Understanding national trends in COVID-19 vaccine hesitancy in Canada: results from five sequential cross-sectional representative surveys spanning April 2020-March 2021.

OBJECTIVE: To examine rates of vaccine hesitancy and their correlates among Canadian adults between April 2020 and March 2021. DESIGN: Five sequential cross-sectional age, sex and province-weighted population-based samples who completed online surveys. SETTING: Canada. PARTICIPANTS: A total of 15 019 Canadians aged 18 years and over were recruited through a recognised polling firm (Leger Opinion). Respondents were 51.5% female with a mean age of 48.1 (SD 17.2) years (range 18-95 years) and predominantly white (80.8%). PRIMARY AND SECONDARY OUTCOME MEASURES: Rates of vaccine hesitancy over the five surveys (time points) and their sociodemographic, clinical and psychological correlates. RESULTS: A total of 42.2% of respondents reported some degree of vaccine hesitancy, which was lowest during surveys 1 (April 2020) and 5 (March 2021) and highest during survey 3 (November 2020). Fully adjusted multivariate logistic regression analyses revealed that women, those aged 50 and younger, non-white, those with high school education or less, and those with annual household incomes below the poverty line in Canada were significantly more likely to report vaccine hesitancy, as were essential and healthcare workers, parents of children under the age of 18 and those who do not get regular influenza vaccines. Endorsing prevention behaviours as important for reducing virus transmission and high COVID-19 health concerns were associated with 77% and 54% reduction in vaccine hesitancy, respectively. Having high personal financial concerns was associated with 1.33 times increased odds of vaccine hesitancy. CONCLUSIONS: Results highlight the importance of targeting vaccine efforts to specific groups by emphasising the outsized health benefits compared with risks of vaccination. Future research should monitor changes in vaccine intentions and behaviour to better understand underlying factors.

Weight gain, weight management and medical care for individuals living with overweight and obesity during the COVID-19 pandemic (EPOCH Study).

Objective: Medical care and weight related experiences have been challenged by the coronavirus disease 2019 (COVID-19) pandemic for those living with obesity. The magnitude of this impact requires further attention in order to optimize patient care and outcomes. The aim of this study was to assess the impact of the COVID-19 pandemic and lockdown on access to, and experience of, medical care, weight gain and management strategies, as well as predictors of weight gain. Methods: An online survey (June-October 2020) was conducted with two samples; one representative of Canadians living with overweight and obesity (n = 1089) and a second of individuals recruited through obesity clinical services or patient organizations (n = 980). Results: Less than half of the total respondents thought that their providers were available for their medical care and most preferred in-person appointments over telemedicine. Only one quarter were satisfied with their obesity care. Sixty percent of the respondents reported weight gain (on average 5.65 kilograms [kg] gained), with 39.0% gaining more than 5% of their body weight (10.2% gained more than 10%). Over half of the respondents experienced decreased motivation for healthy eating or exercise. One third experienced more frequent and greater food consumption. Although worsening sleep occurred in approximately 20%, there was no significant increase in smoking, alcohol, or cannabis use. Predictors of weight gain were younger patients, higher weight categories, those who struggled with obtaining medical care during the pandemic, as well as those who struggled with eating. Conclusion: These results suggest that the COVID-19 pandemic negatively impacted patient care for those living with overweight and obesity and was associated with weight gain and interfered with weight management strategies. Greater attention to personalized weight management and interventions that focus on the predictors of weight gain should be undertaken.

Ending the Pandemic: How Behavioural Science Can Help Optimize Global COVID-19 Vaccine Uptake.

Governments, public health officials and pharmaceutical companies have all mobilized resources to address the COVID-19 pandemic. Lockdowns, social distancing, and personal protective behaviours have been helpful but have shut down economies and disrupted normal activities. Vaccinations protect populations from COVID-19 and allow a return to pre-pandemic ways of living. However, vaccine development, distribution and promotion have not been sufficient to ensure maximum vaccine uptake. Vaccination is an individual choice and requires acceptance of the need to be vaccinated in light of any risks. This paper presents a behavioural sciences framework to promote vaccine acceptance by addressing the complex and ever evolving landscape of COVID-19. Effective promotion of vaccine uptake requires understanding the context-specific barriers to acceptance. We present the AACTT framework (Action, Actor, Context, Target, Time) to identify the action needed to be taken, the person needed to act, the context for the action, as well as the target of the action within a timeframe. Once identified a model for identifying and overcoming barriers, called COM-B (Capability, Opportunity and Motivation lead to Behaviour), is presented. This analysis identifies issues associated with capability, opportunity and motivation to act. These frameworks can be used to facilitate action that is fluid and involves policy makers, organisational leaders as well as citizens and families.

Protecting individuals living with overweight and obesity: Attitudes and concerns toward COVID-19 vaccination in Canada.

OBJECTIVE: The aim of this study was to assess attitudes toward coronavirus disease 2019 (COVID-19) vaccination and the degree of fear of COVID-19 among those living with obesity. METHODS: Two samples were recruited for an online survey: one sample was a representative sample of Canadians living with overweight and obesity (n = 1,089), and the second was a convenience sample of individuals recruited from obesity clinical services or patient organizations (n = 980). Respondents completed ratings of their comfort receiving a COVID-19 vaccination along with the Vaccine Hesitancy Scale and the Fear of COVID-19 Scale. RESULTS: Approximately one-third of respondents, regardless of sample or weight category, were not comfortable receiving a vaccination, and one-half expressed moderate or greater perceived risks of vaccination. Confidence in vaccinations was extremely low, especially for those in the clinical sample. Fear of COVID-19 was substantial and predicted attitudes toward vaccination. Females were less comfortable receiving the vaccine and perceived more risks than males. CONCLUSIONS: These results suggest those living with obesity are highly ambivalent about COVID-19 vaccination. Despite their being at high risk, their confidence in vaccines is very low. Results suggest the need for patient-centered counseling, with a focus on shared decision-making to strengthen confidence and reduce perceived risk.