Report

COSMO Wave 2.7

Exactly one year after Wave 2.1, this wave repeated most of the questions from the Wave 2.1 survey to study of how behaviours and attitudes related to COVID-19 had changed

Public Health Agency of Canada
Public Opinion Research Team, Privy Council Office

Impact Canada, Impact & Innovation Unit, Privy Council Office

Closeup of a clipboard in a healthcare setting

Key Insights

Proximity to COVID-19 & Public Health Measures: 60% of respondents reported having been - or likely having been - infected with COVID-19 at some point in the pandemic (up from 31% in June, 49% in August, 54% in October and 58% in December).14% of those who have been infected reported having experienced symptoms of Post-COVID-19 Condition. A quarter of respondents reported having been sick with a fever, cough, sore throat or runny nose in the past month (down from a third in December). Familiarity with and knowledge of eligibility for COVID-19 treatments is low.

Adult Vaccination: Uptake of 4th and 5th doses has increased over time, while uptake of 1st, 2nd and 3rd doses has plateaued. Intentions to get another dose among those with 0-3 doses are quite low. However, intentions to get another dose remain strong among those with at least four doses. Notably, a quarter of vaccinated respondents report feeling concern that they may develop long-term side effects from the vaccine.

Pediatric Vaccination: Vaccine uptake in children has stalled. The top reasons provided by parents who had not yet vaccinated at least one of their children were: worries about side effects of the vaccine and the view that children are not at risk from COVID-19.

Sources of Information & Trust: Trust in information sources for COVID-19 has not shifted significantly since data collection began. 51% of respondents reported completely or moderately trusting the Canadian federal government, while 38% reported moderate or complete distrust. News consumption about COVID-19 decreased between December 2022 and February 2023. COVID-19 Knowledge & Misinformation Most respondents correctly identified true and false statements about COVID-19. However, some knowledge gaps persist. For example, 29% of respondents rated the statement “COVID-19 vaccines reduce the spread of COVID-19” as inaccurate.

Mental Health & Wellbeing: Life satisfaction has been quite stable over the past year, after an initial increase between February 2022 and April 2022. Younger respondents (18-34) consistently report lower life satisfaction and poorer mental health indicators than older respondents.

Pandemic Outlook & Recovery: Over half of the sample (64%) indicated that the worst of the COVID-19 crisis is behind us. Fewer view COVID-19 as a threat to Canadians and Canadian society than they did one year ago. Over the past year, most of respondents’ health-related worries have declined, with the exception of worry about healthcare systems being overloaded, which has increased. Compared to worries about COVID-19, worries about inflation, increasing divisiveness in society and climate change are higher priority.

Background

From April 2020 to November 2021, Impact Canada led the implementation of the World Health Organization (WHO) Behavioural Insights (BI) Tool on COVID-19 in the Canadian context. This study - COVID-19 Snapshot Monitoring (COSMO Canada) - was conducted in collaboration with the Public Opinion Research Team at the Privy Council Office and the Public Health Agency of Canada. Insights from COSMO Phase One informed the federal response to COVID-19 and enabled whole-of-government decision making to meet the specific, changing needs of citizens throughout the pandemic.

In February 2022, Impact Canada launched the second phase and will continue to monitor the evolving pandemic response context with a new sample of Canadians and a new Advisory Committee.

Methodology

With a longitudinal design, the study follows 2,000 participants recruited from an online panel over eight waves of data collection. Respondents are a representative mix of Canadian adults aged 18 years and older and results are weighted using 2016 Statistics Canada census data to mirror the population distribution in Canada. For more information on the study methodology, please visit the COSMO Canada pre-registration page .

Considerations

Data Collected: February 8-24, 2023
Sample Size: 2,000

When interpreting the COSMO results, it is useful to keep in mind the context of the data collection period, which may have influenced the responses of survey participants. Prior to and during the Wave 2.7 data collection period:

There was low news coverage on COVID-19 during the data collection period.
As of February 2023, approximately 89% of the Canadian population aged 18+ had received at least two doses of a COVID-19 vaccine, 60% had at least three doses, and 30% had at least four doses. As of February 2023, 26% of adult Canadians had received a dose of a COVID-19 vaccine in the past 6 months. Among children aged 12-17, 80% had at least two doses, 19% had three doses, and 5% had four doses.
Among children aged 5-11, 52% had at least one dose, 41% had two doses, and 8% had three doses. 10% of children four and under had at least one dose and 5% had two doses.

Proximity to COVID-19 & Public Health Measures

Over half report having been infected with COVID-19 at some point

In February 2023, 60% of respondents reported having been - or likely having been - infected with COVID-19 at some point in the pandemic (up from 58% in December 2022). The portion of the sample reporting not having been infected with COVID-19 decreased from 69% in February 2022 to 36% in February 2023. Respondents aged 55+ were less likely (47%) to report likely having been infected compared to those aged 35-54 (64%) and 18-34 (72%).

1/5 report having had COVID-19 more than once

Among respondents who reported having had COVID-19, 74% reported having had it one time, 16% had it twice and 3% had it three times. Unvaccinated respondents reported having been infected more than once at a higher rate (35%) than the average (19%).

The majority of COVID-19 infections occurred in 2022

The majority (64%) of self-reported COVID-19 infections occurred in 2022.

Among those who have had COVID-19, ¼ may have experienced symptoms of post-COVID condition

Among those who have likely had COVID-19 (60% of the sample), 14% reported having experienced symptoms of post-COVID condition (i.e. physical or psychological symptoms lasting more than 12 weeks after getting COVID-19). An additional 11% reported being unsure whether they experienced post-COVID condition.

Respondents report a variety of impacts from post-COVID condition

In an open-ended question, the most commonly reported effects of post-COVID condition on respondents' lives were fatigue (26%), persistent cough (19%), lower energy/lower ability to do normal activities (17%), and respiratory conditions (17%).

Use of rapid tests decreased in February

In Wave 2.7, 21% of respondents reported having been tested for COVID-19 in the past month, either using a rapid (19%) or PCR test (2%). 9% of respondents reported that they had administered a rapid test on someone else in the past month. The use of rapid tests decreased in February compared to previous waves of data collection. In a similar question in COSMO Wave 2.1, collected in February 2022, 25% reported having been tested for COVID-19.

Frequent practice of most public health measures is low

Under third of respondents reported often or always practicing public health measures such as wearing a face mask when it is not mandatory (30%), taking steps to improve air quality (28%) and avoiding public places and events (27%). Respondents aged 55+ and women were more likely to report often or always practicing public health behaviours. Younger respondents, men, and residents of Alberta were less likely to report practicing these measures.

Frequent use of public health measures has decreased over time

In general, the portions of respondents who report often or always practicing public health measures have decreased over time. Since the summer months, those who report often or always taking steps to improve air quality and choosing to meet others outdoors have steadily declined with the colder weather. Between October and December, there was a slight uptick in those reporting often or always avoiding public places and events (from 28% to 32%). However, this returned to October levels by February. The majority (60% + 24% reported N/A) continue to report staying home when sick.

Frequent mask-wearing has decreased overtime

The portions of respondents who reported often or always wearing a mask when it was not mandatory has declined overtime (from 57% in April to 30% in February). There was a slight increase in frequent mask-wearing in non mandatory scenarios in the December wave of data collection (from 31% in October to 35% in December). However, mask-wearing decreased again by February.

Frequent use of all mask types has decreased over the past year

In February 2022, 55% of respondents reported often or always wearing a surgical mask, compared to 21% in February 2023. Similarly, 42% reported often or always wearing a cloth mask in February 2022 compared to 10% in 2023. Finally, 28% often or always wore a high quality medical mask in 2022 compared to 14% in 2023.

Over 1/4 report having been sick in the past month

27% of respondents reported having been sick with a fever, cough, sore throat or runny nose in the past month (down from 35% in December). Respondents aged 18-34 were more likely to report having been sick (35%) compared to those aged 35-54 (28%) and those aged 55+ (19%).

Participation in gatherings, events and travel has been stable since June 2022

In general, participation in gatherings, events and travel increased wave-to-wave between February 2022 and June 2022 and remained relatively stable between June 2022 and February 2023. Older respondents have consistently been less likely to report participating in the listed activities. For example, 73% of respondents aged 55+ reporting visiting with family and friends indoors compared to the average, 79%.

Around ½ of respondents support the reintroduction of many public health measures, if necessary

The majority of respondents indicated that they would support the introduction or reintroduction of many public health measures should they be required to respond to a COVID-19 outbreak. The most supported measures included mask requirements (58-65%), proof-of-vaccination requirements (50-54%) and gathering limits (52%). The least supported measures were business closures (29%), school/daycare closures (38%) and stay-at-home orders (42%). Respondents aged 55+ and women were much more likely to support the hypothetical reintroduction of measures.

Over time, support for reintroducing public health measures if needed has gradually declined

Over time, support for reintroducing public health measures if needed has gradually declined for most measures.

Over time, support for reintroducing proof-of-vaccination requirements has decreased but ½ would support them if necessary

Over time, support reintroducing proof-of-vaccination requirements to respond to a widespread outbreak of COVID-19 has decreased. However, around half continue to indicate that they would support vaccine requirements if necessary. Support for proof-of-vaccination requirements varies significantly by respondents' vaccination status, with those with fewer doses being less supportive of these measures.

Many Canadians are unsure about which medications are used to treat COVID-19

Large portions of the sample were unsure about whether Paxlovid, Remdesivir and monoclonal antibodies are used to treat COVID-19. Of these three treatments, Paxlovid was the most commonly known, with 42% of respondents positively identifying it as a medication used to treat COVID-19.

Knowledge of Paxlovid varies by province

Respondents in Ontario were more likely to indicate that Paxlovid is a medication used to treat COVID-19 (49%) compared to those in other provinces. Respondents from BC, Manitoba and Saskatchewan were less likely to correctly identify Paxlovid.

The majority of Canadians are unfamiliar with Paxlovid

Two thirds (66%) of respondents reported being not at all familiar with Paxlovid. 25% reported being slightly familiar with Paxlovid and 8% were somewhat familiar. Only 2% said they were very familiar with Paxlovid.

Even among those who are familiar with Paxlovid, some are unaware of how it is used

Among respondents who were at least slightly familiar with Paxlovid (35% of the sample), 65% correctly identified its use according to current guidelines. However, 39% thought that it is used to treat severe cases of COVID-19 in the hospital.

The majority of seniors are unsure whether they are eligible for Paxlovid

On average, three quarters (73%) of respondents were uncertain about whether they were eligible for Paxlovid. 8% thought that they were eligible for Paxlovid and 18% thought that they were not eligible. Respondents aged 65 and older were slightly more likely to indicate that they are eligible for Paxlovid. However, the majority in this age group were unsure about their eligibility (~69%).

1% of respondents say they have taken Paxlovid

1% of the sample reported having taken Paxlovid. 2% indicated that they considered taking it but did not end up taking it.

Adult Vaccination

Uptake of 4th and 5th doses has increased, uptake of 1st, 2nd and 3rd doses has plateaued

Over the past year, the portions of respondents with 0, 1, 2 and 3 doses of a COVID-19 vaccine have been relatively consistent, while the portions with 4 or more doses have increased*. Respondents aged 55+ were more likely to have at least 4 doses (71%) compared to those aged 35-54 (63%) and those aged 18-34 (35%). *Note: 3rd and 4th dose uptake in COSMO respondents is higher than real world uptake See Annex D for considerations on the discrepancy with official figures.

Intentions to get another dose of a COVID-19 vaccine are lower among those with fewer doses

Over time, intentions to get COVID-19 booster doses have decreased. This is partially explained by intentions converting to uptake. However, in some cases intentions have not converted to uptake. By February 2023, intentions to get another dose among those with 0-3 doses were quite low. For example, 98% of unvaccinated respondents that they will not get a COVID-19 vaccine. However, intentions to get another dose remain strong among those with at least four doses.

¼ of vaccinated individuals are worried about long-term side effects from the COVID-19 vaccine

In February 2022, 23% of respondents with at least one dose of a COVID-19 vaccine agreed that they were worried about developing long-term side effects from the vaccine. One year later, in February 2023, the same portion of respondents were worried about long-term side effects. Respondents with one or two doses were much more likely to be worried about long-term side effects (48%) compared to those with three (21%) and four or more doses (15%).

Most Canadians indicate that their friends and family are vaccinated for COVID-19

87% of respondents indicated that most of their close friends and family are vaccinated. Responses to this question varied significantly by vaccination status. 40% of unvaccinated respondents reported that most of their friends and family are vaccinated and 22% were unsure. 82% of respondents with two doses indicated that most of their friends and family are vaccinated. Approximately 95% of those with three or more doses indicated that their friends and family are vaccinated.

15% have refused or delayed routine vaccinations

15% reported having refused or delayed a routine vaccination at some point. Respondents who were unvaccinated for COVID-19 were more likely to have refused or delayed a routine vaccination (37%) than those with two (19%), three (16%), four (10%) or 5 (7%) doses of a COVID-19 vaccine.

Some respondents with 2 doses may be more likely to get a 3rd dose in certain scenarios

The top scenarios that respondents with two doses of a COVID-19 vaccine indicated would make them more likely to get a third dose were: If proof of a third dose were required for activities like travel (39%) If a new more severe variant of COVID-19 began to spread (36%) If the definition of “fully vaccinated” were changed to at least three doses (32%) However, in most cases, similar number of respondents indicated that these hypothetical scenarios would make them less likely to get a third dose.

New vaccines or the emergence of a more severe variant would motivate 4th dose uptake

The top scenarios that respondents with three doses of a COVID-19 vaccine indicated would make them more likely to get a fourth dose were: If a new more severe variant of COVID-19 emerged (69%) If a new vaccine were available that better prevented infection (66%) If proof of a fourth dose were required to engage in activities (61%)

1/2 report getting a flu vaccine this year

Just under half of respondents (49%) indicated that they got flu vaccine in the 2022-2023 season and 46% reported doing so in the 2021-2022 season. Flu vaccine uptake varied significantly by COVID-19 vaccination status. 1% of respondents who are unvaccinated for COVID-19 indicated that they got a flu shot, while 10% of those with two doses, 35% of those with three doses, 75% of those with four doses, and 88% of those with five doses indicated that they got a flu shot.

Pediatric vaccination

1/3 parents with children aged 12-17 with 2 doses intend to get their children another dose

31% of parents with children aged 12-18 indicated that their children have three doses of a COVID-19 vaccine. Among parents with children aged 12-17 with two doses of a COVID-19 vaccine, 30% intend to get their child a third dose ASAP or after some time. 44% do not intend to get their child a third dose of a COVID-19 vaccine. *Note: vaccine uptake in COSMO respondents was higher than real world. See Annex D for considerations on the discrepancy with official figures.

Vaccine uptake in children aged 5-11 has stalled

First dose vaccine uptake in the 5-11 age group has remained just under 60% since the beginning of data collection in February*. Second dose uptake remained consistent between June and October, at around 50%. There was a slight increase in third dose uptake – from 7% in October to 17% in December. Third dose uptake remained consistent between December and February. *Note: vaccine uptake in COSMO respondents was higher than real world uptake. See Annex D for considerations on the discrepancy with official figures.

Parents who have not yet vaccinated their children aged 5-11 do not intend to

The vast majority (86%) of parents who have not yet vaccinated their children aged 5-11 indicate that they do not intend to in the future.

½ of parents with children aged 5-11 with 2 doses of vaccine intend to get their children 3rd dose

49% of parents who have already vaccinated their children aged 5-11 intend to get their child a third dose either as soon as possible or after some time. A third (33%) of parents in this group do not intend to get their child a third dose.

¾ of parents have not vaccinated their children 4 and under

Vaccines were approved for children aged 6 months to 4 years in July 2022. Since then, approximately 26% of respondents with children in this age group have vaccinated their children*. *Note: Vaccine uptake in COSMO respondents was higher than real world uptake.

Over half of parents who have not yet vaccinated their children 4 and under do not plan to

Of parents who haven’t vaccinated their children in this age group, 59% indicated that they do not plan to vaccinate their children and 32% of parents intend to vaccinate their children aged 6 months to 4 years, either as soon as possible or after some time. Between October and December, the portion of parents who do not intend to vaccinate their children increased (from 51% to 60%, perhaps explained by uptake). The portion who intend to vaccinate their children as soon as possible or after some time decreased (from 40% to 29%). Intentions remained relatively stable between December 2022 and February 2023.

Belief that children are not at risk from COVID and concerns about side effects are top reasons for not vaccinating children

In an open-ended question, parents who had not yet vaccinated at least one of their children were asked to explain the reasons that their children had not yet been vaccinated. The top reason provided by parents were: The view that children are not at risk from COVID-19 (31%) Worries about side effects of the vaccine (30%)

Worries about children being infected with COVID-19 remain low

Worries about children getting COVID-19 have remained low since the summer months. In February 2023, 7% of parents indicated that they were very or extremely worried about their children getting COVID-19, compared to 25% in February 2022. 19% of parents were somewhat worried and 74% reported being not at all or slightly worried about their children getting COVID-19.

3/4 parents report their children have likely had COVID-19

74% of parents reported that their children have or likely have had COVID-19 at some point in the pandemic. Relatedly, 73% of parents reported that they have or likely have been infected themselves, compared to 56% of respondents without children at home.

Sources of Information & Trust

The most trusted sources of information on COVID-19 are scientists and healthcare workers

The majority of respondents trust (4-5 out of a scale of 5) healthcare workers (80%), scientists (77%) and international health authorities (64%) for information on COVID-19. Trust in the federal (61%) and provincial (58%) public health leaders and federal (62%) and provincial (57%) government briefings is also relatively high. Over half trust public broadcasting (55%). Less than half of respondents reported trust in newspapers and other journalism(41%) and television news (38%) for information on COVID-19. Trust in information sources was relatively consistent between February 2022 and 2023.

Half of respondents reported trusting the Government of Canada

51% of respondents reported completely or moderately trusting the Canadian federal government, while 38% reported moderate or complete distrust. Women reported higher trust (56%) than men (45%). University educated respondents reported higher levels of trust (63%) than those with college (45%) or high school education (46%). Respondents from Alberta (40%) and Manitoba and Saskatchewan (41%) reported lower trust relative to other provinces.

1/3 report not following the news on COVID-19 at all

Only 6% of COSMO respondents reported following the news about COVID-19 very closely and 17% reported following it pretty closely. More than a third of respondents (36%) reported not following the news about COVID-19 at all. Older respondents were more likely to report following the news about COVID-19.

COVID-19 news consumption decreased in February 2023

News consumption about COVID-19 decreased between April and June 2022, then remained stable until December 2022. Between December 2022 and February 2023 news consumption on COVID-19 decreased further.

Social media use varies by platform

Respondents were more likely to report using Facebook (49%) and Youtube (40%) either ‘multiple times a day’ or ‘once a day’ compared to other social media platforms. Use of social media platforms varied by respondent age, with younger respondents being less likely to use Facebook and more likely to frequently use all other platforms..

2/3 are familiar with social media algorithm processes

In February 2023, 61% of respondents selected the correct answer: ‘By computer analysis of what stories you’ve interacted with in the past’. Respondents aged 55+ were less likely to select the correct response (47%) than those aged 35-54 (74%) and 18-34 (81%).

COVID-19 Knowledge & Misinformation

Most respondents correctly identified true statements about COVID-19

The majority of respondents accurately rated most true statements about COVID-19 as somewhat/very accurate. However, smaller portions indicated that true statements were somewhat/very inaccurate (6%-29%). The true statement that was rated as inaccurate by the highest portion of respondents (29%) was “COVID-19 vaccines reduce the spread of COVID-19.”

A minority of respondents indicated that false statements about COVID-19 were accurate

A minority of respondents indicated that false statements about COVID-19 were somewhat/very accurate. These portions ranged between 3% and 30%, depending on the statement. For example, 19% of respondents rated the following statement as at least somewhat accurate: “COVID-19 vaccines are resulting in new variants of the virus.”

The majority are aware of COVID-19 variants, but less aware of subvariants

The majority of respondents correctly identified Omicron (91%) and Delta (74%) as variants of the virus that causes COVID-19. Fewer respondents were able to identify subvariants BA.5 (46%) and XBB.1.5 (32%).

Mental Health & Wellbeing

Life satisfaction has been relatively stable over the past year

In February 2023, 71% of respondents reported that they were satisfied with their lives as a whole. 6% were neither satisfied nor dissatisfied and 22% were dissatisfied. Younger respondents (18-34) reported slightly lower life satisfaction (64%) compared to those aged 35-54 (73%) and those aged 55+ (76%).

Many Canadians experienced negative wellbeing at least some of the time in the past two weeks

21% of respondents reported feeling burnt out most or all of the time in the past two weeks. 17% reported feeling anxious, nervous or on edge most or all of the time. Younger respondents and women were more likely to report experiencing these negative indicators most or all of the time in the past two weeks.

Wellbeing has improved in the past year

In February 2023, fewer respondents reported frequently experiencing negative wellbeing indicators compared to February 2022. For example, 18% reported feeling depressed most or all of the time in February 2022 compared to 12% in February 2023.

1/3 report that their mental health has declined since the beginning of the pandemic

In February 2023, 34% of respondents reported that their mental health had declined since the beginning of the pandemic, compared to 49% in February 2022.

Pandemic Outlook & Recovery

2/3 believe the worst of the COVID-19 crisis has passed

In February 2023, just under a third of respondents indicated that the worst of the crisis is behind us (64%) compared to 55% in December 2022. 18% of respondents were unsure whether the worst of the crisis has passed or is yet to come. Consistent with previous waves of data collection, 11% of respondents indicate that they do not consider COVID-19 to be a crisis.

1/3 respondents think life currently resembles pre-pandemic times

Overall, respondents were quite split on when they think life will resemble pre-pandemic times. 32% think that life will never resemble pre-pandemic times, 37% think that life already resembles pre-pandemic times, 17% think that it will be longer than six months, and 4% think it will be one to six months. Over time, there has been a significant increase in those who think life already resembles pre-pandemic times (from 3% in February 2022 to 37% in February 2023).

Cost-of-living and societal divisiveness are top-of-mind concerns, COVID impact on economy less so

In February 2023, two thirds of COSMO respondents (67%) indicated that they were worried about inflation or cost-of living increases, compared to 77% in February 2023. 59% indicated that they were worried about increasing divisiveness and/or conflict in society. Concern over the impact the COVID-19 on the economy continues to trend downwards, from 63% of respondents in February 2022 to 32% in February 2023.

Respondents remain concerned about the healthcare system being overloaded

62% of respondents report being very or extremely worried about the healthcare system being overloaded. Older respondents (64%) and women (69%) were more likely to be worried about the health system being overloaded. 37% of respondents were worried about the pandemic’s impact on the mental health of Canadians. Older respondents (27%) and men (31%) were less worried about mental health impacts.

Most COVID-related worries, aside from health system overload, have declined over time

Over time, most health-related worries have declined. The only exception is the portion of respondents worried about the healthcare system being overloaded, which increased in August and remained steady around 60% between August and February.

Perceptions of COVID-19 as a threat to Canadians and Canadian society have decreased

Overall, perceptions of COVID-19 as a threat decreased between February 2022 and February 2023. For example, 63% thought that COVID-19 was a moderate or major threat to the health of the Canadian population in February 2022 compared to 52% in February 2023.