19 to Zero adopts a multimodal and interdisciplinary research approach to guide interventions aimed at improving vaccine confidence and tackling the COVID-19 pandemic

Research & Insights

Since August 2020, the 19 to Zero research team has conducted a number of mixed-method studies to understand Canadian’s attitudes and behaviours towards COVID-19 public health measures and vaccinations. Our goal is to disseminate our research findings as quickly as possible, using a variety of avenues, including academic publications and public media.

We have created ‘concern archetypes,’ or general demographic trends that correlate with patterns of COVID-19-related attitudes and behaviours based on survey data from 2,000 Canadians. This allowed for an evidence-based approach to target segments of the population that demonstrated low concern or low prosocial behaviours with regards to COVID-19. 19 to Zero has engaged over 160,000 voices in research through surveys, interviews, and focus groups since December 2020. Further, 19 to Zero has published four original research studies in peer-reviewed journals, and presented at three peer-reviewed conferences. These research activities inform 19 to Zero’s ongoing strategies for enhancing vaccine confidence.

Research Findings: Four Effects to Promote Behaviour Change
Traditional Primary Research

Since March 2020, we have engaged over 150,000 Canadians to hear their perspectives during the COVID-19 pandemic.

To understand Canadians' perspectives, attitudes, and awareness of vaccines, we engage directly with individuals through nation-wide surveys and community-based focused groups. This work allows us to understand sentiments towards a variety of public health topics such as:

  • Vaccine hesitancy

  • Brand preferences

  • Public health measures such as lockdowns or masking

  • Re-opening

  • Rapid testing

  • Vaccination site preferences (e.g. pharmacies)

  • Government approval

  • Concern about COVID-19

We also explore the nuance of how demographic, geographic, and psychographic factors can impact Canadians' views towards topics related to COVID-19.

Through our primary research workstreams, we also test each of our interventions with communities and the general public to ensure they are effective, accessible, and culturally-relevant.

If you are interested in learning more about our findings, please contact us at

COVID-19 Interactive Dashboard

The 19 To Zero Social Media Analytics team uses machine learning and natural language processing algorithms to track COVID-19 behaviours and vaccine sentiment on social media across North America.

Social Media Analytics

Conversations on COVID-19 vaccination on social media are structured as social networks. Through social media network analysis, we can understand better how vaccine hesitant and confident groups interact with each other, identify key influencers in each group, and isolate more easily the extent of vaccine hesitancy conversations on digital platforms, such as Twitter.

Network analysis map.png

COVID-19 Network Analysis Maps

The figure shown above reproduces a retweet network of COVID-19 vaccination conversation on twitter between April 10, 2021 and April 16, 2021. Overall, this network map represents 771,748 individual accounts and 1,592,188 specific tweets. 


Through community detection algorithms, we can parse the structure of these networks. Here we find that accounts most associated with vaccine hesitant accounts (in red) represent approximately 15-25% of the conversation. Vaccine confident networks appear to structure itself around national groups: US, UK, India, etc.

COVID19 Vaccine Trends.png

COVID-19 Social Media Trends

Using deep-learning modeling of natural language processing, we analyze on a weekly basis the nature of the conversations in vaccine hesitant and vaccine confident networks. We find, in general and consistently since November 2020, that vaccine hesitancy is fueled by mistrust in institutions, government, pharmaceutical companies, health authorities, highlight the deeply political nature of COVID-19 vaccination. Concern for vaccine safety is usually the second most important topic. 

Vaccine confident networks are mostly concerned about vaccine logistics, often criticizing institutions for the slow roll out, or lack of vaccine accessibility, in some countries


  1. Benham JL, Lang R, Kovacs Burns K, MacKean G, Leveille T, McCormack B, Sheikh H, Fullerton MM, Tang T, Boucher JC, Constantinescu C, Mourali M, Oxoby RJ, Manns BJ, Hu J, Marshall DA. (2021). Attitudes, current behaviours and barriers to public health measures that reduce COVID-19 transmission and what can motivate change: A qualitative study to inform public health messaging. PLoS One. 16(2):e0246941.

  2. Raynell L, Benham JL, Atabati O, Hollis A, Tombe T, Shaffer B, Kovacs Burns K, MacKean G, Léveillé T, McCormack B, Sheikh H, Fullerton MM, Tang T, Boucher JC, Constantinescu C, Mourali M, Manns BJ, Marshall DA, Hu Ju, Oxoby RJ. (2021). Attitudes, Behaviours and barriers to public health measures for COVID-19: a survey to inform public health messaging. BMC Public Health. Apr;21(1):765. DOI: 10.1186/s12889-021-10790-0.

  3. Boucher JC, Cornelson K, Benham JL, Fullerton MM, Tang T, Constantinescu C, Mourali M, Oxoby RJ, Marshall DA, Hemmati H, Badami A, Hu J, Lang R. (2021). Analyzing Social Media to Explore the Attitudes and Behaviors Following the Announcement of Successful COVID-19 Vaccine Trials: Infodemiology Study. JMIR Infodemiology. 12;1(1):e28800. doi: 10.2196/28800.

  4. Desveaux L, Savage RD, Tadrous M, Kithulegoda N, Thai K,  Stall NM, Ivers NM. (2021). Beliefs associated with Intentions of Non-Physician Healthcare Workers to Receive the COVID-19 Vaccine in Ontario, Canada. BMC Public Health. 

Manuscripts Under Review

  1. Attitudes and beliefs toward COVID-19 public health measures: a national cross-sectional survey

  2. Attitudes and beliefs toward COVID-19 vaccine: a national cross-sectional survey

  3. Attitudes and beliefs toward contact tracing app: a national cross-sectional survey

  4. COVID-19 Public Health Messaging: Challenges and Recommendations for Discussing Public Health Measures and Vaccination 

Select Data Samples