Thousands of unvaccinated students head back to school, province has no new plan to boost rates

New Brunswick students head back to school today, resuming in-person classes, with thousands of them still unvaccinated against COVID-19, and a fourth wave driven by the highly transmissible delta variant looming.

Only about 60 per cent ofeligible youth are fully vaccinated, New Brunswick's overall vaccination rates have been slow to budgesince the province movedto the green phase of recovery with no restrictions, and the government has no new plans to boost rates.

In other jurisdictions, some innovative approaches have included targeting youth through gaming, going door-to-door to provide information and answer any questions, holding a back-to-school vaccination clinic at a mall,andoffering cash incentives or lotteries that award prizes to people who get vaccinated.

New Brunswick health officials are "strongly encouraging anyone who is unvaccinated to get vaccinated as soon as possible to help the province battle the next wave of COIVID-19," said Department of Health spokesperson Gail Harding.

In Montreal, Public Health has partneredwith Quebec's video game guild to launch a social media campaign aimed at youth and young adults.

Anyone aged 12 to 25 who receivesa vaccine between May 1 and Oct. 1 is invited to use the hashtag #GamerVaccin_eon social media. They will be entered in a draw to win scholarships totalling$25,000.

A video game-themed vaccination clinic will also be held at the Palais des Congrs Sept. 11-12. Televisions will broadcast live games sessions, entertainment will be provided and cosplayerswillhandout gifts.

Dr. Paul Le Guerrier, who is part of the team overseeing vaccination in the city, saidvaccination rates among young Montrealers arestill lagging.The hope is that by reaching out to the gaming community directly, the effort could galvanize a good portion of young people, he said.

Last week, Quebec's health minister urgedyoung people to get vaccinated, with the latest projections showing a rise in infections particularly in Montreal andLaval.

"Unfortunately, young people are the ones catching the virus these days and they stay in hospital longer. Their symptoms are worse because their immune systems go into overdrive,"Christian Dubsaid.

About 80 per cent of 12 to 17-year-olds across Quebec have a first dose of a COVID-19 vaccine.In Montreal, that number is only70 per cent.

Another Montreal initiativehas outreach workers knocking on doors, bringing information about vaccines and resources directly to people's homes.

Public Health workedwith the Red Cross to evaluate and target different sectors of the citybased on factors, such as vaccination rates andthe number of COVID cases, saidMartha Cadieux, a community organizer with the West Island CIUSSS.

It then worked with community organizations to create brigades to go door-to-door.

The goal is not to convince people to get vaccinated, said Cadieux,but to ensure people have accurate information and to answer any questions they might have.

"A lot of times what we found was people had misinformation. People wouldmention they were afraid of being microchipped. And also some people would say, 'Oh well, my neighbour told me I shouldn't get [the vaccine]because I have a heart condition.'"

The outreach workers, who are trained, can share what they know anddirect people to reliable sources for additional information, said Cadieux.

"I find sometimes people are hesitant because they haven't been able to talk about their fears," she said. "Oftentimes people will come up with the solution as they're speaking. So sometimes they'll be like, 'Oh, I'm really afraid of needles. I guess, you know, I'll go and get it over with. You know, what am I waiting for?'"

If people are afraidof needles, the outreach workers can walk them through special adaptations clinics can offer, such as havinga place for them to lay down, Cadieuxsaid. If they're worried about side effects, the outreach workers cantell them about their own experienceto help reassure them.

Sometimes, people just don't know where they can go to get their shot, or the services available to help make it easier for them, such as community organizationsthat offer free rides, she said. Sometimes, they're just so busy, they haven't taken the time to make an appointment.

So the outreach is usually co-ordinated with pop-up clinics in the area, said Cadieux.

"Ifthey're hesitant about doing something, if it's farther away, if it's complicated to do, there's a lot of excuses we can come up with. So by making it as simple as possible and just even addressing them directly, like, 'Did you know that we're here?'just that removes some of the barriers."

The week before a door-to-door campaign andpop-up clinic in theDuff Court area of LachineJuly 24-25,the rate of increase in vaccination coverage was one per cent for first doses and 4.7 per cent for second doses.

Afterward,the rates jumped to 2.3 per cent and 11.4 per cent respectively.

"You don't say, 'I'm going to reach hundreds of thousands of people,' but every single person that we can help and that we can offer the references to, it makes a difference to them," said Cadieux.

In Hamilton,Public Health Services partneredwith CF Lime Ridge Mallto hold a pop-up clinic last weekend, providing a "one-stop shop" for students and theirfamilies to get their back-to-school supplies and their shots, said Mayor Fred Eisenberger.The first 500 people to receive their first or second dose of a vaccine also received a$5 gift card for themall.

Last month, Hamilton Public Health partnered with the Hamilton Tiger-Cats to offerathree-day vaccination clinic at Tim Hortons Field; what Matt Afinec, the president of the professional football team, described as "unique setting and experience."

People who received a COVID-19 vaccine were able to watch theteampractise. They alsoreceived two free tickets to a Forge FC game, the local professional soccer club, and were entered into a raffle for a chance to win Ticats tickets.

Rebecca Hargot, who attended with her sonOwen, whorecentlyturned 12, thought holding the clinic at the stadium wasa "great way to bring people together" and encourage people to get vaccinated.

"People who are on the fence, if it takes some enticing, at least they're getting it done regardless."

A total of 430 doses were administered over the three days, said spokesperson James Berry.

Nearly another 400 doses were administered at a two-day after-hoursclinic held at the FirstOntario Centre, which includedprize draws, free food and free skating.

"We were very pleased with these results, and continue to explore other tools and creative partnerships to increase vaccine rates in our community," said Berry.

More than 63.5 per cent of Hamilton youth aged 12 to 17 are fully vaccinated, while more than 76 per cent have received one dose.

Alberta to offer $100 incentive

In Alberta, faced with surging cases and the lowest vaccination rate in the country, Premier Jason Kenney announced last Friday the provincewill begin paying $100 to people who get a first or second dose of COVID-19 vaccine.

"I wish we didn't have to do this, but this is not a time for moral judgments," hesaid.

Alberta is the first province in Canada to offer a financial incentive for vaccinations, though the tactic has been used in the United States.The programis expected to cost about $20 million.

Alberta announces $100 COVID-19 vaccine incentive program

3 years ago

Duration 2:04

With COVID-19 cases still surging in Alberta, Jason Kenney announced tighter masking measures and a new incentive program that would pay $100 to anyone receiving their first or second vaccine.

Kenney previously announceda vaccine lottery, offering three $1-million prizes toAlbertans aged 18 and over who have had at least one dose.

Dr. Stephanie Smith, an infectious diseases specialist at the University of Alberta Hospital and director of infection prevention and control, said the lottery "didn't move the needle very much" in terms of increasing vaccinationrates.

When the lottery was announced,about 68 per cent of the eligible population had been vaccinated with at least one dose. "Wesaw that rate gradually increase to around 70. But certainly there was no sharp increase," she said.

Smith thinks lotteries, which some other provinces, such as Manitoba and Quebec, have also adopted, could actually backfire with some people.

"I've heard at least anecdotal evidence from some of my patientswho said that they felt that when the lottery was announced, that that actually made them more wary of getting the vaccine. Because, you know 'What's the problem withthe vaccine that you have to kind of pay someone to get it?'"

She notes such incentives could also set adangerous precedent thatmay not be sustainable.

While Smith believes provinces should be encouragingpeople to get vaccinated any way they can, she thinks the focus should be because it's safe and effective and will promote the health of the individual as well as society not because they're going to win something.

She said there's still some misinformation about COVID and vaccines out there, so being clear and consistent in messaging is key.

The information shouldbe available in all languages and at all education levels, and the vaccines should be easily accessible, she said.

"Unfortunately, at this point in time, I think that really the only [other] way to really increase our vaccination rates is to make it mandatory, or to at least make it mandatory for certain activities," such as employment or leisure activities, Smith said.

We need to absolutely try to get everyone that's eligible vaccinated. It's the way out of this pandemic.- Dr. Stephanie Smith, infectious diseases specialist

"It's clear that having that 75 per cent of those eligible vaccinated is not enough," given the Delta variant, she said.

"We're living that right now in Alberta, where we have, you know, a sharp spike in our hospitalizations. We have, you know, a large number of young people in ICU and our health-care system is really becoming overwhelmed."

Roughly 99 per cent of all hospitalizations in Alberta are in people who are unvaccinated, Smith said.

"We need to absolutely try to get everyone that's eligible vaccinated. It's the way out of this pandemic."

Simon Bacon, a behavioural medicine professor at Concordia University in Montreal, who studies how people respond to public health policy, says the people who are still unvaccinated fall into two main groups.

There are those who are vaccine-resistant, who make up about five to 10 per cent of the total population. "So they're the anti-vaxxers, the conspiracy theorists. They're very entrenched in their beliefs."

And there are the vaccine-hesitant, who make up about15 to 25 per cent of the population. "These are people that, you know, are still on the fence."

A largeinternationalstudy callediCARE, whichstarted in March 2020, looking at people's behaviour related to COVID, and has received more than 100,000 questionnaire and polling responses from about 175 countries to date, shows the biggest factors influencing their decisions about vaccination are safety and efficacy, he said.

Incentives and other measures, such as vaccine passports, might help persuade some people who have been dragging their feet, but will have little effect on this group, Bacon said.

"If Iwanted to really focus on influencing them and trying to help them make a positive decision to get the vaccine, I would certainly focus my messaging around" safety and efficacy, he said.

A newly published study in the New England Journal Medicine showedthe probability of having complicationslike blood clots was almost four to 15 times greater in people whocontracted COVID-19than in those who were vaccinated.

"So that kind of information becomes really important to repackage and send out there, because a lot of people still, I think, have in the back of their mind on the safety side, for example, you know, the AstraZeneca story and the concerns around that," Bacon said. "Even though most people are getting the mRNA vaccines, that story still sullies the mind in terms of putting some doubt there."

Hospital data is also effective, he said.In Quebec, for example, if an unvaccinated person catches COVID, they're 22 times more likely to be hospitalized compared to someone who's fuly vaccinated, he said.

Bacon also recommends using differentcampaigns aimed atdifferent groups.

Youth, for example, are much more likely to engage with screens, if you can "gamify" the information, he said, whereas other people might respond to more traditional TV ads.

Positive messaging is also important, Bacon said.

"One of the things we have a tendency to do is sort of highlight the negatives. So, you know, 'If you don't get vaccinated, this is going to happen to you.' Whereas actually, that doesn't really motivate people."

The federal government ran a positive campaignjust before summer, he said. It showedsomeone hugging theirgrandparents after getting their shot, someone graduating fromuniversity with people around them, and someone participating in a sport.

Quebec also ran a TV ad with people saying they're getting vaccinated for X person, or for Y reason, "reinforcing some of the altruistic elements," he said.

'Continue to monitor the situation'

New Brunswick Public Health will "continue to monitor the situation and take the appropriate steps to protect the public, if and when required," said Department of Heatlh spokesperson Gail Harding.

Promotions and marketing efforts continue to encourage vaccination uptake in the province while Public Health works to provide timely, accessible clinics and walk-in clinics, she said.

Vaccine passports are also being considered, she added.