Geographical differences in vaccination coverage prompt call from Alberta doctors to boost uptake

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Alberta as a whole may have passed the 70 per cent vaccination threshold to move into Stage 3 of the provincial reopening plan, but vaccination coverage differs dramatically across the province. Julia Wong reports on why that may be and what can be done about it. – Jun 21, 2021

The province may have surpassed a threshold with 70 per cent of eligible residents having one dose of COVID-19 vaccine, allowing it to move into Stage 3 of reopening on July 1, but vaccination coverage varies dramatically across Alberta.

Read more: COVID-19: Alberta public health measures to end on July 1

Alberta Health data excludes aggregate doses reported by First Nations Inuit and Health Branch, Indigenous Services Canada.

As of June 20, vaccination data from Alberta Health shows geographical areas in northern and southern Alberta with all ages, one-dose coverage ranging between 20 and 40 per cent:

  • Wood Buffalo: 36.2%
  • Wabasca: 31.7%
  • Manning: 38.6%
  • Fairview: 39.4%
  • High Prairie: 34.1%
  • Valleyview: 39.1%
  • Municipal District of Taber: 34.6%
  • County of Forty Mile: 28.2%
  • Cardston-Kainai: 35.4%

Also as of June 20, in the High Level geographic area, 14.1 per cent of the eligible population had received one dose.

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“When you look across the province, there are quite significant differences in vaccine uptake,” said Dr. Stephanie Smith, an infectious disease physician at the University of Alberta Hospital.

“I think we really do need to look at those populations and what is the issue? What is the barrier?”

Tony Nickonchuk, a pharmacist based in Peace River who has been analyzing vaccination trends, points to several factors that can determine higher vaccination uptake, such as level of education acquired and geography.

For example, the High Level geographic area runs north to the border with the Northwest Territories, west to British Columbia, east beyond La Crete and Fort Vermilion, and south past Paddle Prairie.

“It’s a massive geographic area. There are no, for example, pharmacies doing any COVID vaccines north of Manning. There’s a huge access issue in some of those areas as well. Generally, when you look at it, the areas that are really sparsely populated definitely have lower uptake,” he said.

READ MORE: Doctor says Alberta needs to get creative, bring vaccine to people to boost 1st dose uptake

Nickonchuk also points to historical trends.

“There are communities in the [High Level] area that are well-known to have very low immunization rates, even among non-COVID immunizations, so standard routine infant immunizations,” he said.
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Other obstacles can range from concerns about vaccine safety to the sentiment that COVID-19 is not a problem. Last month, the provincial government specifically spoke about rural versus urban experiences with COVID-19.

It pinpointed how rural hospitalization rates for COVID-19 are 26 per cent higher compared to urban rates, and it highlighted how ICU rates for COVID-19 in rural areas are 30 per cent higher.

“Certainly, we’ve heard that in rural areas where there haven’t been as many cases, people think, ‘It doesn’t really affect me,’” Smith said.

“There has been some work in certain communities related to that, really targeted messaging, so Hutterite colonies, that type of thing. It’s labour intensive but that’s probably what we now need to start doing to try to get vaccination rates to continue to rise.”

High Level Mayor Crystal McAteer, who is fully vaccinated, said members of the High Level community have been vaccinated through federal programs with First Nations communities but there are people in the area who may never get vaccinated.

“They don’t believe in the vaccinations and those are their personal beliefs. No matter what you do — give money to get vaccinated or make a vaccination passport — they’re just not going to do it,” she said.

McAteer said there are also residents who have safety concerns about the vaccine that do not believe the virus can lead to serious disease. She said there is misinformation online.

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READ MORE: New social media campaign targets COVID-19 misinformation with science

She also points to how there is poor internet and broadband in some northern Alberta communities, making it difficult for people to book an appointment.

“If we would have had more walk-in clinics, I would say we probably would have more people vaccinated. But having to make an appointment and drive in 120 kilometres plus, it’s very difficult,” she said.

Alberta Health Services has set up walk-in clinics across the province for first doses, but experts said more work to be done to remove obstacles.

“It’s difficult in more sparsely populated areas because you don’t have these centralized community hubs as much, and even if you do, you have people travelling in from quite far to get to those places,” said Nickonchuk.

“As much as it can be brought to as close to the people, the better. But it is difficult in these really geographically massive areas because it obviously, comes down cost too.”

Dr. Kelly Burak, a professor of medicine and an epidemiologist at the University of Calgary, said the province has to make it easy for people to get the vaccine and points to the vaccine rodeo that was held in northeast Calgary earlier this month.

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“It was a very important initiative. We have to do more of that. We have to get the vaccine to people,” he said.

READ MORE: Alberta doctors nervous about Stage 3 of reopening, pointing to more transmissible Delta variant

Burak said this is especially important as more cases of the Delta variant, which is more transmissible than the original strain of the novel coronavirus, are identified in the province.

“If we have large proportions of the population that are unvaccinated, it really is where the Delta variant will take hold, and we’re likely going to see a fourth wave because of that,” he said.

Many businesses and residents are eagerly awaiting more of a return to normal come Canada Day, but Dr. Chris Mody, head of the University of Calgary department of microbiology, immunology and infectious diseases, said now is not the time to relax.

“People still need to get their vaccine… We should not stop vaccinating people in any way because we’ve reached a threshold and we’ve opened up,” he said.

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