Seasonal Influenza Vaccination Coverage Survey, 2018–2019 - Final Report

Submitted to Public Health Agency of Canada
Contract Number 6D034-183551/001/CY

Prepared By: Leger

Ce rapport est également disponible en français.

Contract value: $168,415.20
Award date: 06/11/2018
Delivery date: 13/03/2019

Registration number: POR 065-18

For more information on this report, please contact hc.cpab.por-rop.dgcap.sc@canada.ca

Leger
507 Place d'Armes, Suite 700
Montréal, Quebec
H2Y 2W8
Telephone: 514-982-2464
Fax.: 514-987-1960

SEASONAL INFLUENZA VACCINATION COVERAGE SURVEY

Final Report

Prepared for the Public Health Agency of Canada
Supplier Name: Leger
March 2019

This public opinion research report presents the results of a telephone survey conducted by Leger Marketing Inc. on behalf of the Public Health Agency of Canada. The research was conducted with 3,737 Canadians between January 21 and February 24, 2019.

Cette publication est aussi disponible en français sous le titre : Sondage concernant la couverture de la vaccination contre la grippe saisonnière, 2018-2019.

This publication may be reproduced for non-commercial purposes only. Prior written permission must be obtained from Health Canada. For more information on this report, please contact Health Canada at hc.cpab.por-rop.dgcap.sc@canada.ca or at:

Health Canada, CPAB
200 Eglantine Driveway, Tunney's Pasture
Jeanne Mance Building, AL 1915C
Ottawa, Ontario K1A 0K9

Catalogue Number:
H14-315/2019E-PDF

International Standard Book Number (ISBN):
 978-0-660-30264-5

Related publications (registration number: POR 065-18):
Catalogue Number: H14-315/2019F-PDF (Final Report, French)
ISBN 978-0-660-30265-2

©Her Majesty the Queen in Right of Canada, as represented by the Minister of Health, 2019.

Table of Contents

1. Summary

Leger is pleased to submit this report to the Public Health Agency of Canada (PHAC) on the results of a quantitative survey assessing seasonal influenza vaccination coverage among the Canadian population.

This report was prepared by Leger following the awarding of a contract by PHAC (contract number 6D034-183551/001/CY, awarded November 6, 2018).

1.1 Background and objectives

For several years now, PHAC has been conducting a study at the beginning of the year on the incidence of seasonal influenza vaccination in the Canadian population. This study has multiple research objectives. The survey covers a variety of elements and topics. This year, some secondary objectives were added to the study while other items covered in previous years were removed from the study.

The primary objective of the research is to:

Provide national vaccination coverage estimates for seasonal influenza and estimates in four community-dwelling (i.e. non-institutionalized) groups: adults 18-64 years of age; adults 65 years of age and older; adults with a chronic medical condition; and young children (aged 6 to 59 months).

Secondary research objectives (new section in 2019) include:

Provide national vaccination coverage estimates for four antigens routinely offered to adults (i.e. tetanus, pertussis, shingles and pneumococcal disease) and;

For the pneumococcal vaccine, provide estimates for two groups to whom the vaccine is recommended (adults 65 years of age and older; and adults with a chronic medical condition).

Tertiary research objectives include:

Measure Canadians' awareness, knowledge, attitudes and beliefs towards these vaccines, determine reasons for non-vaccination, identify health care providers administering the influenza vaccine (i.e. nurse vs. doctor vs. pharmacist), and identify factors associated with vaccine uptake.

Once again, this year, special attention was paid to parents of children under 5 years to find out the reasons they choose whether or not to vaccinate their children.

1.2 Application of results

The survey results allow PHAC and the Government of Canada to monitor and evaluate vaccination programs during the flu seasons. They also identify factors that influence influenza vaccine uptake and sub-populations with low immunization coverage. This information is important for the development of targeted programs or strategies to improve immunization coverage of unvaccinated and under-vaccinated populations.

1.3 Methodology-Quantitative research

The quantitative research consisted of telephone interviews, which were conducted using a computer-assisted telephone interviewing system (CATI technology).

Data collection for this survey took place between January 21 and February 24, 2019. The national response rate for the survey was 20.1%. The comprehensive distribution of calls is presented in Appendix A. A pre-test of 100 interviews, in both official languages, was conducted between December 3 and 13, 2018. More specifically, 50 interviews were conducted in French and 50 in English. The interviews lasted an average of ten minutes. The interviews were recorded to assess the level of understanding of each issue in the population. Some adjustments were made to the questionnaire as a result of this evaluation. Another test was conducted prior to the full launch of data collection in January to confirm that all changes were properly implemented.

To obtain reliable data for each of the subgroups, we surveyed a total sample of 3,737 Canadian adults in all regions of the country. Only one adult respondent was interviewed per household. The national margin of error for this survey is +/- 1.60%, 19 times out of 20. Among these, 1,000 are parents of children under 5. The margin of error for this survey sample is +/- 3.10%, 19 times out of 20.

To estimate vaccine coverage in children aged 0 to 5 years, it was necessary to oversample parents of children of that age group because a simple random sample of all Canadian adults might not generate a sufficiently large sample of parents for an accurate analysis of young children. To avoid clustering, only one child per dwelling could be surveyed. Based on the previous edition of this survey, we estimated that we would find about 300 parents with children under 5 years of age in the random sample of the general population. Then, we oversampled this subgroup of the population to recruit 700 more in order to reach the PHAC target of 1,000 parents with children under 5 years of age. The additional sample was therefore a way to maximize the proportion of parents participating in the survey.

According to 2016 national census data from Statistics Canada, Leger weighted the results of this survey by age, gender, region, language (mother tongue) and education level. The results were also weighted according to the presence of children under 5 in the household (yes or no), as this question was asked and is important for this study. In addition, the weighting of respondents in the cellular sample only was also controlled to 32.5% after weighting, which corresponds to the latest Canadian Radio-television and Telecommunications Commission (CRTC) assessment of the percentage of Canadian households that do not have a landline.

Leger meets the strictest quantitative research guidelines. The questionnaire was prepared in accordance with the Standards for the Conduct of Government of Canada Public Opinion Research-Series B-Data collection and data tabulation for telephone surveys.

Details on the methodology, information on Leger's quality control mechanisms, the questionnaire, and details on weighting procedures are provided in the appendix.

1.3 Notes on the interpretation of the findings

The opinions and observations expressed in this document do not reflect those of the Public Health Agency of Canada. This report was compiled by Leger based on research conducted specifically for this project. This research is probabilistic; the results can be applied to the general population of Canada. The research was designed with this objective in mind.

1.4 Declaration of political neutrality and contact information

I hereby certify, as chief agent of Leger, that the deliverables are in full compliance with the neutrality requirements of the Policy on Communications and Federal Identity and the Directive on the Management of Communications—Appendix C (Appendix C: Mandatory Procedures for Public Opinion Research).

Specifically, the deliverables do not include information on electoral voting intentions, political party preferences, party positions, or the assessment of the performance of a political party or its leaders.

Signed by:

Christian Bourque
Executive Vice President and Associate
Leger
507 Place d'Armes, Suite 700
Montréal, Quebec
H2Y 2W8
cbourque@leger360.com

Seasonal Influenza Vaccination Coverage Survey, 2018-2019

Appendix A-Detailed research methodology

A.1 Quantitative methodology

A.1.1 Methods

For tracking and comparability purposes, the methodology used for this survey was the same as that of previous waves of surveys. Leger used the same methods as those used in the 2017-2018 survey with respect to sampling methodology, data collection methods and some elements of the questionnaire.

The quantitative research consisted of telephone interviews, which were conducted using a computer-assisted telephone interviewing system (CATI technology). This approach is the most suitable for assessing seasonal influenza vaccination coverage among different subgroups of the Canadian population, while ensuring a high level of representativeness.

Leger meets the strictest quantitative research guidelines. The survey questionnaire was prepared in accordance with the Standards for the Conduct of Government of Canada Public Opinion Research-Series B-data collection and data tabulation for telephone surveys.

Respondents were assured of the voluntary and confidential nature of the approach, and the anonymity of their responses. As with all research conducted by Leger, any information that could identify respondents was removed from the data, in accordance with Canada's Privacy Act.

All research interviews were conducted from the Montréal call centre, which has three separate divisions: one made up exclusively of English-speaking interviewers, another exclusively of French-speaking interviewers, and the last of bilingual interviewers. These divisions ensure that all telephone surveys can easily be conducted in either official language.

A.1.2 Data collection

Data collection for this survey was conducted between January 21 and February 24, 2019. The national response rate for the survey was 20.1%. The comprehensive distribution of calls is presented below. A pre-test of 100 interviews, in both official languages, was conducted between December 3 and 13, 2018. More specifically, 50 interviews were conducted in French and 50 in English. The interviews lasted an average of ten minutes. This pre-test allowed some adjustments to be made to the questionnaire. Results from the pre-test were not included in the coverage calculations.

To obtain reliable data for each of the subgroups, we surveyed a total sample of 3,737 Canadian adults in all regions of the country. Only one adult respondent was interviewed per household. The national margin of error for this survey is +/- 1.60%, 19 times out of 20. Among these, 1,000 are parents of children aged 0 to 5 years. The margin of error for this survey sample is +/- 3.10%, 19 times out of 20.

A representative sample of approximately 3,000 Canadian adults, and an oversample of approximately 1,000 parents of children under 5 years of age
A. Representative sample of approximately 3,000 Canadians

A sample of 3,000 Canadian adults was selected using a stratified regional sampling approach. Flexible regional quotas were applied to ensure that a sufficient number of interviews were conducted in each region of Canada. The following table shows the regional quotas. Within the random sample of 3,000 Canadian adults, 297 parents of children under 5 years of age were recruited.

The following table details the regional quotas for the 3,000 Canadian adults:

Table 1. Flexible regional quotas

Region		 Quotas Number of completed interviews
Atlantic Between 220 and 260 296
Quebec Between 720 and 780 940
Ontario Between 890 and 1,090 1,311
Manitoba and Saskatchewan Between 220 and 260 (15 interviews in Nunavut) 266
Alberta Between 340 and 380 (15 interviews in the NWT) 444
British Columbia Between 400 and 440 (15 interviews in the Yukon) 480
Total 3,000 3,737
B. Oversample of parents of children under 5 years of age

To meet the quota of 1,000 parents of children under 5 years of age, an oversample of 703 parents of children under 5 years of age was required, in addition to the 297 naturally collected from the sample of 3,000 Canadian adults. Because children aged 6 to 59 months are one of the groups with the highest risk for influenza-related complications, PHAC wanted to estimate coverage in that group. The additional sample was therefore a way to maximize the proportion of parents with children aged 5 years and under participating in the survey. Only one child per household was included in the calculation of coverage. If there was more than one child in the dwelling, the child who answered the questions was selected randomly using a grid in order to have a good distribution in every age group.

A.1.3 Sampling procedures

Landline telephone numbers were generated, and only cell phone numbers were purchased1 using a stratified regional sampling approach. Telephone interviews were conducted using Leger's computer-assisted telephone interviewing system (CATI technology). This system manages the sampling electronically, by selecting and randomly dialing the phone number to call. To ensure perfect coverage of a population, the sample included residential telephone numbers located in all of Canada's provinces and territories, as well as the cell phone numbers of Canadians who do not have a residential landline (i.e., pre-validated cell numbers only). Flexible quotas were established to ensure a sufficient number of interviews in each region of Canada. In addition to these regional quotas, data was collected to ensure proper distribution of respondents by gender (men and women) and language (English and French), using flexible quotas.

Canada-wide sampling: Households with a landline

We defined a Canada-wide sample of telephone numbers. All numbers were randomly selected to generate this basic sample. Each telephone number in this sampling frame was associated with a Canadian province. Subsequently, we used this Canada-wide sample to randomly select numbers by province or region, in proportion with the provincial or regional quotas established for the project.

Canada-wide sampling: households with a cell phone number only

For the portion of the sample composed of "households with only a cell phone," candidates were randomly selected for each province or region taking into account provincial or regional quotas. Based on the CRTC's 2016 communications monitoring report, which revealed that 32.5% of Canadian households used a cell phone exclusively, Leger ensured that 32.5% of the final sample came from cell phone numbers only.

Among the 3,737 interviews conducted as part of this project, 1,718 were conducted with respondents from households using only a cell phone. This represents 45.9% of the final sample, which is higher than the CRTC's estimate of 32.5% of Canadian households without landlines. Statistical weighting corrects the small difference between the sample and the actual proportion in the population.

A.1.4 Maximizing response rate

A low response rate compromises the reliability and validity of a survey. Based on their experience in surveying various populations, Leger has established the following methods to maximize response rates:

A.1.5 Call distribution

The overall response rate for this study is 20.1%. The response rate is calculated using the following formula: (Completed interviews + Out of sample) / (Total sample - Invalid sample). This is the former Marketing Research and Intelligence Association's standard calculation method for the response rate of a telephone survey. The table below provides details of the calculation.

Table 2. Call determination and response rate

ÉCHANTILLON DE BASE		 50,834
Invalid sample 7,943
No service 7403
Non-residential 156
Fax / modem / pager 367
Double 17
Numbers outside of sample 4,870
Language Barrier 691
Unqualified 3897
Quota attained 282
EFFECTIVE SAMPLE* 38,021
Non-completed interviews 34,284
Refusal 11,974
No answer 10,066
Answering machine 10,775
Line busy 412
Incomplete 272
Appointment 785
COMPLETED INTERVIEWS 3,737
Response rate 20.1%

*Note that effective sample is calculated using the following formula: Non-completed interviews + Completed interviews

A.1.6 Non-response biases and additional socio-demographic analysis

An effective response rate of 20.1% is the average for a national telephone survey of 3,737 respondents conducted over a period of approximately four weeks. This rate is consistent with similar surveys. Participation rates in telephone surveys rarely exceed 25% for a national survey of the general public. Such a response rate reduces the risk of significant non-response bias in the survey, as it reduces the likelihood of an unrepresentative sample.

Weighting

According to Statistics Canada's 2016 national census data, Leger weighted the results of this survey by age, gender, region, language (mother tongue) and education level. The results were also weighted according to the presence of children under 5 in the household (yes or no), as this question was asked and is important for this study. In addition, the weighting of respondents in the cell phone-only sample was also controlled to match the 32.5% expected after the weighting.

Nevertheless, a baseline comparison of weighted and unweighted samples was conducted to identify potential non-response biases that could be introduced by lower response rates in some demographic subgroups (see tables in the next section). As is usually the case for a telephone survey targeting mainly households with a landline, it was more difficult to reach young respondents and parents of young children. To compensate for this, Leger conducted 1,718 interviews with individuals whose homes do not have landlines (called on their cell phones). Through this procedure, we found that the size of our unweighted sample was very close to that of the weighted sample, calculated using the most recent data from Statistics Canada.

A.1.7 Weighted and unweighted samples

The table below shows the geographical distribution of respondents, before and after weighting. There is almost no geographical distribution imbalance in the unweighted sample. The weighting process mainly adjusted the weighting of Ontario and British Columbia-which were slightly underrepresented in the sample-to obtain more respondents in the smaller provinces and territories.

Table 3. Unweighted and weighted sample distribution by province

Province or territory		 Unweighted Weighted
Newfoundland and Labrador 61 57
Prince Edward Island 21 15
Nova Scotia 130 101
New Brunswick 84 81
Quebec 940 877
Ontario 1,311 1,430
Manitoba 136 131
Saskatchewan 115 112
Alberta 429 417
British Columbia 465 505
Nunavut 15 3
Northwest Territories 15 4
Yukon 15 4

The tables below illustrate the demographic distribution of respondents by gender, age, language (mother tongue), education and household income.

First, with respect to gender, we can see that the weighting adjusted the proportion of female respondents to male respondents, with women still slightly over-represented in telephone surveys.

Table 4. Unweighted and gender-weighted sample distribution

GENDER		 Unweighted Weighted
Male 1,572 1,805
Female 2,157 1,922
Refusal 8 11

With respect to age distribution, the unweighted sample far exceeds the Public Health Agency of Canada's expectations, which requires that at least 50% of the sample comprise people aged 18 to 64 years. In fact, 78% of the people in our unweighted sample are under 65 years of age and 61% of the unweighted sample is under 55 years of age.

Table 5. Unweighted and age-weighted sample distribution

AGE		 Unweighted Weighted
From 18 to 24 years old 195 348
From 25 to 34 years old 755 672
From 35 to 44 years old 803 604
From 45 to 54 years old 497 670
From 55 to 64 years old 654 653
From 65 to 74 years old 558 511
75 years old and older 275 278

Minor imbalances in language distribution have been corrected through weighting, as shown below.

Table 6. Unweighted and weighted sample distribution by mother tongue

LANGUAGE (MOTHER TONGUE)		 Unweighted Weighted
French 934 777
English 2,196 2,368
Other 596 582
Refusal 11 9

The table below shows the distribution of respondents according to the presence of children under 5 years of age in the household, before and after weighting. As we wanted to reach a larger number of parents than in a normally distributed sample, a quota of 1,000 parents of children under 5 years of age was set. It should be noted that a normally distributed sample would include about 11.5% of households with children aged 0-5 years, which is insufficient for proper data analysis of this very important group. As a result, there is a major imbalance in the distribution in the unweighted sample. However, weighting the sample made it possible to adjust the proportion of the two targets.

Table 7. Unweighted and weighted distribution of samples by the presence of children under 5 years of age in the household

PRESENCE OF CHILDREN UNDER 5 YEARS OF AGE IN THE HOUSEHOLD.		 Unweighted Weighted
1 701 236
2 267 87
3 29 11
4 3 1
5 2 0
TOTAL Yes 1,002 335
None 2,728 3,388
Refusal 7 13

The relatively small size of the weighting factors and differences in the responses of the various subgroups suggest that the quality of the data was not affected by the process. The weighting applied corrected the original imbalance for data analysis purposes; no further manipulation was required.

As with all research conducted by Leger, contact information was kept completely confidential, and any information that could identify respondents was removed from the data, in accordance with Canada's Privacy Act.

A.1.9 Weighting factors

Certain subgroups tend to be underrepresented or overrepresented in a sample compared to the general population. The weighting of a sample makes it possible to correct for differences in the representation of the various subgroups of that sample compared to what is usually observed in the overall study population. Weighting factors are therefore the weight given to each respondent that corresponds to a subgroup of the sample.

The following tables illustrate the proportion allocated to each target in the sample.

Table 8. Weighting by gender and age

GENDER*AGE		 Weighting
Male AND aged 18 to 34 years 0.1371
Male AND aged 35 to 44 years 0.0791
Male AND aged 45 to 54 years 0.0881
Male AND aged 55 to 64 years 0.0854
Male AND aged 65 and older 0.0959
Female AND aged 18 to 34 years 0.1358
Female AND aged 35 to 44 years 0.0826
Female AND aged 45 to 54 years 0.0912
Female AND aged 55 to 64 years 0.0894
Female AND aged 65 and older 0.1154
Total 1
Table 9. Weighting by gender and region

GENDER*REGION		 Weighting
Newfoundland AND Male 0.007374
Newfoundland AND Female 0.007882
Prince Edward Island AND Male 0.001959
Prince Edward Island AND Female 0.002133
Nova Scotia AND Male 0.012915
Nova Scotia AND Female 0.014101
New Brunswick AND Male 0.010549
New Brunswick AND Female 0.011226
Quebec AND Male 0.114013
Quebec AND Female 0.119994
Ontario AND Male 0.184346
Ontario AND Female 0.198504
Manitoba AND Male 0.017095
Manitoba AND Female 0.017934
Saskatchewan AND Male 0.014739
Saskatchewan AND Female 0.015196
Alberta AND Male 0.055674
Alberta AND Female 0.056123
British Columbia AND Male 0.065618
British Columbia AND Female 0.069703
Yukon AND Male 0.000502
Yukon AND Female 0.00051
Northwest Territories AND Male 0.000568
Northwest Territories AND Female 0.000544
Nunavut AND Male 0.000408
Nunavut AND Female 0.000389
Total 1
Table 10. Weighting by region and language

REGION*LANGUAGE		 Weighting
QC AND French 0.1809
QC AND English 0.0537
Rest of Canada AND French 0.0271
Rest of Canada AND English 0.7382
Total 1
Table 11. Households with a cell phone number only

HOUSEHOLDS WITH A CELL PHONE NUMBER ONLY		 Weighting
Yes 0.325
No 0.675
Total 1

PHAC wanted to have the opportunity to consider the oversample of children as a representative sample of children under five in Canada. Leger produced a separate SAS file and data set of the 1,000 oversampled participants in this subgroup. As we had information on child age, gender and region, we were able to weight the 1,000 respondents to reflect the actual distribution of children under 5 years of age in Canada.

The following table illustrates the proportion factor according to each target in the sample.

Table 12. Age- and region-specific weighting of children

CHILDREN*REGION		 Weighting
ATLANTIC AND less than 1 year old (from 1 to 11 months) 0.0106
ATLANTIC AND 1 year old to less than 2 years old (12 to 23 months) 0.0109
ATLANTIC AND from 2 years old to less than 3 years old (from 24 to 35 months) 0.0111
ATLANTIC AND from 3 years old to less than 4 years old (from 36 to 47 months) 0.0112
ATLANTIC AND from 4 years old to less than 5 years old (from 48 to 59 months) 0.0118
QC AND less than 1 year old (from 1 to 11 months) 0.0452
QC AND from 1 year old to less than 2 years old (from 12 to 23 months) 0.0456
QC AND from 2 years old to less than 3 years old (from 24 to 35 months) 0.047
QC AND from 3 years old to less than 4 years old (from 36 to 47 months) 0.048
QC AND from 4 years old to less than 5 years old (from 48 to 59 months) 0.0486
ON AND less than 1 year old (from 1 to 11 months) 0.071
ON AND from 1 year old to less than 2 years old (from 12 to 23 months) 0.0717
ON AND from 2 years old to less than 3 years old (from 24 to 35 months) 0.0732
ON AND from 3 years old to less than 4 years old (from 36 to 47 months) 0.0749
ON AND from 4 years old to less than 5 years old (from 48 to 59 months) 0.0766
MB/SK AND less than 1 year old (from 1 to 11 months) 0.0161
MB/SK AND from 1 year old to less than 2 years old (from 12 to 23 months) 0.0161
MB/SK AND from 2 years old to less than 3 years old (from 24 to 35 months) 0.0163
MB/SK AND from 3 years old to less than 4 years old (from 36 to 47 months) 0.0164
MB/SK AND from 4 years old to less than 5 years old (from 48 to 59 months) 0.0162
AB AND less than 1 year old (from 1 to 11 months) 0.0283
AB AND from 1 year old to less than 2 years old (from 12 to 23 months) 0.028
AB AND from 2 years old to less than 3 years old (from 24 to 35 months) 0.0279
AB AND from 3 years old to less than 4 years old (from 36 to 47 months) 0.028
AB AND from 4 years old to less than 5 years old (from 48 to 59 months) 0.0282
BC AND less than 1 year old (from 1 to 11 months) 0.0226
BC AND 1 year old to less than 2 years old (12 to 23 months) 0.0228
BC AND from 2 years old to less than 3 years old (from 24 to 35 months) 0.0231
BC AND from 3 years old to less than 4 years old (from 36 to 47 months) 0.0238
BC AND from 4 years old to less than 5 years old (from 48 to 59 months) 0.0239
North AND less than 2 years old (from 1 to 23 months) 0.0019
North AND from 2 years old to less than 3 years old (from 24 to 35 months) 0.001
North AND from 3 years old to less than 4 years old (from 36 to 47 months) 0.001
North AND from 4 years old to less than 5 years old (from 48 to 59 months) 0.001
Total 1
Table 13. Weighting by region and gender of children

REGION*GENDER		 Weighting
ATLANTIC AND male 0.0284
ATLANTIC AND female 0.0273
QC AND male 0.1200
QC AND female 0.1143
ON AND male 0.1881
ON AND female 0.1791
MB/SK AND male 0.0416
MB/SK AND female 0.0396
AB AND male 0.0719
AB AND female 0.0685
BC AND male 0.0597
BC AND female 0.0565
North AND male 0.0026
North and female 0.0024
Total 1
Table 14. Weighting by gender and age of children

GENDER*AGE		 Weighting
MALE AND under 1 year old (from 1 to 11 months) 0.0996
MALE AND from 1 year old to less than 2 years old (from 12 to 23 months) 0.1005
MALE AND from 2 years old to less than 3 years old (from 24 to 35 months) 0.1021
MALE AND from 3 years old to less than 4 years old (from 36 to 47 months) 0.1046
MALE AND from 4 years old to less than 5 years old (from 48 to 59 months) 0.1056
FEMALE AND under 1 year old (from 1 to 11 months) 0.0951
FEMALE AND from 1 year old to less than 2 years old (from 12 to 23 months) 0.0957
FEMALE AND from 2 years old to less than 3 years old (from 24 to 35 months) 0.0974
FEMALE AND from 3 years old to less than 4 years old (from 36 to 47 months) 0.0988
FEMALE AND from 4 years old to less than 5 years old (from 48 to 59 months) 0.1006
Total 1

Appendix B — Questionnaire

English Survey Questionnaire

INFLUENZA COVERAGE INSTRUCTION 2018/2019

GENERAL PROGRAMMING INSTRUCTIONS :
[TYPE DE PROJET : Tel]
[LANGUES : FR/EN]
[TRACKING : Non]

NOTE TO READER : Text in green and in gray indicate programming instructions.

LEGEND FOR ATTRIBUTE COLUMN
X= Exclusive choice
F= Fixed Choice (not part of the rotation or permutation)
O= Open-ended

Over sample

Oversample of parents of child under 5

Section info
Page info
[ASK ALL]
QINF#
Good morning (afternoon, evening), my name is XX and I'm calling from LEGER research. We are currently conducting a study on flu vaccine. This survey is led by the Public Health Agency of Canada. Your answers will help improve services that impact Canadians like you. We would therefore greatly appreciate your cooperation.

Your participation is voluntary and completely confidential. Your answers will remain anonymous and cannot affect in any way your dealings with the government of Canada. Can I ask you a few questions? It will take no more than 10 minutes.

IF ASKED: Your opinion counts. Leger research is a renowned company throughout Canada. Today's study is about a topic related to public health in Canada. There are no wrong answers. When may I contact you again? When would be a good time to contact you? Whom should I ask to speak with when I call back? Is there another person in your household with whom we could talk?

NOTE: If a respondent requests to speak with a study leader at Health Canada, please take his / her name and phone number and mention that a supervisor will call back to establish the link with Health Canada.

Contact:
Jared Cohen
Health Canada / Government of Canada
Phone number: 613-608-4123

Section info
[ASK ALL]
QSCTDEMO1
INTERVIEWER SCRIPT:
To begin, I have a few questions about you.

Simple mention question
[ASK IF ECHA=CELL]
ADTADM_010
Do you currently have a residential land-line telephone service at home?

INTERVIEWER INSTRUCTIONS: (DO NOT READ LIST. ONLY ONE MENTION)

Numeric question
[ASK ALL]
[NUMeric : Min=18, Max=150]
[NOTES: Under 18 = terminate]
[VALIDATION: ÂGE]
ADTDEM_010
How old were you as of September 1, 2018?

INTERVIEWER INSTRUCTIONS: (RECORD THE NUMBER.)

Calculated variable
[NOTES: CALCULATION FROM ADTDEM_010]
ADTDEM_011

Simple mention question
[ASK PROV TO ALL]
PROV
In which province or territory do you live?

Simple mention question
[ASK ALL]
ADTDEM_020
What is the language you first learned at home in your childhood and that you still understand?

INTERVIEWER INSTRUCTIONS: (DO NOT READ LIST. ONLY ONE MENTION)

Simple mention question
[ASK ALL]
ADTDEM_030
What is your gender?

INTERVIEWER INSTRUCTIONS:
Clarification, if asked: Gender is the way a person internally feels and/or publicly expresses in their daily life. A person's gender may differ from the sex they were assigned at birth (male or female). (DO NOT READ LIST. ONLY ONE MENTION)

Simple mention question
[ASK ALL]
ADTKAB_010
As far as you know, are you up to date on your vaccines?

INTERVIEWER INSTRUCTIONS:
Clarification, if asked: Getting your flu vaccine this season is included in being up to date on your vaccines. If you missed it in a previous season, but got it this time, then you can still be considered up to date. READ. ONLY ONE MENTION

INTERVIEWER SCRIPT:
The next few questions I will ask you how much do you agree or disagree with a series of statements. The options are: strongly disagree, somewhat disagree, somewhat agree, or strongly agree.

Simple mention question
[ASK ALL]
ADTKAB_020
"In general, I consider vaccines to be important for my health." :

INTERVIEWER INSTRUCTIONS:
Clarification, if asked: "The options are: strongly disagree, somewhat disagree, somewhat agree, or strongly agree".
DO NOT READ, UNLESS ASKED BY RESPONDENT.
ONLY ONE MENTION.

Simple mention question
[ASK ALL]
ADTKAB_030
"I know enough about vaccines to make an informed decision about getting vaccinated." :

INTERVIEWER INSTRUCTIONS:
Clarification, if asked: "The options are: strongly disagree, somewhat disagree, somewhat agree, or strongly agree".
DO NOT READ, UNLESS ASKED BY RESPONDENT.
ONLY ONE MENTION.

ADULT - Flu vaccination
INTERVIEWER SCRIPT: Now, I will ask you some questions about the flu vaccine, and your vaccination status.

Simple mention question
[ASK ALL]
ADTFLU_010
Before September 1st, 2018, have you ever received the seasonal flu vaccine (also known as the flu shot)?

INTERVIEWER INSTRUCTIONS:
Note: The flu vaccine can be received by a shot (needle) or nasal spray.
(DO NOT READ LIST. ONLY ONE MENTION)

Simple mention question
[ASK ALL]
ADTFLU_020
From September 1st 2018 to now, have you received the seasonal flu vaccine?

INTERVIEWER INSTRUCTIONS:
Note: The flu vaccine can be received by a shot (needle) or nasal spray. (DO NOT READ LIST. ONLY ONE MENTION)

Simple mention question
[ASK IF ADTFLU_020=0]
ADTFLU_030
How likely is it that you will get the seasonal flu vaccine between now and June? Would you say you:

INTERVIEWER INSTRUCTIONS: (READ LIST. ONLY ONE MENTION)

Simple mention question
[ASK IF ADTFLU_020=0]
ADTFLU_040
What was the most important reason why you did not receive the flu vaccine this time? Would you say it is because…?

INTERVIEWER INSTRUCTIONS:
If the respondents say, 'all of the above', prompt them to pick, among those, the most important reason
If the respondent says, "Other specify" (96) - capture verbatim response. Do not back-code. (READ LIST. ONLY ONE MENTION)

Simple mention question
[ASK IF ADTFLU_040=01]
ADTFLU_041
When you say, "You don't need the flu vaccine", would you say that is because…

INTERVIEWER INSTRUCTIONS:
If the respondents say, 'all of the above', prompt them to pick, among those, the most important reason
If the respondent says, "Other specify" (96) - capture verbatim response. Do not back-code. READ. ONLY ONE MENTION

Simple mention question
[ASK IF ADTFLU_040=02]
ADTFLU_042
When you say, "The flu vaccine does not work", would you say that is because …

INTERVIEWER INSTRUCTIONS:
If the respondents say, 'all of the above', prompt them to pick, among those, the most important reason
If the respondent says, "Other specify" (96) - capture verbatim response. Do not back-code. READ. ONLY ONE MENTION

Simple mention question
[ASK IF ADTFLU_040=03]
ADTFLU_043
When you say, "You did not get around to it", would you say that is because …

INTERVIEWER INSTRUCTIONS:
If the respondents say, 'all of the above', prompt them to pick, among those, the most important reason
If the respondent says, "Other specify" (96) - capture verbatim response. Do not back-code. READ. ONLY ONE MENTION

Simple mention question
[ASK IF ADTFLU_040=04]
ADTFLU_044
When you say, "You have concerns about the flu vaccine, and/or its side effects", would you say your concern is about …:

INTERVIEWER INSTRUCTIONS:
If the respondents say, 'all of the above', prompt them to pick, among those, the most important reason
If the respondent says, "Other specify" (96) - capture verbatim response. Do not back-code. READ. ONLY ONE MENTION

Simple mention question
[ASK IF ADTFLU_020=1]
ADTFLU_050
Was the flu vaccine you received this year given by a shot (with a needle) or a spray in the nose?

INTERVIEWER INSTRUCTIONS: READ. ONLY ONE MENTION

Simple mention question
[ASK IF ADTFLU_020=1]
ADTFLU_060
In which month did you receive the flu vaccine this time?

INTERVIEWER INSTRUCTIONS: READ. ONLY ONE MENTION

Simple mention question
[ASK IF ADTFLU_020=1]
ADTFLU_070
Where did you receive the flu vaccine this time?

INTERVIEWER INSTRUCTIONS: (READ IF NEEDED - ONE ANSWER ALLOWED)

Multiple mentions question
[ASK if ADTFLU_020=1]
[MENTIONS MULTIPLES : Max=12]
[NOTES AU PROGRAMMEUR : Assurer de créer une colonne par choix de réponses code 0,1]
ADTFLU_080
What are the reasons you decided to receive the flu vaccine this time?

INTERVIEWER INSTRUCTIONS:
If the respondent says "Other specify" (96) - capture verbatim response. Do not back-code. DO NOT READ - MULTIPLE ANSWERS ALLOWED
Please select all that apply.

INTERVIEWER SCRIPT: The next few questions I will ask you how much do you agree or disagree with a series of statements. The options are: strongly disagree, somewhat disagree, somewhat agree, or strongly agree.

Simple mention question
[ASK ALL]
ADTKAB_040
"Getting sick with the flu can be serious." :

INTERVIEWER INSTRUCTIONS:
Clarification, if asked: "The options are: strongly disagree, somewhat disagree, somewhat agree, or strongly agree".
DO NOT READ, UNLESS ASKED BY RESPONDENT.
ONLY ONE MENTION.

Simple mention question
[ASK ALL]
ADTKAB_050
"I will probably get sick with the flu this season." :

INTERVIEWER INSTRUCTIONS:
Clarification, if asked: "The options are: strongly disagree, somewhat disagree, somewhat agree, or strongly agree".
DO NOT READ, UNLESS ASKED BY RESPONDENT.
ONLY ONE MENTION.

Simple mention question
[ASK ALL]
ADTKAB_060
"The flu does not affect very many people.":

INTERVIEWER INSTRUCTIONS:
Clarification, if asked: "The options are: strongly disagree, somewhat disagree, somewhat agree, or strongly agree".
DO NOT READ, UNLESS ASKED BY RESPONDENT.
ONLY ONE MENTION.

INTERVIEWER SCRIPT: As a reminder, the options are: strongly disagree, somewhat disagree, somewhat agree or strongly agree.

Simple mention question
[ASK ALL]
ADTKAB_070
"The flu vaccine does not protect you against getting the flu.":

INTERVIEWER INSTRUCTIONS:
Clarification, if asked: "The options are: strongly disagree, somewhat disagree, somewhat agree, or strongly agree".
DO NOT READ, UNLESS ASKED BY RESPONDENT.
ONLY ONE MENTION.

Simple mention question
[ASK ALL]
ADTKAB_080
"Sometimes, you can get the flu from the flu vaccine.":

INTERVIEWER INSTRUCTIONS:
Clarification, if asked: "The options are: strongly disagree, somewhat disagree, somewhat agree, or strongly agree".
DO NOT READ, UNLESS ASKED BY RESPONDENT.
ONLY ONE MENTION.

Simple mention question
[ASK ALL]
ADTKAB_090
"The opinion of my family doctor, general practitioner or nurse practitioner is an important part of my decision when it comes to getting the flu vaccine.":

INTERVIEWER INSTRUCTIONS:
Clarification, if asked: "The options are: strongly disagree, somewhat disagree, somewhat agree, or strongly agree".
DO NOT READ, UNLESS ASKED BY RESPONDENT.
ONLY ONE MENTION.

Simple mention question
[ASK ALL]
ADTKAB_100
"The flu vaccine is safe.":

INTERVIEWER INSTRUCTIONS:
Clarification, if asked: "The options are: strongly disagree, somewhat disagree, somewhat agree, or strongly agree".
DO NOT READ, UNLESS ASKED BY RESPONDENT.
ONLY ONE MENTION.

Section info
CHILDREN - Flu vaccination
INTERVIEWER SCRIPT: Now, I will ask you a few questions about children in your household under the age of 5 years, and their flu vaccination status.

Numerical question
[ASK ALL]
[NUMERIC: Min=0, Max=5]
[NOTES: ALLOW 5 CHILD]
ADTCHD_010
On September 1 2018, how many children under 5 years of age, of whom you are the parent or guardian, were living in your household?

INTERVIEWER INSTRUCTIONS: We do not want the respondent to provide information about children of which he or she is not the parent or guardian, such as younger siblings. If a respondent asks if they can answer for their spouse's children, the answer would be "yes, if you are aware of the vaccines they received and their state of health" (Record number of children: VALIDATE THAT THEY ARE LESS THAN 5 YEARS.

Numerical question
[ASK IF AT ADTCHD_010>0, < 999]
[NUMERIC YEAR: Min=1, Max=5]
[NUMERIC MONTH: Min = 1, Max=59]
[NOTES: PROGRAM FOR UP TO THE NUMBER OF CHILD <5 YEARS PER HOUSEHOLD]
[ENABLE SEIZURE IN MONTH OR YEARS]

[MUST BE LESS THAN 5 YEARS OLD OR LESS THAN 60 MONTHS]
CHDDEM_011 to CHDDEM_015
How old was your child as of September 1, 2018?

INTERVIEWER INSTRUCTIONS: (RECORD THE AGE OF THE CHILD)

Simple mention question
[ASK IF ANY OF CHDDEM_01X >0, < 6. IF CHDDEM_01X ≥ 6 then CHDDEM_02X = YEARS]
CHDDEM_021 to CHDDEM_025
And to confirm - was that [CHDDEM_01X] months, or [CHDDEM_01X] years?

Calculated variable
[IF CHDDEM_02X=1 THEN CHDDEM_03X = CHDDEM_01X. ELSE, IF CHDDEM_02X = 2 THEN CHDDEM_03X = (CHDDEM_01X *12) ]
CHDDEM_031 to CHDDEM_035
RECODE AGE OF EVERY CHILD IN MONTH FORMAT (FROM YEAR(S) TO MONTHS)

Calculated variable
CHDDEM_041 to CHDDEM_045
Assign value(s) from CHDDEM_03X to category, below

Calculated variable
CHDDEM_050
RANDOMLY SELECT ONE CHILD about whom to complete the survey, and indicate their age in months.

NOTE FOR PROGRAMMING: [IF ADTCHD_010>0, <999] - RANDOMLY SELECT ONE USING GRID FROM CHDDEM_04X. IN THE END WE WOULD LIKE TO HAVE A GOOD DISTRIBUTION IN EVERY AGE GROUP OF THE TABLE. BASE THE SELECTION ON ANSWER AT CHDDEM_04X FOR AGE GROUP MATCHING. INDICATE AS THE VALUE FROM CHDDEM_03X FOR THE CHILD THAT WAS SELECTED.

INTERVIEWER SCRIPT: For the next few questions in this survey, please respond about your child who is ***(CHDDEM _01X) (CHDDEM_02X) ***-old.

Simple mention question
[ASK IF ADTCHD_010 >0, < 999]
CHDDEM_060
What is the gender of your ***(CHDDEM _01X) (CHDDEM_02X)***-old child?

INTERVIEWER INSTRUCTIONS:
Clarification, if asked: Gender is the way a person internally feels and/or publicly expresses in their daily life. A person's gender may differ from the sex they were assigned at birth (male or female). DO NOT READ. ONLY ONE MENTION

Simple mention question
[ASK IF ADTCHD_010 >0, < 999]
CHDFLU_010
From September 1st 2018 to now, has your ***(CHDDEM _01X) (CHDDEM_02X) ***-old child received the seasonal flu vaccine?

INTERVIEWER INSTRUCTIONS: (DO NOT READ LIST. ONLY ONE MENTION)

Simple mention question
[ASK IF CHDFLU_010=1]
CHDFLU_020
In which month did your child receive their most recent flu vaccine?

INTERVIEWER INSTRUCTIONS: (READ LIST. ONLY ONE MENTION)

Simple mention question
[ASK IF CHDFLU_010= 1]
CHDFLU_030
Was it the first time your ***(CHDDEM _01X) (CHDDEM_02X) ***-old child has ever received the flu vaccine?

INTERVIEWER INSTRUCTIONS: (DO NOT READ LIST. ONLY ONE MENTION)

Simple mention question
[ASK IF CHDFLU_030=1]
CHDFLU_040
From September 1st 2018 to now, has your ***(CHDDEM _01X) (CHDDEM_02X) ***-old child received one or two doses of the flu vaccine?

INTERVIEWER INSTRUCTIONS: (DO NOT READ LIST. ONLY ONE MENTION)

Single mention question
[ASK IF CHDFLU_040=1; AND CHDDEM_03X IS ≥6, and ≤59]
CHDFLU_050
Young children who are receiving the flu vaccine for the first time are sometimes given two doses. What was the most important reason why your ***(CHDDEM _01X) (CHDDEM_02X) ***-old child did not receive a second flu vaccine? Would you say it is because…?

INTERVIEWER INSTRUCTIONS:
If respondents says, 'all of the above', prompt them to pick, among those, the most important factor.
If respondent selects "Something else (other; specify) (96)", capture verbatim response. Do not back-code. READ. ONLY ONE MENTION

Simple mention question
[ASK IF CHDFLU_010=1]
CHDFLU_060
Children do not always get the flu vaccine during the same visit as for their other childhood vaccines. Knowing that, how sure are you that your child got the flu vaccine? Would you say you are…?

INTERVIEWER INSTRUCTIONS:
Clarification, if asked: childhood vaccines means the vaccines usually given during a 'Well Child' visit with a health care professional. They protect against diseases like measles, mumps and rubella (MMR), diphtheria, tetanus, pertussis, polio and Haemophilus influenzae b (DTaP-IPV-Hib). (READ LIST. ONLY ONE MENTION)

Simple mention question
[ASK IF CHDFLU_010=0]
CHDFLU_070
What was the most important reason why your ***(CHDDEM _01X) (CHDDEM_02X) ***-old child did not receive the flu vaccine this year? Would you say it is because…?

INTERVIEWER INSTRUCTIONS:
If the respondents say, 'all of the above', prompt them to pick, among those, the most important reason
If the respondent says, "Other specify" (96) - capture verbatim response. Do not back-code. READ. ONLY ONE MENTION


Simple mention question
[ASK IF CHDFLU_070=01]
CHDFLU_071
When you say "S/he doesn't need the flu vaccine", would you say that is because…:

INTERVIEWER INSTRUCTIONS:
If the respondents say, 'all of the above', prompt them to pick, among those, the most important reason
If the respondent says, "Other specify" (96) - capture verbatim response. Do not back-code. READ. ONLY ONE MENTION

Simple mention question
[ASK IF CHDFLU_070=02]
CHDFLU_072
When you say, "The flu vaccine does not work", would you say that is because…:

INTERVIEWER INSTRUCTIONS:
If the respondents say, 'all of the above', prompt them to pick, among those, the most important reason
If the respondent says, "Other specify" (96) - capture verbatim response. Do not back-code. READ. ONLY ONE MENTION

Simple mention question
[ASK IF CHDFLU_070=03]
CHDFLU_073
When you say, "You did not get around to it", would you say that is because…:

INTERVIEWER INSTRUCTIONS:
If the respondents say, 'all of the above', prompt them to pick, among those, the most important reason
If the respondent says, "Other specify" (96) - capture verbatim response. Do not back-code. READ. ONLY ONE MENTION

Simple mention question
[ASK IF CHDFLU_070=04]
CHDFLU_074
When you say, "You have concerns about the flu vaccine, and/or its side effects", would you say your concern is about …:

INTERVIEWER INSTRUCTIONS:
If the respondents say, 'all of the above', prompt them to pick, among those, the most important reason
If the respondent says, "Other specify" (96) - capture verbatim response. Do not back-code. READ. ONLY ONE MENTION

Section info
ADULT VACCINATION - OTHER
INTERVIEWER SCRIPT:
This section, we will ask questions about you again, but this time about diseases other than the flu.

Simple mention question
[ASK ALL]
ADTPNE_010
As an adult, have you ever had the pneumococcal vaccine, which protects against pneumonia?

INTERVIEWER INSTRUCTIONS:
Clarification, if asked: This vaccine might also be called Prevnar-13, or Pneumovax-23

Pronunciations:

READ. ONLY ONE MENTION

Simple mention question
[ASK IF ADTPNE_010= 1, and ADTDEM_010≥ 65]
ADTPNE_020
How old were you when you received your most recent pneumococcal vaccine?

INTERVIEWER INSTRUCTIONS:
Pronunciations:
Pneumococcal (noo-muh-kok-uhl)
READ. ONLY ONE MENTION

Multiple mentions question
[ASK IF ADTPNE_010 =00]
[MENTIONS MULTIPLES: Max=10]
ADTPNE_030
What are the reasons that you have not had the pneumococcal vaccine?

INTERVIEWER INSTRUCTIONS:
Pronunciations:
Pneumococcal (noo-muh-kok-uhl)
DO NOT READ. MULTIPLE ANSWERS ALLOWED
Select all that apply

Simple mention question
[ASK ALL]
ADTSHZ_010
As an adult, have you ever had the shingles vaccine?

INTERVIEWER INSTRUCTIONS:
Clarification, if asked: Shingles is also known as herpes zoster. This vaccine might also be called Shingrix, or Zostavax

Pronunciations:

READ. ONLY ONE MENTION

Multiple mentions question
[ASK IF ADTSHZ_010=00]
[MENTIONS MULTIPLES: Max=10]
ADTSHZ_020
What are the reasons that you have not had the shingles vaccine?

INTERVIEWER INSTRUCTIONS:
Pronunciations:
Shingles (shing-guh lz)
DO NOT READ. MULTIPLE ANSWERS ALLOWED
Select all that apply

Simple mention question
[ASK ALL]
ADTTET_010
Within the last ten years, have you had the tetanus vaccine?

INTERVIEWER INSTRUCTIONS:
Clarification, if asked: This vaccine might also be called Adacel, Boostrix, Tdap or Td Adsorbed

Pronunciations:

READ. ONLY ONE MENTION

Multiple mentions question
[ASK ADTTET_010=0]
[MENTIONS MULTIPLES: Max=10]
ADTTET_020
What are the reasons that you have not had the tetanus vaccine?

INTERVIEWER INSTRUCTIONS:
Pronunciations:
Tetanus (tet-n-uh s)
DO NOT READ. MULTIPLE ANSWERS ALLOWED
Select all that apply

Simple mention question
[ASK ADTTET_010=1]
ADTTET_030
Some tetanus vaccines also protect against pertussis, or whooping cough. This vaccine can be called Tdap, Adacel or Boostrix. Is this the vaccine you got?

INTERVIEWER INSTRUCTIONS:
Pronunciations:

READ. ONLY ONE MENTION

Simple mention question
[ASK IF ADTTET=0, OR IF ADTTET_030 DOES NOT =1]
ADTPER_010
As an adult, have you had the pertussis vaccine? Pertussis is also known as whooping cough.

INTERVIEWER INSTRUCTIONS:
Clarification, if asked: This vaccine can be called Tdap, Adacel or Boostrix

Pronunciations:

READ. ONLY ONE MENTION

Multiple mentions question
[ASK IF ADTPER_010=00]
[MENTIONS MULTIPLES: Max=10]
ADTPER_020
What are the reasons that you have not had the pertussis vaccine?

INTERVIEWER INSTRUCTIONS:
Pronunciations:
Pertussis (per-tuh-sis)
DO NOT READ. MULTIPLE ANSWERS ALLOWED
Select all that apply

Section info
HEALTH STATUS
INTERVIEWER SCRIPT:
In this next section, I will ask you a few general questions about your health.

Simple mention question
[ASK ALL]
ADTHLT_010
On a scale of one to five, with one being poor and five being excellent, how would you rate your health?

INTERVIEWER INSTRUCTIONS: READ. ONLY ONE MENTION

Multiple mentions question
[ASK ALL]
[MENTIONS MULTIPLES: Max=12]
[ORDRE DE LA LISTE : En ordre]
ADTCMC_010
Are you currently suffering from or being treated for any of the following conditions? Indicate only conditions that have been diagnosed.

INTERVIEWER INSTRUCTIONS: (READ LIST - MULTIPLE ANSWERS ALLOWED)
Please select all that apply.

Single mention question
[ASK ALL]
ADTHLT_020
Do you have a regular family doctor, general practitioner or nurse practitioner?

INTERVIEWER INSTRUCTIONS: READ LIST. ONLY ONE MENTION

Single mention question
[ASK IF ADTHLT_020=1]
ADTHLT_030
Since September 1, 2018, have you seen your family doctor, general practitioner or nurse practitioner?

INTERVIEWER INSTRUCTIONS: READ LIST. ONLY ONE MENTION

Simple mention question
[ASK IF ADTHLT_030=1]
ADTHLT_040
Did your family doctor, general practitioner or nurse practitioner recommend that you get the flu vaccine?

INTERVIEWER INSTRUCTIONS:
READ. ONLY ONE MENTION

Single mention question
[ASK ALL]
ADTHLT_050
This flu season, have you had the flu?

INTERVIEWER INSTRUCTIONS:
If asked: "This flu season" means September 1, 2018 to now
If asked: flu refers to influenza, which is different from a stomach flu (i.e. gastrointestinal illness) READ LIST. ONLY ONE MENTION

Single mention question
[ASK IF ADTHLT_050=1]
ADTHLT_051
Would you say that you had a severe, moderate or mild case of the flu?

INTERVIEWER INSTRUCTIONS:
Clarifications, if asked: A severe case might include hospitalization or pneumonia. A mild case might include sudden onset of high fever, chills, sore throat, cough or muscle pain.
DO NOT READ LIST. ONLY ONE MENTION

Single mention question
[ASK ALL]
ADTHLT_060
Not including this flu season, have you ever had the flu?

INTERVIEWER INSTRUCTIONS:
If asked: "This flu season" means September 1 2018 to now
If asked: flu refers to influenza, which is different from a stomach flu (i.e. gastrointestinal illness).
READ LIST. ONLY ONE MENTION

Single mention question
[ASK IF ADTHLT_060=1]
ADTHLT_061
Thinking about the worst flu you ever had, not including this flu season, would you say you had a severe, moderate or mild case of the flu?

INTERVIEWER INSTRUCTIONS:
Clarifications, if asked: A severe case might include hospitalization or pneumonia. A mild case might include sudden onset of high fever, chills, sore throat, cough or muscle pain.
DO NOT READ LIST. ONLY ONE MENTION

Section info
QSCTDEMO
INTERVIEWER SCRIPT:
The next questions are for statistical purposes only. It will allow us to group your answers with those of other similar respondents.

Single mention question
Scola
[ASK ALL]
[ORDRE DE LA LISTE : En ordre]
ADTDEM_040
First, what is the highest level of formal education that you have completed?

INTERVIEWER INSTRUCTIONS: (DO NOT READ LIST. ONLY ONE ANSWER)

Single mention question
Reven
[ASK ALL]
[ORDRE DE LA LISTE : En ordre]
ADTDEM_050
Which of the following categories best describes your total household income? That is, the total income of all persons in your household combined, before taxes.

INTERVIEWER INSTRUCTIONS: (READ LIST UP TO CATEGORY THAT RESPONDENT SELECTS. ONE MENTION POSSIBLE.)

Simple mention question
[ASK ALL]
ADTDEM_060
Were you born in Canada?

INTERVIEWER INSTRUCTIONS: (DO NOT READ LIST. ONLY ONE MENTION)

Simple mention -open
[ASK IF ADTDEM_060=0]
ADTDEM_070
In which country were you born?

INTERVIEWER INSTRUCTIONS: (DO NOT READ LIST. ONLY ONE MENTION)

Numerical question
[ASK IF ADTDEM_060=0]
[NUMERIC: BORNES Min=1, Max=100]
ADTDEM_080
How many years have you been living in Canada?

INTERVIEWER INSTRUCTIONS: (RECORD NUMBER OF YEARS.)

Thank you for your participation.