After months spent watching with envy as millions of Americans were vaccinated against COVID-19, Canada is now administering more doses per capita each day than the U.S., according to federal data from both countries.
Yet health experts warn it’s not an apples-to-apples comparison. While Canada is still struggling to match demand with supply, the U.S. — which has had a growing stockpile — is running into vaccine hesitancy and access issues after inoculating a majority of those eager to take the shot.
Whether Canada will see the same issues is a question that can’t yet be answered, those experts say.
“Hesitancy is defined as when you have vaccine available and people choose not to take it. And up until this point, (Canada) has not had enough vaccine for everyone,” said Julie Bettinger, a professor at the University of British Columbia’s faculty of medicine.
“Our numbers are going up because we’re getting more vaccines, but we still can’t get the vaccine to everyone who wants it.”
How do the countries compare?
Despite having more vaccine doses on hand, the U.S. vaccination rate has been falling steadily since April 13, when more than one dose was being administered per 100 people, according to Our World in Data.
While Canada’s rate also saw a drop from a peak of 0.79 doses per 100 people on April 27, it’s now starting to ramp up again as more supply arrives.
On Wednesday, Canada reported a rate of 0.66 per 100 people, surpassing the U.S. — at 0.64 per 100 people — for the first time. The gap grew wider on Thursday, with Canada administering 0.68 doses per 100 people compared to 0.62 in the U.S.
About 45 per cent of the American population has already received at least one dose of the vaccine, while one in three are fully vaccinated, according to the U.S. Centers for Disease Control and Prevention.
By comparison, Health Canada data says over 33 per cent of the population has received at least one dose, with just 2.68 per cent receiving their second.
The two countries have had very different rollout stories, thanks largely to the U.S.’s domestic manufacturing capabilities. By mid-April, when Canada was bringing in roughly 1.5 million doses per week from overseas, the U.S. was delivering 10 times that number to states.
The Canadian government says it is now on track to receive more than two million doses per week through May and June — when the government says there will be enough supply for the entire population — and age eligibility requirements are dropping in response.
Why is the U.S. rate falling?
Polls vary as to how big of a problem vaccine hesitancy in the United States is. A U.S. Census Bureau survey released on Wednesday found close to 20 per cent of adults either definitely or probably won’t get vaccinated or are unsure if they will. Ipsos suggested in March that 35 per cent of Americans won’t get a vaccine if it’s available to them.
The Census Bureau survey also found hesitancy differs by state, with more than 30 per cent of adults in Wyoming, Montana and North Dakota — all Republican states — saying they are resistant or unsure.
But Devon Greyson, an assistant professor in health communication at the University of Massachusetts, says that doesn’t fully account for why fewer people are getting vaccinated now compared with last month.
“Even where people are eligible, there are barriers that range from online enrollment systems to language barriers to transportation,” she said. “They get in the way of people receiving vaccines, and access barriers themselves can sort of see hesitancy.”
Many of those access issues are occurring in rural areas of multiple states, where the Rural Policy Research Institute found many areas that have no pharmacies to administer vaccines. Only 65 per cent of rural households have broadband internet access needed to book appointments online, according to the Federal Communications Commission.
Greyson doesn’t discount the role vaccine misinformation and conspiracy theories have played, however, particularly among the right and far-right of the political spectrum.
“This is taking place on both sides of the border, but has been exceptionally pronounced in the United States, where, of course, there was a conspiracy theory-fueled, right-wing insurrection at the national capital,” she said.
“When vaccination becomes an identity issue, including part of one’s partisan political identity, the views can get quite entrenched and harder to correct with information itself.”
U.S. President Joe Biden is aiming to have 70 per cent of Americans inoculated by July 4. But Greyson says vaccinating eager adults was “the easy part.”
“Improving access and addressing hesitancy is more time- and labour-intensive and involves a lot more building relationships with local communities and local leaders,” she added.
Canada could face similar problems
Canadians are some of the most accepting of vaccines in the world. The global Ipsos survey from March found 79 per cent of Canadians would get a vaccine right away if it’s available.
But similar gaps in access remain. Federal data says 87 per cent of Canadian households have access to high-speed internet, a number that falls to less than 50 per cent for rural households. The College of Family Physicians of Canada has noted that while 18 per cent of Canadians live in rural areas, they’re served by only eight per cent of Canada’s practising physicians.
Shannon MacDonald, an assistant professor at the University of Alberta’s School of Public Health, says provinces need to combat access issues rather than convincing resistant populations.
“Trying to change the mind of somebody who doesn’t believe in science is is a pretty daunting proposition,” she said.
“Ensuring that vaccines are being offered in a site that people can access as close to where they live and work as possible is a lot of work, but it is a bit more straightforward.”
Bettinger says Canada may have a better shot than the U.S. at getting a higher majority of the population vaccinated, but it depends on what happens next.
“The fact that the country is able to come together a bit better than what we’re seeing south of the border, I think, you know, it bodes well,” she said. “It means it means we have less of an uphill battle, I think.”“Once supply ramps up and more of these people who are lining up for it now get the shot, then we’ll be able to say, ‘OK, who’s staying home, who’s not booking an appointment?’ And that’s when the real work begins.”