Vulnerable and Hard-to-reach Populations COVID-19 Immunization Coverage Survey (VHCICS): Understanding the data

The current tab presents information on the importance of COVID-19 vaccination among key Canadian populations, introduces the data source used to build this dashboard, and offers useful explanations and definitions of the terminology used throughout the publication.

On this page

• Why are we exploring COVID-19 vaccination?
• Summary of survey characteristics
• Notes on the presented estimates and terminology
• Definitions used in this dashboard
• Data suppression
• Acknowledgements
• Suggested citation
• Learn more
• Have more questions?

Why are we exploring COVID-19 vaccination?

Data suggest that vaccine coverage is uneven across Canada. Vaccination tracking tools show that some populations are under-surveyed, leaving data gaps. Data gaps undermine immunization by limiting:

• COVID-19 vaccine surveillance
• public trust in vaccines (confidence)
• data availability
• policy and public health guidance
• knowledge sharing (mobilization activities)

The Vulnerable and hard-to-reach populations COVID-19 Immunization Coverage survey (VHCICS) addresses data gaps in COVID-19 vaccine coverage. The survey focuses on these vulnerable and hard-to-reach populations. It provides timely, trusted and evidence-based information. The data help people in Canada make decisions about personal and collective health related to COVID-19. Survey results will inform policy and public education and areas where we need interventions to improve vaccine coverage.

Summary of survey characteristics

The Vulnerable and Hard-to-reach Populations COVID-19 Immunization Coverage Survey (VHCICS) was first conducted in 2023. It is a large, national survey of individuals aged 18 years and older from various populations of interest within Canada. The survey collects data on COVID-19 vaccination coverage, barriers to vaccination, as well as respondents’ knowledge, attitudes, and beliefs regarding COVID-19 vaccines.

The detailed data tables and methodological report from the 2023 cycle can be found on Library and Archives Canada.

2023 VHCICS

Key specific population

Individuals living in Canada, who were 18 years of age or older.

Sampling approach

Probability-based survey of respondents from the general population.

Period of data collection

January 9 to February 23, 2023

Data collection tool

Electronic questionnaire

Sample size of key population, response rate (%), and final sample size by population

Population	Sample size	Response rate (%)	Final sample size*
Low education	4,048	(37.4%)	1,515
Low income	7,762	(28.8%)	2,234
Younger adults	6,397	(21.6%)	1,382
Urban Indigenous	2,357	(18.9%)	445
Visible minorities (including Indigenous)	7,147	(30.4%)	2,175
Recent immigrants	4,208	(14.1%)	592
Rural or remote communities	2,848	(37.6%)	1,070

Total survey completions by region

Region	Survey completions
Alberta	674
British Columbia and Territories	855
Manitoba	213
Saskatchewan	190
Ontario	2,185
Quebec	1,189
Atlantic	397
Canada	5,703

The VHCICS had the required number of completed surveys for only certain populations that could be directly determined listed in the table above. The populations for which quotas could not be directly targeted included: health care workers, industry workers, transportation workers, and people who use drugs.

It should be noted that populations are not mutually exclusive; respondents can be part of multiple groups.

The VHCICS had a sufficient number of respondents to derive national- and regional-level estimates for most regions; however, the number of respondents from New Brunswick, Nova Scotia, Prince Edward Island, and Newfoundland and Labrador were insufficient and needed to be collapsed into an Atlantic region to allow for the reporting of reliable and accurate estimates for these provinces. Similarly, the number of respondents for Yukon, Northwest Territories, and Nunavut were insufficient and needed to be collapsed with British Columbia.

The VHCICS is a self-report based survey that relies on recall. Such surveys are prone to recall bias (i.e., not remembering or misremembering past events or experience), social desirability bias (i.e., when respondents conceal their true opinion on a subject in order to make themselves look good to others), and non-response bias (i.e., when those who agree to participate in a survey are different in certain characteristics than those who choose not to participate). If present, these biases may lead to over- or under-estimation of immunization coverage and other measures estimated using survey data.

For more detailed information on the survey methodology, please visit Library and Archives Canada.

Notes on the presented estimates and terminology

The estimates (percentages) derived using data from the VHCICS are all weighted estimates. This means that survey sampling weights, adjusted for age, gender, education, income, population centre, visible minority identity, recent immigrant status, and Indigenous status, were applied to the calculations to ensure that the derived estimates are representative of the Canadian population.

The small black bars visible on some of the charts represent the confidence intervals around the estimates. Confidence intervals (CIs) are one way to relay information about how "good" an estimate is. The wider the confidence interval for a particular estimate, the more caution is required when using the estimate.

Definitions used in this dashboard

Vaccination (or immunization) coverage

Refers to the percentage of a population that is appropriately immunized against a specific vaccine-preventable disease.

At least one dose

People who have received a COVID-19 vaccine, regardless of the number of doses. People in this category may have received 1 or more doses, regardless of the type of COVID-19 vaccine administered.

Vaccine hesitancy

The World Health Organization (WHO) defined vaccine hesitancy as a delay in acceptance or refusal of vaccines despite availability. Although vaccine hesitancy is influenced by multiple factors itself, hesitancy also plays a role in understanding vaccine uptake.

Data suppression

Data are suppressed in this report if a province or territory has concerns around releasing values less than 5 for their jurisdiction. Provinces and territories that suppress values less than 5 include Saskatchewan, Quebec, New Brunswick, Prince Edward Island, Yukon and Northwest Territories.

Generally, if a province or territory requiring data suppression has a category with a value of less than 5, some counts are reclassified as “unknown.” This is done to reduce the number of values that must be suppressed. Remaining values less than 5 after recategorization are then removed from provincial or territorial and national totals to prevent the value from being calculated.

Acknowledgements

This report would not be possible without the respondents who generously dedicated their time and thoughtfully responded to the multitude of survey questions presented to them. We would like to thank everyone who participated in the 2023 VHCICS.

Suggested citation

Public Health Agency of Canada. Canadian 2023 Vulnerable and Hard-to-reach Populations COVID-19 Immunization Coverage Survey (VHCICS) report. Ottawa: Public Health Agency of Canada; .

Learn more

To learn more about health inequalities and the work being done to promote health equity in Canada, please visit the following resources:

• Report: Vision and priorities of Canada's Chief Public Health Officer (CPHO)
• News release: The federal government addresses health inequities across Canada

Have more questions?

Inquiries about this publication can be directed to:

vacc.cover.effect.surveil-surveil.couvert.efficacite.vacc@phac-aspc.gc.ca