title: Trends in influenza vaccine coverage and vaccine hesitancy in Canada, 2006/07 to 2013/14: results from cross-sectional survey data.
abstract: BACKGROUND
  Past studies have reported influenza vaccination coverage below national targets, but up-to-date estimates are needed to understand trends and to identify areas for intervention. The objective of this study was to describe recent trends in influenza vaccination in Canada, timing of uptake and reasons for not receiving the vaccine.
  
  
  METHODS
  We pooled data from the 2007 to 2014 cycles of the Canadian Community Health Survey. Using bootstrapped survey weights, we examined influenza vaccine coverage by various groups, including by age and by presence of chronic medical conditions.
  
  
  RESULTS
  The overall sample included 481 526 respondents. Across all survey cycles combined, 29% of respondents reported receiving seasonal influenza vaccination in the past 12 months. Coverage levels were fairly consistent during the study period, but varied by province or territory. Vaccination coverage decreased over time among those aged 65 years and older. Among those who received a vaccination, it was most common to do so in October or November. Among those not vaccinated, the most frequently cited reason was believing it was unnecessary.
  
  
  CONCLUSIONS
  Influenza vaccination coverage continues to fall below national targets, with substantial declines seen among those aged 65 years and older, a group for which vaccination is particularly important. More intensive efforts are needed to improve coverage in Canada, particularly for high-risk groups.
authors.affiliation: Dalla Lana School of Public Health (Buchan, Kwong), University of Toronto; Institute for Clinical Evaluative Sciences (Kwong); Department of Family and Community Medicine (Kwong), University of Toronto, Toronto, Ont.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Buchan
authors.affiliation: Dalla Lana School of Public Health (Buchan, Kwong), University of Toronto; Institute for Clinical Evaluative Sciences (Kwong); Department of Family and Community Medicine (Kwong), University of Toronto, Toronto, Ont.
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Kwong