When volunteers with the South Asian Health Network in the Toronto and Peel area wanted to get their community vaccinated against COVID-19, they hit the phones.
“We actually did tons of cold-calling,” said Sabina Vohra-Miller, co-founder of the organization. “We cold-called businesses in the area because we knew that [they] had precarious employment and we’d call them up and we’d encourage the businesses to allow their employees to go get vaccinated.”
The team wrote and signed letters showing proof of employment for people to take with them to the vaccine clinic, when many were only giving shots to people who lived or worked in the area, she said.
She said this kind of extra effort was necessary for “breaking down barriers of accessibility” and getting people vaccinated.
“These are not the people on Twitter following Vaccine Hunters Canada, trying to figure out their neighbourhood pop-ups.”
Many of the people the health network contacted had no idea there was a pop-up vaccine clinic nearby, she said, even if it was just a kilometre or two from their homes.
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Extraordinary measures like this might be required to reach the remaining roughly 20 per cent of eligible Canadians who have yet to receive a first dose of COVID-19 vaccine, experts say.
While Canada continues to dole out vaccines at a breathtaking pace, the vast majority of those are now second doses – meaning that the percentage of Canadians who have no vaccine protection at all is hardly budging.
According to data from the Public Health Agency of Canada, 66 per cent of Canadians had at least one dose of vaccine as of June 19. A week later on June 26, that number had grown to only 67 per cent.
A new study released Friday from Statistics Canada showed that most Canadians intended to get the COVID-19 vaccine, even if they hadn’t gotten it yet at the time of the survey, in mid-May. More than 90 per cent of those who hadn’t received a shot wanted one, the survey found.
Staunch anti-vaxxers are a relatively small group in Canada – accounting for only about two or three per cent of people, said Ève Dubé, a medical anthropologist who works at the Quebec National Institute of Public Health and an invited professor at Laval University. A slightly larger group might be called “vaccine hesitant”: they have questions or fears, but they can be convinced to get vaccinated, she said.
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Direct consultations with care providers are a great way to reach this group, she said, as is addressing their specific concerns.
“The more you understand what makes people tick and the more you address these concerns within your communication strategy, the more effective they will be,” she said.
However, the majority of unvaccinated people aren’t especially hesitant, she thinks, they just haven’t gotten the shot because of other issues, like not being able to easily access appointments or simple complacency.
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In Alberta, some rural communities have lower vaccination rates, said Dr. Gabriel Fabreau, a general internist and assistant professor at the University of Calgary.
Within Calgary itself, he said, some lower-income neighbourhoods have lower rates of vaccination than more affluent parts of the city.
“That’s worrisome because that’s the group or those are the communities that have faced the highest rates of COVID throughout the entire pandemic and also experienced the worst outcome,” he said.
At clinics in these areas, “it was remarkable to me that vaccine hesitancy was not the issue. It was reducing barriers and making it as easy as possible for people,” Fabreau added.
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Measures like extending clinic hours, making sure people didn’t have to drive or take transit to get their vaccines and bringing vaccines directly to workplaces – like a Calgary team did to bring shots to local meat plants – will help to reach these populations, he says.
Big enclosed workplaces like meat-packing plants and warehouses have had many outbreaks over the course of the pandemic, so Fabreau says it’s especially important to get people vaccinated there.
“It’s just logical to try to bring the firefighters to where the fires are.”
Reaching out to immigrant communities, who might face language barriers or who have precarious employment that they can’t take time away from to get vaccinated, is also important, says Vohra-Miller.
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Young people are another area of concern – with vaccination rates in younger age groups lagging behind older ones.
Canada’s chief public health officer, Dr. Theresa Tam, said at a press conference Thursday that she is particularly concerned about young people.
“They are a group that has more social mixing and are also connected to the other higher-risk populations as well, who, even with 80 per cent vaccine coverage, are not necessarily entirely protected,” she said. “And so it is very important to try and get as much vaccines into arms, as it were, for that group.”
Focusing on reaching employers, community groups and engaging people on social media will help to do this, she said. Even having the ability to travel internationally – as other countries require proof of vaccination to enter – could become an incentive, she thinks.
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While she notes that it can cause a backlash, Dubé thinks that “vaccine passports” – where you need to show proof of vaccination to attend a concert or eat indoors at a restaurant – can be a helpful incentive for some groups. “I think it’s really effective for those who might be complacent,” she said.
Whatever the method, it’s clear that the final few percentage points of people will require more effort to reach than the first people to be vaccinated, Dubé said.
“I think reaching 95 per cent, 93 per cent of the population vaccinated is possible, but it needs a lot of effort and it needs a lot of diverse strategies, especially when you get closer to this level.”
“It’s a bit like running a marathon. It’s not the first kilometres that are hard to run. It’s the last one.”
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