Albertans & COVID-19 Vaccinations

Michelle Maroto | University of Alberta | maroto@ualberta.ca

October 13, 2021

This research brief examines the progress made toward vaccinating Albertans against COVID-19 by the fall of  2021. As Alberta faced a fourth wave of the pandemic, marked by high case counts and full ICUs, we offer an  assessment of views on the COVID-19 vaccine at a critical time in the pandemic. Results come from the  September 2021 Viewpoint Alberta Study.

Context

Nationally, 87% of people age 12 and older had received one dose of the vaccine and 81% were fully vaccinated  as of October 2, 2021 (1). National figures, however, obscure variation across regions and groups. Alberta, in particular, has some of the lowest vaccination rates in the country with 82% of people age 12 and older having  received one dose and 73% fully vaccinated at this time. In the North and Central Zones of Alberta, 73% of eligible Albertans had received one dose and 62% were fully vaccinated at this time (2). Rates for some geographic areas were even lower (3).

Alberta has one of the lowest vaccination rates across provinces and territories in Canada.

At a time when coronavirus cases are surging, and hospitals and ICU beds are at capacity, it is imperative to  examine who is and is not vaccinated in Alberta in order to better understand why vaccination rates have been lagging in this province. This data brief provides insight into these questions based on survey data collected from a sample of 1,204 Alberta residents between September 21 and October 6, 2021.

Who is vaccinated? 

The vast majority of adults in Alberta are fully or partially vaccinated against COVID-19. This is wonderful and important. As shown in Figure 1, 86% of respondents had already received at least one dose of the COVID-19 by the end of September 2021 and 4% reported that they were likely to be vaccinated. However, 2% were unsure about receiving the vaccine, 3% were unlikely to be vaccinated, and 5% said that they were certain not to.

Survey data therefore show a vaccination rate similar to official administration data for Alberta. They also help to highlight the positions of those who have not been vaccinated, indicating that many of the unvaccinated might be open to vaccinations with only 5% firmly against being vaccinated.

Figure 1: Likelihood of Receiving a COVID-19 Vaccination 

Further breaking down the data across groups also demonstrates who is more likely to have been vaccinated. Figure 2 examines vaccination status by race, education, age group, and location (4). Figure 3 provides further information in relation to gender, marital status, and number of children in the household. Variables are grouped by color in both figures.

Figure 2: Vaccination Rates across Demographic Groups

Figure 3: Vaccination Rates across Gender and Family Groups

These figures show limited demographic and family differences among vaccinated and unvaccinated persons with location and number of children standing out as important factors. Eighty-eight percent of people in urban and suburban locations were vaccinated, compared to only 78% of rural residents (Figure 2). Vaccination rates were also lower within households with a larger number of children (Figure 3). 

Although few differences in vaccination status appear across demographic, gender, and family variables, examining respondents’ economic situations (Figure 4) and political affiliations (Figure 5) showed larger disparities.

Figure 4: Vaccination Rate by Economic Situation

Figure 4 examines vaccination rates by a respondent’s income level, their reported ability to meet their monthly expenses, whether the respondent indicated that they could pay for an emergency $1000 expense from their savings, and their employment status. Income presented a clear relationship with vaccination status. Seventy nine percent of respondents who reported earning $40,000 or less as a household last year were vaccinated compared to 92% of those with household incomes above $160,000 per year. Respondents who experienced difficulties meeting their monthly expenses and those with limited savings to cover emergency costs were also less likely to be vaccinated. Finally, unemployed respondents and those who worked part-time were less likely than full-time employees and people not in the labor force to report being vaccinated. 

Vaccination rates are connected to economic situation and political affiliation.

Figure 5: Vaccination Rate by Provincial Political Affiliation 

Lower rates of vaccination were also apparent among respondents with certain political affiliations. Figure 5 presents results for vaccination status based on respondents’ reported vote intention if an Alberta election were to be held today and their response to a question asking whether Alberta should separate from Canada and form an independent country. The lowest vaccination rates were present among respondents who reported that they would vote for the Wildrose Independent Party; only 61% of these respondents were vaccinated. Additionally, 68% of respondents who supported separating from Canada were vaccinated compared to 91% of those who did not support separatism.

Who are the unvaccinated and why won't they get vaccinated?

In our data, only 154 respondents were unvaccinated, which makes it hard to generalize about characteristics of unvaccinated people with so few unvaccinated respondents. The data presented above, however, tell us that vaccination rates vary across groups with lower rates associated with economic struggles and certain political ideologies.

Expanding on these graphs, we can also look at characteristics of vaccinated and unvaccinated people, which tell a similar story. Unvaccinated people are more likely to have low incomes and struggle financially with 32% of unvaccinated respondents reporting incomes below $40,000 per year compared to 19% of vaccinated respondents (see Table 1 at end of document for data). There is also a clear association between political perspectives and vaccination. Unvaccinated respondents are more likely to support very conservative political parties like the Wildrose party. They are also more likely to support ideas like separating from the rest of Canada. Among unvaccinated respondents, 49% supported separatism compared to 17% of vaccinated respondents (see Table 1).

In addition to comparing vaccinated and unvaccinated respondents, we also asked unvaccinated respondents why they had yet to be vaccinated. Figure 6 presents the results from this question. Respondents were allowed to indicate multiple options, meaning that the responses in Figure 6 are not mutually exclusive.

The two most common reasons provided for not getting vaccinated were related to aspects of the vaccine itself. Approximately 62% of unvaccinated respondents were worried about the vaccine’s side effects and 45% believed that the vaccine was unsafe. These were followed by 36% of respondents who cited a lack of trust in the pharmaceutical industry and 36% who said that they did not trust government. Additionally, 28% reported that they were not worried about COVID-19, 21% noted that they had bad past experiences with vaccines, and 14% said that they already had contracted COVID-19.

Responses varied among those who indicated that they had other reasons for not getting vaccinated. Four respondents noted severe allergies or health reasons, three indicated that relatives or doctors told them not to, four described the vaccine as ineffective or unnecessary, and six thought it was too new and not tested enough. Others also referred larger rhetoric, saying things like, "I value my civil liberties," "I don't like being strong-armed to do anything," and "I'm not making the rich richer." A few indicated that they simply don't know.

Figure 6: Unvaccinated Respondents’ Reported Reasons for Not Getting Vaccinated

From these responses, it is clear that there is not a single reason driving vaccine hesitancy in Alberta. However, concerns about vaccine safety and side effects tend rank higher than other reasons. When we asked unvaccinated respondents a follow-up question regarding which reason they saw as most important for not getting vaccinated, 30% reported that they were most worried about side effects and 24% reported they were concerned about safety.

What types of vaccination policies do Albertans support?

Governments have multiple means for improving vaccine uptake. Early on, quickly securing vaccines and making them easily available to residents was the primary way to get people vaccinated. Once uptake began to decline, however, governments had to consider other methods. The most common methods included education campaigns, enacting vaccine mandates, and providing direct incentives.

Thus, in addition to understanding who is vaccinated and unvaccinated and why, it is also important to gauge support for different types of vaccine policies within the provinces. We first asked respondents if they supported mandates for specific groups. Figure 6 breaks down answers for these questions by the respondent’s vaccination status.

Figure 7: Support for Mandatory Vaccines for Different Groups by Vaccination Status

Unsurprisingly, support for mandating vaccines was high among vaccinated respondents. Eighty-six percent of vaccinated respondents supported mandates for frontline health works and 82% supported mandates for school teachers. Additionally, 79% supported mandates for elected officials, 76% supported them for restaurant and hospitality workers, and 72% supported them for retail workers. Vaccinated respondents were less likely to support mandates for all Albertans, though.

Support was much lower for unvaccinated respondents, but many still supported for mandates among certain groups. In particular, 22% of unvaccinated respondents supported mandates for frontline health workers, 21% supported mandates for school teachers, and 22% supported mandates for elected officials.

Mandates are not the only means for improving vaccination rates. As a way to increase vaccine uptake in Alberta, the provincial government announced a $100 vaccine payment program in early September 2021. This program provided Albertans 18 or older are eligible for a one-time payment if they got their first or second dose of an approved COVID-19 vaccine between September 3 and October 14, 2021. The program only applied to newly vaccinated persons and provided no payments to people who had been vaccinated earlier in the year.

We asked respondents what they thought about this program and assess their views regarding if they thought the program was necessary, fair, and effective. Figure 8 presents the results of these survey questions.

Figure 8: Perspectives on the $100 Vaccination Payment Program

Most respondents (72%) disagreed with the statement that the program is fair. Most also did not think the program was necessary or that it would be effective, either. Fifty-nine percent disagreed that it was necessary, and 59% disagreed that it was effective.

Breaking down these perspectives by vaccination status in Figure 9 further highlights diverging opinions across these groups. Although more vaccinated than unvaccinated respondents disagreed that the program is fair or effective, vaccinated respondents were more likely to believe it is necessary. Among vaccinated respondents, 58% thought the program was unnecessary, 75% thought it was unfair, and 61% thought it would be ineffective. The corresponding percentages for unvaccinated respondents were 66%, 58%, and 49%, respectively.

Figure 9: Perspectives on the $100 Vaccination Payment Program by Vaccination Status

Most respondents thought the $100 vaccine payment program was unfair, unnecessary, and

ineffective.

In addition to the $100 vaccine payment program, the Alberta government also introduced a restriction exemption program in early October. This program allows some non-essential businesses to remain fully open provided they require proof of vaccination or negative COVID-19 tests from customers (5). It is somewhat like the vaccine passport systems used by other provinces that requires proof of vaccination for visiting non-essential public places, such as bars, gyms, and restaurants where many people are present. The key difference between the systems lies in the fact that restriction exemption programs are voluntary and allow for unvaccinated people to gain access through testing, while vaccine passport systems tend to be mandated on all non-essential businesses without a testing exemption. We asked respondents about their views on both programs. The results are presented in Figure 10.

Figure 10: Perspectives on Different Vaccine Programs

Overall, we found greater support for vaccine passports above the restriction exemption program. Fifty-nine percent of respondents strongly supported instituting a vaccine passport program compared to 48% who strongly supported the restriction exemption program. Combining the categories for strongly and somewhat support, however, shows that respondents were generally supportive of both types of programs, even though approximately one-fifth of respondents did not support either program.

Most Albertans support vaccine mandates and passport programs.

Taken together, the findings presented in this data brief help to provide insight into questions regarding who is and is not vaccinated in Alberta, why some Albertans have not yet been vaccinated, and how much Albertan support policies to increase vaccine uptake. By and large, most Albertans have been vaccinated and support vaccine mandates and passports to help curb the spread of COVID-19. A small minority, however, approximately 14% of respondents still remain unconvinced about the importance of vaccination. Such views also vary across the population. For many, these views are bound up in other political perspectives and connected to strong ideological opposition against vaccination. For others, concerns regarding vaccine side effects and safety have kept them from getting vaccinated. Regardless, it is clear that the province still has more to do to improve vaccination rates and that vaccine mandates and passport programs are an important means for accomplishing this goal.

Methodology of the Viewpoint Alberta Survey

The Viewpoint Alberta Survey was conducted between September 21 and October 6, 2021. The survey was deployed online by Leger. A copy of the survey questions can be found here: https://bit.ly/2YEMObS. Leger co-ordinates the survey with an online panel system that targets registered panelists that meet the demographic criteria for the survey. Survey data are based on 1204 responses with a 17-minute average completion time. The Viewpoint Alberta Survey was led by co-principal investigators Jared Wesley, Michelle Maroto, Feodor Snagovsky, and Lisa Young. It was funded in part by a Research Cluster Grant from the Kule Institute for Advanced Study (KIAS) at the University of Alberta.

Online survey methods are currently one of the best ways to quickly solicit responses from a broad range of people; however, they do have certain limitations that must be noted. First, although they include participants from many backgrounds, online samples are not always representative of the population and do not offer the same benefits as fully random samples. People who participate in online surveys likely differ in certain ways from those who do not. This makes weighting against other population characteristics very important for accounting for such bias. Second, social desirability bias, which occurs when respondents answer questions based on how they think they should answer them versus how they really feel, could also affect survey responses to sensitive questions. This is harder to account for in survey analysis and must always be considered. Third, sample size for certain subgroups also limited our ability to fully explore variation across different outcomes. Future surveys with larger sample sizes and those targeted to specific groups could help to overcome this limitation.

In order to address these limitations, all estimates presented in this data brief are weighted using a set of survey sampling weights. These weights are based on the respondent’s age, education, gender, and region of the province. However, bias might also occur in relation to other observed and unobserved factors. We also include error bars around estimates and provide 95% confidence intervals when possible.

Endnotes

1. Public Health Agency of Canada. Canadian COVID-19 vaccination coverage report. Ottawa: Public Health Agency of Canada; October 8, 2021. https://health-infobase.canada.ca/covid-19/vaccination-coverage/

2. COVID Tracker Canada. Alberta Vaccination Data. https://covid19tracker.ca/provincevac.html?p=AB

3. Government of Alberta. COVID-19 Alberta Statistics, Vaccinations. https://www.alberta.ca/stats/covid-19-alberta-statistics.htm

4. Our original race-related questions allowed respondents to choose from a list of detailed racial and ethnic categories. However, due to the small sample sizes within these more detail categories, we were only able to study differences across an aggregated variable including categories of racial minority and white. Although this categorization obscures important variation across groups, it still provides some assessment of racial differences in vaccination status.

5. Alberta Government. COVID-19 Information: Requirements for the Restrictions Exemption Program. https://open.alberta.ca/publications/covid-19-information-requirements-for-restrictions-exemption-program

Additional Tables

Table 1: Descriptive Statistics for Unvaccinated and Vaccinated Respondents

Table 1: Descriptive Statistics for Unvaccinated and Vaccinated Respondents (Continued)