Vancouver Region Research Articles

To cool or not to cool: understanding and improving cooling centre use in metro vancouver through community-based participatory action research

Abstract Extreme heat events present significant health risks, particularly for populations facing systemic marginalization. Through interviews and focus groups with 63 (n=60 residents; n=3 service providers) participants, this paper explores the barriers and opportunities related to access and use of cooling centres from both user and provider perspectives, as well as broader implications for addressing vulnerability to extreme heat in the metro Vancouver region of British Columbia, Canada. Initially focused on cooling centres, our research expanded to include the complexities of individual and systemic responses to heat, highlighting the complex interplay between personal preferences and structural barriers. Key barriers to cooling centre usage reported by participants included concerns over safety, hygiene, stigma, lack of information, and infrastructural challenges such as transportation. Service providers faced constraints with staffing, limited hours, and underutilization of additional services. Tensions emerged between individual, do-it-yourself (DIY) approaches and collective solutions, with participants seeking agency in their choices while acknowledging the need for improved, community-based interventions. The study also uncovered the unintended effects of inclusivity, as the presence of individuals who use substances or are unhoused in cooling spaces deterred some potential users, underscoring the challenges of designing universally accessible services. Broader systemic issues, such as housing security and the quality of indoor environments, further intersected with vulnerability to extreme heat, exacerbating risks for those opting to stay at home. The paper recommends leveraging existing public spaces, enhancing social networks, improving tenant protections, and fostering ‘right to cool’ initiatives to balance immediate relief with long-term systemic reform, particularly around the rental housing crisis and tenant insecurity. By addressing both individual and collective needs, this approach can mitigate the health impacts of extreme heat while promoting greater equity and resilience.

Accumulation by repossession: Capitalist settler colonialism in Coast Salish territory

Several Coast Salish First Nations are actively involved in land reclamation and redevelopment in the greater Vancouver region (Canada). Through their for-profit development corporations, entities like Nch’ḵay̓ Development Corporation (Squamish Nation) and the joint-venture Musqueam, Squamish and Tsleil-Waututh Development Corporation have become key players in the lucrative Vancouver property market in partnership with other public and private land developers. Situating multibillion-dollar holdings like the Jericho and Sen̓áḵw projects that further highest-and-best-use appraisal within the context of the area’s settler colonial history, we argue that land repossession and its associated development was made possible through settler colonial forms like corporate decisions, legal judgements and political frameworks that rendered land ready for disposal. Repossession thus created options for new types of reintegration into capitalist spheres, primarily as residential real estate projects, independent from specific configurations of land tenure as fee simple or reserve land. Advancing the concept of ‘accumulation by repossession,’ a recursive moment associated with dispossession, we describe how First Nations peoples are regaining land title and political-economic control at the same time as their development corporations are promoting urban capital accumulation through privatized profit-making. Land ‘improvement’, speculation, and the creation of private real property have driven Indigenous dispossession in Coast Salish territory just as they now shape repossession.

Local honey reflects environmental changes in metal concentrations and lead isotope ratios during COVID-19 restrictions in Brussels, Belgium, and Vancouver, Canada.

Effective methods for measuring sudden environmental changes are crucial for understanding how cities respond to shifts in human activity. This study examines atmospheric metal outputs during the COVID-19 restrictions using honey samples collected from three land use types in Brussels Capital Region (BCR), Belgium, and Metro Vancouver Regional District (MVRD), Canada to study changes as the result of restrictions. By comparing these cities with distinct sizes, ages, and structures, we assess how urban environments responded to pandemic-induced restrictions. We present honey samples, analyzed for metal concentration and Pb isotope ratios, to provide insights into the impacts of reduced human activity in different land use types. In BCR, significant increases of Al, Cd, Cr, Cu, Fe, Ni, Pb, Ti, and V were observed in suburban sites, while in MVRD, significant decreases of Cr, Pb, Sb, Ti, and V were observed in suburban sites. The increase in metal concentrations in BCR suburban sites indicates a shift in metal emission patterns due to changes in human activity during the restrictions. Conversely, the decrease in metal concentrations in MVRD suburban areas aligns with expectations of reduced pollution during restrictions. Pb isotope ratios of BCR vary more widely and do not show any spatial trends by land use, suggesting that Pb concentrations in BCR may be more homogenized. In MVRD, significant differences in 208Pb/206Pb were observed during the restrictions, wherein honey sampled from rural sites had more radiogenic (lower 208Pb/206Pb) Pb isotope ratios. This difference suggests that honey may be more sensitive to Pb isotope ratio changes in environments with a less extensive history of metal use, such as rural British Columbia. This research demonstrates the potential of honey as a biomonitor for sudden environmental shifts. This study contributes to a global geochemical honey database, enabling tracking of environmental trends across diverse urban settings worldwide.

Whole-genome sequencing of Western Canadian Borrelia spp. collected from diverse tick and animal hosts reveals short-lived local genotypes interspersed with longer-lived continental genotypes.

Changing climates are allowing the geographic expansion of ticks and their animal hosts, increasing the risk of Borrelia-caused zoonoses in Canada. However, little is known about the genomic diversity of Borrelia from the west of the Canadian Rockies and from the tick vectors Ixodes pacificus, Ixodes auritulus and Ixodes angustus. Here, we report the whole-genome shotgun sequences of 51 Borrelia isolates from multiple tick species collected on a range of animal hosts between 1993 and 2016, located primarily in coastal British Columbia. The bacterial isolates represented three different species from the Lyme disease-causing Borrelia burgdorferi sensu lato genospecies complex [Borrelia burgdorferi sensu stricto (n=47), Borrelia americana (n=3) and Borrelia bissettiae (n=1)]. The traditional eight-gene multi-locus sequence typing (MLST) strategy was applied to facilitate comparisons across studies. This identified 13 known Borrelia sequence types (STs), established 6 new STs, and assigned 5 novel types to the nearest sequence types. B. burgdorferi s. s. isolates were further differentiated into ten ospC types, plus one novel ospC with less than 92 % nucleotide identity to all previously defined ospC types. The MLST types resampled over extended time periods belonged to previously described STs that are distributed across North America. The most geographically widespread ST, ST.12, was isolated from all three tick species. Conversely, new B. burgdorferi s. s. STs from Vancouver Island and the Vancouver region were only detected for short periods, revealing a surprising transience in space, time and host tick species, possibly due to displacement by longer-lived genotypes that expanded across North America.This article contains data hosted by Microreact.

Recovery of Intertidal Mussel Stands Three Years after the Severe 2021 Heatwave in British Columbia, Canada

In the early summer of 2021, an intense heatwave killed millions of intertidal mussels in British Columbia, Canada. Using photographs taken three years later (June 2024), this article provides visual evidence of active recovery of intertidal mussel stands in the Vancouver region, revealing the resilience of these intertidal systems. Future monitoring should evaluate their ability for long-term persistence in light of the ongoing climate change, which is expected to increase the frequency and intensity of heatwaves.

Visible minority status and occupation were associated with increased COVID-19 infection in Greater Vancouver British Columbia between June and November 2020: an ecological study.

The COVID-19 pandemic has highlighted health disparities, especially among specific population groups. This study examines the spatial relationship between the proportion of visible minorities (VM), occupation types and COVID-19 infection in the Greater Vancouver region of British Columbia, Canada. Provincial COVID-19 case data between June 24, 2020, and November 7, 2020, were aggregated by census dissemination area and linked with sociodemographic data from the Canadian 2016 census. Bayesian spatial Poisson regression models were used to examine the association between proportion of visible minorities, occupation types and COVID-19 infection. Models were adjusted for COVID-19 testing rates and other sociodemographic factors. Relative risk (RR) and 95% Credible Intervals (95% CrI) were calculated. We found an inverse relationship between the proportion of the Chinese population and risk of COVID-19 infection (RR = 0.98 95% CrI = 0.96, 0.99), whereas an increased risk was observed for the proportions of the South Asian group (RR = 1.10, 95% CrI = 1.08, 1.12), and Other Visible Minority group (RR = 1.06, 95% CrI = 1.04, 1.08). Similarly, a higher proportion of frontline workers (RR = 1.05, 95% CrI = 1.04, 1.07) was associated with higher infection risk compared to non-frontline. Despite adjustments for testing, housing, occupation, and other social economic status variables, there is still a substantial association between the proportion of visible minorities, occupation types, and the risk of acquiring COVID-19 infection in British Columbia. This ecological analysis highlights the existing disparities in the burden of diseases among different visible minority populations and occupation types.

Identification of Neighborhood Hotspots via the Cumulative Hazard Index: Results From a Community-Partnered Low-Cost Sensor Deployment.

The Strathcona neighborhood in Vancouver is particularly vulnerable to environmental injustice due to its close proximity to the Port of Vancouver, and a high proportion of Indigenous and low-income households. Furthermore, local sources of air pollutants (e.g., roadways) can contribute to small-scale variations within communities. The aim of this study was to assess hyperlocal air quality patterns (intra-neighborhood variability) and compare them to average Vancouver concentrations (inter-neighborhood variability) to identify possible disparities in air pollution exposure for the Strathcona community. Between April and August 2022, 11 low-cost sensors (LCS) were deployed within the neighborhood to measure PM2.5, NO2, and O3 concentrations. The collected 15-min concentrations were down-averaged to daily concentrations and compared to greater Vancouver region concentrations to quantify the exposures faced by the community relative to the rest of the region. Concentrations were also estimated at every 25m grid within the neighborhood to quantify the distribution of air pollution within the community. Using population information from census data, cumulative hazard indices (CHIs) were computed for every dissemination block. We found that although PM2.5 concentrations in the neighborhood were lower than regional Vancouver averages, daily NO2 concentrations and summer O3 concentrations were consistently higher. Additionally, although CHIs varied daily, we found that CHIs were consistently higher in areas with high commercial activity. As such, estimating CHI for dissemination blocks was useful in identifying hotspots and potential areas of concern within the neighborhood. This information can collectively assist the community in their advocacy efforts.

THE ROLE OF THE NEIGHBORHOOD-BUILT ENVIRONMENT ON OUTDOOR MOBILITY OF PEOPLE LIVING WITH DEMENTIA

Abstract Dementia-friendly communities (DFCs) aim to foster a supportive, inclusive and empowering environment that promotes equal rights and resources for people living with dementia and their care partners. Central to DFCs is promoting access and navigation of outdoor spaces and destinations in the neighbourhood. While there is a growing interest and uptake of DFCs in policy and practice, there is scarce empirical evidence on the role of the built environment on mobility and navigation for people living with dementia. The “Dementia-inclusive Spaces for Community Access, Participation, and Engagement (DemSCAPE)” study aims to identify spatial and temporal patterns in activities undertaken outside home by people living with dementia, and ways in which the neighbourhood built environment affects their outdoor mobility and social participation. A series of sit-down and video-and-photo-documented walk-along interviews were conducted with 26 participants who are living with (mild to moderate) dementia or mild cognitive impairment in the Metro Vancouver region of British Columbia, Canada. Findings shed light on how people living with dementia understand and navigate the neighbourhood environment, and features that prompt recall of routes, places, and events, and support orientation and wayfinding. Findings also underscore the importance of participants’ awareness of barriers and obstacles in their neighbourhood, and how they cope with challenges and demands encountered while walking outside. The study offers planners and designers awareness and insights into the lived experience of navigating the neighbourhood environment with the condition of dementia and guidance on adopting a dementia-friendly and inclusive approach in policy and practice.

Assessing the Mpox and Infection Prevention and Control Knowledge of Personal Service Establishments' Operators in Metro Vancouver Regional District of British Columbia

Mpox virus, formerly known as the Monkeypox virus, is a re-emerging pathogen that causes the infectious disease Mpox. Mpox was designated as a public health emergency of international concern by the World Health Organization due to its rapid spread outside West and Central Africa. Personal service establishments (PSEs) could be a setting for exposure to Mpox because some of their services involve direct contact with their patrons. The aim of this research was to investigate the infection prevention and control (IPAC) and Mpox knowledge levels among PSE operators and to determine the associations between IPAC knowledge, Mpox knowledge, years of experience, and point-of-service risk assessment

Identifying profiles of ride-sourcing users in the Metro Vancouver Region for a better understanding of ride-sourcing behaviour

Ride-sourcing has the potential to attract demand from more sustainable modes, alter activity patterns, and worsen congestion; however, it can also help increase the mobility and accessibility of those who cannot drive. Understanding how and why these services are used can help inform policies that address the negative externalities of these services while taking advantage of their benefits. This study examines the use of ride-sourcing services, which were introduced just before the COVID-19 pandemic, in the Metro Vancouver Region. Using data from a web-based survey, this study applies latent class cluster analysis to identify profiles of ride-sourcing users based on the purposes for which they use ride-sourcing. To the authors’ knowledge, this is only the second study to identify latent segments of ride-sourcing users and the first to do so based on the purposes of their ride-sourcing trips. Additionally, the decision to use ride-sourcing and the profile to which an individual belongs are jointly modelled using a two-stage multinomial logistic regression model. The results suggest the impacts of ride-sourcing use on other modes and the frequency of ride-sourcing use may differ based on the profile to which the user belongs. Besides, the findings of this study highlight the influence of socio-demographic attributes, the use of other shared mobility services, and attitudinal factors on the utilization of ride-sourcing. This study aims to contribute to the literature by offering further insights into the heterogeneity among ride-sourcing users, which can help inform a more targeted approach to addressing the negative externalities of these services.

Effectiveness of landscape indicators for explaining the variability of benthic macro-invertebrates in urban streams

Landscape indicators – measures of land use and land cover – are widely used as proxies for monitoring urban stream conditions, particularly for benthic invertebrates which are often negatively impacted by watershed urbanization. However, multi-scale and nonlinear relationships between benthic macroinvertebrates and landscape configuration derived from fine spatial resolution land cover are not well explored. Here, we developed a series of landscape indicators and assessed their effectiveness in explaining the variability of benthic macroinvertebrate communities in 63 streams across the Greater Vancouver Region in British Columbia, Canada. We asked: 1) How effective are multi-scale landscape indicators in explaining the variability of instream benthic macroinvertebrates? 2) Does the explanatory power of landscape indicators vary at different spatial scales? 3) Do different urban forest classification schemes and their spatial configurations impact the explanatory power of landscape indicators? We developed high spatial resolution (5-m) landscape indicators and evaluated their utility in statistical models explaining taxa richness, instream benthic indices of biological integrity (B-IBI), % Ephemeroptera, Plecoptera, and Trichoptera (EPT), and % Oligochaetes. For all benthic responses, landscape indicators measured at the watershed scale explained 5–25% more variation than riparian-based indicators. Combining indicators mapped at multiple scales further improved the explanatory power of landscape indicators for % EPT and % Oligochaetes, ultimately explaining over 70% of the variability of benthic macro-invertebrates in streams. Distinguishing deciduous and coniferous forest types improved the explanatory power of landscape indicators in a riparian model for B-IBI by 10%. When considering the spatial arrangement of land cover, patch density of forests in the surrounding watersheds of stream explained as much as 47% of the variability in % Oligochaetes. Our results highlight the importance of investigating nonlinear relationships between benthic macroinvertebrates and landscape configuration. This monitoring approach is transferable across cities interested in maintaining the ecological health of urban streams while supporting urban expansion and growth.

Filamentous fungal associates of the alder bark beetle, Alniphagus aspericollis, including an undescribed species of Neonectria.

Bark beetles (Coleoptera: Curculionidae; Scolytinae) are tree-infesting insects that consume subcortical tissues and fungi. Species capable of killing their host trees are most commonly associated with conifers, as very few bark beetle species infest and kill hardwood hosts directly. The alder bark beetle, Alniphagus aspericollis, is a hardwood-killing bark beetle that colonizes and kills red alder, Alnus rubra. Conifer-killing bark beetles have well-known associations with symbiotic ophiostomatoid fungi that facilitate their life histories, but it is unknown whether A. aspericollis has any fungal associates. This study was conducted to identify any consistent filamentous fungal associates of A. aspericollis and characterize the consistency of observed beetle-fungus relationships. Beetles and gallery phloem samples were collected from seven sites throughout the Greater Vancouver region in British Columbia, Canada. Filamentous fungi were isolated from these samples and identified by DNA barcoding using the internal transcribed spacer (ITS) region and other barcode regions for resolution to the species-level for the most dominant isolates. The most common fungal associate was a previously undescribed Neonectria major-like fungus, Neonectria sp. nov., which was isolated from ~67% of adult beetles, ~59% of phloem samples, and ~94% of the beetle-infested trees. Ophiostoma quercus was isolated from ~28% of adult beetles, ~9% of phloem samples, and ~56% of infested trees and deemed a casual associate of A. aspericollis, while a putatively novel species of Ophiostoma was more infrequently isolated from A. aspericollis and its galleries. Cadophora spadicis, a new record for red alder, was rarely isolated and is probably coincidentally carried by A. aspericollis. Overall, A. aspericollis was only loosely associated with ophiostomatoid fungi, suggesting that these fungi have little ecological significance in the beetle-tree interaction, while Neonectria sp. nov. may be a symbiote of A. aspericollis that is vectored by the beetle.

The joint impact of environmental awareness and system infrastructure on e-waste collection

The prevailing literature on the design of reverse logistics networks for e-waste collection recognizes the accessibility of the collection sites as a key driver of the consumers’ return behavior. The propensity of a consumer to return an end-of-use or an end-of-life item, however, also depends on his/her sensitivity to environmental sustainability. In this paper, we study the impact of simultaneously determining the optimal density of a network of collection centers as well as the most appropriate level of investment in the public's environmental awareness. We adopt a Nerlove-Arrow-type advertising model to capture the potential influence of public awareness campaigns in increasing the consumers’ environmental sensitivity over time. The potential negative impact of the travel distance to the nearest collection site is also incorporated. Thus, we present a dynamic modeling framework for the joint design of the network infrastructure and the public campaign intensity. A case study is presented based on the operations of the Canadian E-Waste Stewardship Program in the Greater Vancouver region. We find that investments into environmental awareness can enable the take-back scheme to improve its collection rates significantly. Our findings through the case study also reveal that running an advance campaign prior to the launch of the collection network can be an effective strategy in most cases. In addition, we present an extended model, which highlights that increasing the investment in environmental awareness can be utilized as a lever to offset the impact of increased hauling costs.

Reaching into the Community to Interpret Labor History

Reaching into the Community to Interpret Labor History

The effect of season and urbanisation on Calliphoridae (Diptera) diversity in British Columbia, Canada, using baited traps

Abstract Forensic entomology is an important component of criminal investigations, providing information surrounding a death using region-specific data on the local necrophagous community. To understand the community within the Metro Vancouver region of British Columbia, Canada, a field study monitored the abundance and diversity of necrophagous Calliphoridae (Diptera) over a nine-month period in distinct terrestrial environments. Baited bottle traps (n = 9) were deployed weekly for 12-hour intervals in three different environments. Species, sex, and gravidity of collected specimens were determined. Bivariate analyses revealed significant relationships between species, geographic location, and month of collection, suggesting that Calliphoridae species composition is influenced by habitat type and seasonal shifts in temperature. Sex ratios and reproductive ranges of Calliphoridae differed among the habitats sampled.

Spatial policies for growth management in metropolitan regions. A comparison of U.S. American, Canadian and German approaches

Many metropolitan regions face concerns over sprawling development, increased costs of maintaining infrastructure, and loss of green space and farmland. Some metropolitan regions have intentionally created spatial policies to govern development patterns and manage growth within their region. This paper compares the spatial policies applied in three case studies: the Puget Sound region (Washington State, USA), Metro Vancouver region (British Columbia, Canada) and Stuttgart region (Baden-Württemberg, Germany). While all three regions share a vision that can broadly be summarised as transit-connected communities, each metropolitan planning organisation leverages a variety of spatial policies. Based on the unique planning cultures, various governmental actors take on different roles at the local, county, regional and state levels. This paper categorises and compares the multi-level responsibilities for defining, mapping, and implementing spatial policies. With this focus, the paper provides an international comparative perspective on approaches, context, and contents of multi-level growth management.

Climate action in urban mobility: personal and political transformations

Although many municipalities have climate action plans with targets and goals, effective climate action still faces significant implementation gaps. Implementation can falter due to barriers for the deployment of low-carbon solutions, as well as the lack of cultural, systemic, and psychological support for such solutions. Cultural drivers and perceptions shape citizens’ behaviors and can perpetuate carbon-intensive lifestyles. This paper focuses on measures in climate action planning in the Metro Vancouver region of Canada regarding transportation, which remains the largest single source of greenhouse gas emissions and has a low chance of reaching its emissions-reductions targets. Shifting towards greater sustainability will entail a challenge of transformative change, involving shifts in systems, behaviors, worldviews, and cultures. In implementation, the full complexity of the climate action challenge becomes most evident. A scoping review of climate action documentation and semi-structured interviews are used to examine (1) barriers to effective implementation, (2) socio-cultural perceptions and approaches to public engagement and (3) novel areas for transformational action. The study found a need to reweight the focus of climate action, which is predominantly set on techno-managerial efforts, also to include communication, narratives and broader systems change, which are the key barriers to low-carbon urban mobility. Practice relevanceTransportation remains a significant source of greenhouse gases and air pollutants in urban areas. To effectively shrink emissions, novel approaches are needed that go beyond technical fixes and view climate action as a challenge of transformative change. This study identifies the dominance of (1) practical, techno-managerial solutions, yet notes an inadequate focus brought to (2) the political restructuring of systems and developmental trajectories pertaining to mobility and (3) thepersonal aspects of social perceptions and culture. Recommendations are made about how to better account for the deeper human dimensions that present persistent barriers to climate action in transportation by reweighting the focus to include the personal and political spheres of transformation.

Examining the relationship between urban density and sense of community in the Greater Vancouver Regional District

This study investigated whether highly dense urban environments have a negative influence on residents' sense of community. It used an online survey to measure respondents' sense of community and compared it to the density of the areas in which they live. Findings of this study suggest that urban density has a negative but weak relationship with sense of community among survey respondents. They also suggest that providing some types of public space may encourage higher levels of sense of community among residents in high-density areas.

An Intervention to Increase Outdoor Play in Early Childhood Education Centers (PROmoting Early Childhood Outside): Protocol for a Pilot Wait-list Control Cluster Randomized Trial

BackgroundParticipation in outdoor play has been extensively documented as beneficial for the health, well-being, and development of children. Canadian early childhood education centers (ECECs) are important settings in young children’s lives and provide opportunities to participate in outdoor play. However, there are barriers to the provision of outdoor play opportunities at ECECs, such as adverse weather conditions, poorly designed outdoor spaces, outdoor time policies, and early childhood educator comfort levels.ObjectiveThe PROmoting Early Childhood Outside (PRO-ECO) study is a wait-list control cluster randomized trial that evaluates the impact of the PRO-ECO intervention, an innovative outdoor play intervention, on children’s outdoor play behavior. The purpose of this paper was to provide a detailed overview of the pilot study protocol and the methods that will be used to develop, implement, and evaluate the PRO-ECO intervention.MethodsA total of 8 ECECs delivering licensed care to children aged 2.5 to 6 years in the Greater Vancouver region of British Columbia, Canada, and operated by the YMCA of Greater Vancouver (YMCA GV) are included in this study. Using a wait-list control cluster randomized trial design, we randomly allocated ECECs to either the PRO-ECO intervention arm (n=4) or the wait-list control arm (n=4). The primary outcome measures include changes in the proportion and diversity of observed outdoor play behavior during dedicated outdoor times at the ECECs as measured through observational behavior mapping. Secondary outcome measures include changes in educator attitudes; quality of ECECs’ outdoor play space; and children’s psychosocial strengths, physical activity levels, and social behaviors. A process evaluation of the acceptability of the PRO-ECO intervention in the 8 YMCA GV ECECs will also be assessed. Outcome data will be collected at baseline, 6-month follow-up, and 12-month follow-up. Mixed effect models will test the effect of the PRO-ECO intervention on quantitative outcomes. Baseline and postintervention data will be included in the analysis, controlling for the cluster design. Qualitative data will support quantitative findings and provide evidence for the acceptability of implementation.ResultsParticipant recruitment for this study began in August 2021, and baseline data collection was completed at all 8 ECECs in November 2021. As of April 2022, a total of 130 children have been recruited to participate in this study.ConclusionsThe PRO-ECO pilot study will develop, implement, and evaluate the PRO-ECO intervention within 8 YMCA GV ECECs in the Vancouver region of British Columbia, Canada. The findings of this study will be useful for early childhood educators, ECEC providers, and policy makers to consider means for enhancing outdoor play provision and assessing the sustainability of the intervention in ECEC settings.Trial RegistrationClinicalTrials.gov NCT05075580; https://clinicaltrials.gov/ct2/show/NCT05073380International Registered Report Identifier (IRRID)DERR1-10.2196/38365

How do mothers’ vaccine attitudes change over time?

Although many interventions aim to reduce parents' hesitancy about childhood vaccinations, parents' experiences of vaccine attitude change trajectories remain underexplored. This constructivist grounded theory study examines trajectories of change in vaccine confidence and uptake among mothers in the Greater Vancouver region of Canada. Specifically, we explored what mothers identified as causes and facilitators to these changes, the processes involved, and how they experienced these changes in the contexts of their parenting lives. The study population comprised 23 mothers (mean age 41.3 years), each with at least one child aged 6–12 years. Nine (39%) had become more confident in vaccines, 10 (43%) more hesitant, and four (17%) experienced multiple changes over time. Trajectories of growing vaccine confidence were portrayed by participants as cognitive journeys, moving toward facts and away from fear, and influenced by a participant's growing knowledge and experience. Trajectories of increased hesitancy about vaccination involved underlying concerns about vaccines that were augmented by negative peer attitudes or negative personal experiences with vaccination or health care. In both trajectories, a mother's growing confidence as a parent was perceived as empowering her to make decisions over time. Mothers with multiple changes in vaccine attitudes either had hesitations about specific vaccines, which were allayed over time, or experienced negative vaccine reactions that caused them to pause, then later resume, vaccination.