This is part a continuing series of recommendations put out by CoVaRR-Net. These recommendations are directed to local and provincial governments and their health officials.


The Public Health Agency of Canada (PHAC) reported that 15%–17% of the general population in Canada is hesitant to receive a COVID-19 vaccine.

Vaccine hesitancy is a threat to the success of COVID-19 vaccination programs and is considered a top-10 public health threat by the World Health Organization. Vaccine hesitancy is also a danger to public health, given that the large majority (88.1%) of COVID-19 cases in Canada as of August 21, 2021 are among the unvaccinated.

In Canada, gains in combatting vaccine hesitancy have been achieved through removing barriers to access, targeted communications and advertising, targeting outreach by mobilizing trusted partners, equipping health care providers with guidance, mobilizing community-level interventions through grants, and securing COVID-19 vaccine supply. Alberta, Manitoba, Quebec, and the Northwest Territories even used financial incentives, implementing prize lotteries to improve vaccine uptake rates.

  • A PHAC Health Care Provider Study indicated that 95% of physicians in Canada would find additional training on vaccine hesitancy useful for their practice.
  • As of August 31, 2021, the rate of reported active cases of COVID-19 among First Nations individuals living on reserve is 3.5 times the respective rate in the general Canadian population.
  • Israel combatted levels of vaccine hesitancy by using community-based nurses, primary care physicians, paramedics, and emergency medical technicians. Some countries, such as Indonesia, have mandated COVID-19 vaccination, whereas others, such as Australia and Greece, have made vaccines mandatory only among certain groups (e.g., long-term care workers).
  • Vaccine passports have been explored by many countries and are suggested to impact vaccine acceptance because they result in vaccinated individuals engaging in activities with proof of vaccination. More than one million people booked vaccination appointments the day France announced its vaccine passport.

CoVaRR-Net Recommendations

At the national level

  • Fund and support a pan-Canadian rapid evaluation that would describe and assess approaches/frameworks at the provincial/territorial/regional/local/First Nations government levels for overcoming vaccine hesitancy and commit to reporting findings and recommendations.

At the provincial level

  • Mandate vaccine certification in high-risk settings and review as vaccine rates and pandemic indicators change.
  • Train and educate provincial health workers about Canada’s colonial roots to ensure that vaccine hesitancy education campaigns foster trust among local Indigenous populations.
  • Engage Indigenous leaders and trusted individuals to communicate public health messages and ensure they are central to vaccination rollout programs.

At the local and regional level

  • Implement creative strategies to overcome vaccine hesitancy with local leaders and figureheads. Strategies may include the highlighting of community figureheads receiving their vaccine, text message reminders, media campaigns and local myth-busting sessions.
  • Clinicians must incorporate conversations around vaccine adoption at each patient encounter to assess the current state of individual behaviour and adopt tools and supports with scripted responses to questions and concerns. One possible tool that can help navigate these conversations with hesitant patients is the Vaccine Hesitancy Guide.
  • When possible, medical professionals with whom equity-seeking groups can identify should provide one-on-one COVID-19 vaccine guidance to marginalized and racialized populations.

Read CoVaRR-Net’s full Situation, Background, Assessment and Recommendation (SBAR) document on vaccine hesitancy.

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