primary healthcare providers (29%), followed by the Government of Canada (27%). Use of provincial government information sources was less common (19%). Notably, 21% of respondents lack access to a primary care provider. These respondents were more likely to say that they do not consult any sources for information on vaccines (19%) than those with a primary care provider (13%).

Public Health Measures

One-in-five report often or always wearing a mask in public settings

Over a quarter (29%) report often or always having taken actions to improve indoor air quality in Fall 2023, while one-fifth (20%) report having worn a mask and 14% used at-home rapid tests. Women are more likely than men to often or always practice these three public health measures. Respondents aged 35-54 are less likely to report often or always wearing a mask (15%) compared to those aged 55+ (24%) and 18-34 (21%).

Over one-third report never or rarely wearing masks when sick

Over two-thirds of respondents (40%) report having been sick with a fever, cough, sore throat or runny nose between September and December 2023. Among respondents who had been sick, 43% reported that they have always or often worn a mask while sick, while 38% have never or rarely worn a mask. Respondents aged 55+ are more likely to report often or always wearing a mask while sick (51%) compared to those aged 34-54 (40%) and 18-34 (38%).

Two-thirds report often or always staying home when sick

Among respondents who had been sick with a respiratory illness in Fall 2023, 39% report having always stayed home when they are sick and 22% report having often stayed home. 19% reported never or rarely staying home when sick. Respondents aged 55+ are more likely to report often or always staying home when sick (71%) than those aged 35-54 (58%) and 18-34 (53%). Women (67%) are more likely than men (53%) to often or always stay home when sick.

Antibiotics & Antimicrobial Resistance

Only a quarter are familiar with the term “antimicrobial resistance”

The term ‘antibiotic’ is familiar to most (77%) respondents, while concepts likes ‘drug resistance’ and ‘antiviral’ also have widespread recognition (61% and 58% respectively). The term ‘antibiotic resistance’ is more widely recognized than ‘antimicrobial resistance’ (57% vs. 23%). Older age groups (55+) show greater familiarity with most terms. For example, ‘superbugs’ is much more widely known among those 55 years and older than those 18-34 years of age (72% vs. 37%). These data highlight the importance of communicating the concept of antibiotic resistance across different demographics.

Two-thirds are worried about antibiotic resistance

62% report being either somewhat or very worried about antibiotic resistance. Concern about antibiotic resistance is lower among respondents aged 18-34 (58%), and higher among respondents aged 65+ (68%).

A third have used prescribed antibiotics in the past year to treat a variety of conditions

In the past 12 months, 34% of respondents report having taken prescribed oral antibiotics at least once with the highest prevalence of use for ear, nose, throat, sinus and eye infections (27%). Chest infections and urinary tract infections were also common reasons for antibiotic use (24% and 20% respectively). Notably, 10% were uncertain why they had been prescribed antibiotics.

Over one-in-ten have used unprescribed antibiotics in the past 12 months

More than one-in-ten (14%) have taken antibiotics that were not prescribed to them in the past 12 months. Of those who report self-medicating with unprescribed antibiotics, 38% primarily do so for ear, nose, throat, sinus and eye infections. Chest infection, gastrointestinal infection, and dental issues are among the other leading reasons. Notably, 15% of respondents were uncertain about the conditions they were treating.

have taken unprescribed antibiotics

Many report improper disposal of unused antibiotics

Most respondents reported either never having surplus antibiotics (37%) or returning them to the pharmacy if they did (36%). However, a significant minority report keeping them for future use (15%) or disposing of them into the environment (19%). Older respondents (55+) were more likely to report returning their surplus antibiotics to the pharmacy (44%) in contrast to only 25% of while younger respondents (18-34 years old).

Over half get antibiotics from sources other than primary care providers

Most respondents report obtaining their oral antibiotics through prescriptions from doctors or other primary care providers (44%). Pharmacist prescriptions, an option that is increasingly available across Canada for some conditions, were used by 14% of respondents. Alternative means of obtaining antibiotics were also reported. For example, 4% reported obtaining them from a family member or friend and 3% reported using a website that did not require a prescription. These findings suggest a need for more education on proper antibiotic sourcing to ensure safe an appropriate use.

Many hold misconceptions about antibiotics

Most (69%) respondents correctly understand that antibiotics can kill bacteria, but nearly a third (29%) mistakenly believe that antibiotics can kill viruses. Younger respondents (18-34) were more likely to believe that antibiotics were effective against colds and flus (36%).

Health Services

A fifth do not have a primary care provider, with access varying by age

79% of respondents have access to a primary care provider, while 21% do not. Those aged 18-34 are less likely to have a primary care provider (71%), compared to those aged 35-54 (77%) and 55+ (86%). Residents of Quebec (70%) are also less likely than the average (79%) to have a primary care provider. Note: results for this question were unchanged between waves 1 and 2.

One-in-three are dissatisfied with health services in their area

More than one-in-three respondents (35%) reported being either somewhat or very dissatisfied with the quality of health services in their area. Dissatisfaction was highest among respondents aged 35-54 (39%), while young respondents (18-34) showed higher rates of neutrality (29%).

One-in-ten used a phone-based mental health service in the past year

11% of respondents used a phone-based mental health service in the past year, and 7% indicate that they wanted to use a phone-based service but ultimately did not. Those aged 55+ are less likely to have used a phone-based mental health service (6%), compared to those aged 35-54 (12%) and 18-34 (19%). Those with lower levels of self-reported mental health are more likely to have used – or know someone who used – telephone-based mental health services in the past year.

A fifth report being at least somewhat familiar with the new 9-8-8 Crisis Helpline

37% of respondents report being “somewhat familiar,” “familiar,” or “very familiar” with at least one phone-based mental health service. ​ 28% report being at least “somewhat familiar” with the 9-8-8 Suicide Crisis Helpline, while 46% were not at all familiar.

More than one quarter of respondents do not maintain any personal health records

The most common health record maintained by respondents is vaccination history (58%). A third of respondents maintain medical (36%) and blood type (32%) information. Only 7% maintain mental health records. Residents of QC are more likely than residents of other provinces to maintain vaccination (67%) and blood type (40%) records. Residents of BC and AB are more likely to maintain medical records.

One-in-five do not have any extended health benefits

The most commonly held health benefits are prescription drug (65%), dental (56%), life insurance (52%), and vision care (49%) benefits. Middle aged respondents (35-54) are more likely to have these benefits than younger and older respondents.

Almost half are organ donors, and a quarter are not but want to be

44% of respondents indicate that they are currently registered organ donors. 23% are not currently organ donors but would like to be. 33% are not organ donors and do not want to become donors. Residents of QC (54%) and Atlantic Canada (55%) are more likely to be organ donors than respondents from other provinces.

Trust in Public Health Institutions & Information

Around half are at least somewhat familiar with the role of the Public Health Agency of Canada

Awareness of the Public Health Agency of Canada (PHAC)’s functions varies among respondents. The highest rate of familiarity was with its role as a source of health information for people in Canada (22% familiar or very familiar), with higher recognition among those aged 18-34 (26%). Respondents were less familiar with PHAC’s role in the public health care system within Canada (15%).

Half trust the Public Health Agency on public healthcare

Respondents’ trust in public health leadership varies across different levels of government. Overall, 51% of respondents report trusting the Public Health Agency of Canada (PHAC), with trust peaking at 58% among those 55+. The Government of Canada is trusted by 45% of respondents, with those 55+ again showing the highest rate of trust (51%). Provincial and territorial governments have the overall lowest rate of trust (42%), though again this rate is higher among those 55+ (51%).

Under half think the federal government is able, caring, and has integrity

HABIT asked respondents about three core facets of trust in institutions: ability (competence, delivery on promises, and delivery of results), integrity (honest and consistent with its values), and care (shows care and concern for citizen wellbeing). Overall, 37% agree or strongly agree that the federal government is competent (ability), 35% agree that the government provides all relevant information to the public (integrity), and 30% agree that the federal government listens to concerns raised by the public (care).

Less than half agree that PHAC is able, caring, and has integrity

Under half viewed the Public Health Agency of Canada (PHAC) as competent, with 47% agreement across all ages. Similarly, 45% of respondents agreed that PHAC provides the public with all relevant information. Relatively fewer respondents felt that PHAC listened to concerns raised by the public (35%).

Over a quarter distrust large Canadian news organizations

Trust in medical health professionals, including doctors and nurses, is robust at 74% overall, particularly among the oldest respondents (84% among those 55+). Trust in large Canadian news organizations, as well as trust in the pharmaceutical industry, is lower at 40% for each.

Most are not actively following COVID-19 or influenza news

Engagement with COVID-19 and influenza-related news is relatively low among respondents, with the majority checking in either never, or less than weekly (72% for COVID-19, and 79% for influenza). Adults over 55 were more likely to actively follow the news on COVID-19 (85%) and influenza (75%) at least once a month.

One third say the federal government is responsible for health care services

Most (61%) respondents recognize that their province or territory is primarily responsible for delivering publicly funded healthcare. However, approximately 1 in 3 (34%) respondents believe that the Federal Government holds this responsibility.

Physical & Mental Health Outcomes & Attitudes

While most respondents report good physical health, many report their health is fair or poor

While most respondents say they are in good health, only 1 in 4 self-rated their physical health as very good or excellent. Notably, 28% report their physical health as fair or poor. Relative to Wave 1, slightly more report good physical health. Respondents with household incomes under $40K were more likely to report poor (9%) or fair (32%) physical health, compared to the average, which suggests meaningful disparities in this outcome by income. Self-rated health did not vary significantly by age or gender.

More than half say some of their habits negatively impact their health

Most respondents somewhat or strongly agree that taking care of their physical health is important to them (81%) and that they know how to take care of their physical health (82%). However, slightly fewer respondents report that they know how to access services to improve their physical health (76%) and just over half (58%) indicate that their current habits negatively impact their physical health. 53% of respondents indicate that the majority of their peers prioritize their physical health.

Most respondents report having good mental health, but one-in-four rate it as fair or poor

At a similar rate to physical health ratings, 75% of respondents report having good, very good, or excellent mental health. Despite this, 25% of respondents report having poor or fair mental health. Self-reported mental health differs by age. Respondents aged 18-34 (37%) and 35-54 (29%) are more likely to report poor or fair mental health than respondents aged 55+ (15%). Low-income respondents ( <$40K) are also more likely than the average to report poor or fair mental health (11%).

Over one-in-three say some of their habits negatively impact their mental health

Most respondents somewhat or strongly agree that taking care of their mental health is important to them (85%). Respondents are slightly less likely to say they know how to take care of their mental health (73%) than their physical health (82%). Similarly, respondents are slightly less likely to indicate that they know how to access services to improve their mental health (64%) than their physical health (76%). Over a third (39%) indicate that their current habits negatively impact their mental health. Younger (57%) and middle-aged (44%) respondents are much more likely than older respondents (23%) to say their habits negatively impact their mental health.

Majority of respondents are generally satisfied with their life as a whole

17% of respondents indicate that they are completely satisfied with their life as a whole and 51% are somewhat satisfied. In contrast, 13% report being somewhat dissatisfied with their life as a whole and 4% are completely dissatisfied. respondents aged 55+ are more likely to be completely or somewhat satisfied (77%) than those aged 35-54 (64%) and 18-34 (59%). Respondents with a household income under $40K are less likely to be completely or somewhat satisfied (57%) than the average Canadian (68%).

Regional and Demographic Profile