What Flu Shot Behaviour Tells Us About Canadians’ Likely Response To A COVID-19 Vaccine

BY Vijay Wadhawan

Public health communications are more effective when they’re crafted in tone and content to align with people’s pre-existing perspectives on the world – their social values.

Teams of scientists around the world are racing to develop a vaccine for COVID-19. This effort has been marked by extraordinary investments and collaborations, and tireless work among many researchers, as well as tainted with accusations of espionage. And all this activity is occurring in an environment where vaccines – and related issues of trust, responsibility and vaccine hesitancy – were already topics of conversation in many healthcare settings, schools and communities.

In this unprecedented context, we wanted to understand how Canadians view vaccines and, if possible, find some clues as to how they might respond to the prospect of a COVID-19 vaccine specifically. To share what we’ve found, we’re creating a series of blog posts on vaccinations, drawing on insights we’ve gathered through a range of methodologies, but all ultimately grounded in the social values of Canadians.


Using data from a robust survey on Canadians’ values and attitudes when it comes to health, Environics has developed a segmentation, PatientConnectTM, that clusters people into five distinct segments according to their values. These groups differ in their thinking and behaviour when it comes to vaccines, as well as on other health decisions. Underlying these differing health choices are variations in Canadians’ fundamental orientations to key issues, including respect for authority, trust in science and technology, and sense of personal control.


On issues ranging from the flu shot to the pandemic, a key challenge for public health officials is communicating with Canadians in ways that resonate. Delivering a message that makes sense goes beyond clarity and logic. Each values segment in our framework is motivated differently. Public health communications are more effective when they’re crafted in tone and content to align with people’s pre-existing perspectives on the world – their social values.

Overall, about half of Canadians (49%) report getting an annual flu shot. But the share of those who do so varies widely among values segments. The Responsible Proactive group is the most likely to seek an annual flu shot (63%), while the Health-Seeking Intuitives are the least likely (27%) to do so.

These two groups have some things in common: notably their belief that their own choices and actions can improve their health. But while Health-Seeking Intuitives are more inclined to believe that they don’t need a vaccine because they’re successful at optimizing their health through personal behaviours, Responsible Proactives are more inclined to believe that getting vaccinated is one of the personal choices they make that support their own health and that of other people. In part, this divergence is grounded in the two groups’ different orientations to physicians: Responsible Proactives see their doctors as trusted partners who help to guide and inform their personal choices; while Health-Seeking Intuitives believe they themselves are best positioned to understand their health – and they’re sometimes skeptical of a physician’s advice if it doesn’t “feel” right.

For these reasons, Responsible Proactives are most likely to be responsive to standard public health advice and the advice of their doctors; but Health-Seeking Intuitives may be more likely to be persuaded by creative messaging that appeals to their emotions, including messages about keeping their families safe.

After Health-Seeking Intuitives, the second least likely to report getting an annual flu shot are the Anxious Avoiders. As their name suggests, these Canadians are fearful about the state of their health, and are often inclined to avoid discussion or action on health out of fear – fear of unwanted news, unpleasant experiences, hard-to-follow rules, and so on. The best way to reach these Canadians is to try to harness their fear about keeping safe; underscoring the risks of skipping the flu shot, especially in a pandemic year with so many additional health risks in the environment.


Canadians’ views and behaviours when it comes to the flu shot may offer clues as to how they’ll respond to the availability of a COVID-19 vaccine. Plenty of caveats apply. COVID-19 and the seasonal flu have vastly different impacts on most people’s lives; and many will feel more urgency about getting a shot that will let them eat in restaurants, hug their families, and resume favourite community activities than they do about a vaccine that prevents an illness they consider ordinary. It’s also true that the race for a COVID-19 vaccine has led to suggestions that some countries, and their respective research institutions, have made unnerving deviations from standard safety protocols. These accusations may cause hesitancy even in those who are normally trustful of medical science and vaccines.

Still, some fundamentals – such as deference to doctors, and a sense of personal responsibility for protecting community health – will underpin Canadians’ orientations to both vaccines. Responsible Proactives will likely do some research, listen to experts, and follow public health guidance. Health-Seeking Intuitives and Anxious Avoiders may be more reluctant, likely for different reasons: “I’m fine” versus “I’m scared.” All three groups, as well as our other two segments, the Doctors’ Disciples and Impulsive Fatalists, can likely be reassured and persuaded to accept an eventual vaccine. But messages that tap into their deepest values and motivations will make their acceptance more likely and more enduring.

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