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311 Decisional needs of Canadians considering vaccination during the covid-19 pandemic: a population-based cross-sectional survey
  1. Qian Zhang1,
  2. Krystina B Lewis1,2,
  3. J Craig Phillips1,
  4. Meg Carley2,
  5. Claire Ludwig3,
  6. Patrick Archambault4,
  7. Maureen Smith5,
  8. Monica Taljaard2,6,
  9. Karine Plourde7,8,
  10. France Légaré4,7,9,
  11. Dawn Stacey1,2
  1. 1School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
  2. 2Ottawa Hospital Research Institute, Ottawa, Canada
  3. 3Patient Partner, Ottawa, Canada
  4. 4Department of Family Medicine and Emergency Medicine, Université Lava, Québec, Canada
  5. 5Patient Partner and Cochrane Consumer Network Executive, Ottawa, Canada
  6. 6School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
  7. 7VITAM Centre de recherche en santé durable Quebec, Canada
  8. 8CHU de Québec Research Centre, Université Laval, Quebec, Canada
  9. 9Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Quebec, Canada


Introduction Since the first COVID-19 vaccine was approved in December 2020, Canadians faced the decision of whether or not to get the COVID-19 vaccination. We sought to identify Canadians’ decisional needs about COVID-19 vaccination.

Methods We conducted two online surveys of adult Canadians (aged≥18) to explore decisions and decisional needs during the first two years of the COVID-19 pandemic (1454 participants in May 2021; 1718 in May 2022). This is a sub-analysis of participants who identified the COVID-19 vaccination as a difficult decision. In the sub-analysis, we assessed the decisional needs using questions informed by the Ottawa Decision Support Framework including Decisional Conflict and Decision Regret Scales. We analyzed data descriptively. We reported the methods according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) statement.

Results In the first and second year, 490 (33.7%) and 465 (27.6%) participants respectively selected the decision about COVID-19 vaccination. The rate of clinically significant decision conflict (CSDC, score

>37.5 out of 100) was 22.7% and 26.3%. Common factors influencing the decision were: worried about choosing the ‘wrong’ option (45.5%; 32.0%), difficulty separating fake news/fake science results from scientific evidence (39.4%; 30.9%) and worry about getting COVID-19 (30.4%; 30.9%). Of 440 and 463 participants who had made a decision, 23.9% and 38.4% had moderate to severe decision regret (score

>25 out of 100).

Discussion Many Canadians who faced the decision about COVID-19 vaccination experience clinically significant decisional conflict. Decision regret increased in the second year. This decision was influenced by uncertainty, misinformation, and fear of getting COVID-19.

Conclusion Decision support interventions are needed to address the decisional needs of Canadians considering new COVID-19 vaccination.

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