In a sleepy Eastern Ontario pocket, residents boast an enviable record: the highest COVID-19 vaccination rate in all of Ontario.
Over 76 per cent of the residents of the Leeds, Grenville & Lanark District Health Unit have received at least one dose of a COVID-19 vaccine as of July 17. Another 58.6 per cent were fully immunized against the disease on that day, according to data from Public Health Ontario.
However, sitting at the bottom of Ontario’s map, we can find the region with quite the opposite record. Haldimand-Norfolk Health Unit, where just 62.3 per cent of residents have had one dose of a COVID-19 vaccine, accounts for the lowest vaccination rate in the province. That’s the lowest rate in Ontario.
So what’s the secret to vaccine success? According to experts, everything plays a role including things like where you live, how old you are, and what you’re reading.
Here’s what we know.
Does location matter?
There are spots in Calgary and Edmonton where at least 60 per cent of residents are fully immunized against COVID-19. But when confronted with the rural locations in Alberta, that number quickly dwindles.
In some rural areas of the province, just 30 per cent of residents — or fewer — have been fully vaccinated.
According to experts, this is in part because we’re more likely to do something if we see people around us doing it.
“If there’s a lot of people that you associate with, that you’re socially involved with, and they’re getting vaccinated, that actually increases the likelihood you will get vaccinated,” said Dr. Gerald Evans, chair of Queen’s University’s infectious diseases division.
“One of the things that we’ve seen within a sort of urban environment is that there’s a lot of social context there to say, ‘Everybody around me is getting immunized. I’m going to get immunized, too.'”
On top of that, Evans said there’s an “argument to be made” that those living in dense, downtown centres might be more acutely aware of the benefits a vaccine can offer.
“They’re thinking and feeling, ‘Boy, I really need the benefits of vaccination.’ And if you’re in a rural environment, sometimes your perception is, well, you’re kind of socially distanced from everyone. And maybe it isn’t important,” Evans said.
“Then you look and talk to neighbours who live in the same area and maybe they’re coming to the same conclusion. So that’s a social process that’s going on.”
While vaccine uptake appears to trend higher in downtown cores, rural areas might actually feel the impact of vaccine hesitation more quickly, one expert warned.
“You can actually get a localized flare up. So that’s really the concern going forward,” said Dr. Omar Khan, a professor of biomedical engineering at the University of Toronto.
“Because if urban centers are well protected, but our rural areas are not, the concern is that if you have an increase in cases (in rural areas), will their local health unit be able to handle those increased cases? Will people have to be transferred to other places?”
Age: more than just a number?
In Ontario, your age can reveal more than just whether you can legally drink in a bar or drive a car. It also has ties to the likelihood that you’ve had your COVID-19 vaccine.
Over 75 per cent of seniors living in Ontario have had two doses of a COVID-19 vaccine. But among those between 12 and 29 years old, fewer than 50 per cent have had both of their shots.
While the youngest groups were also the last to have access to vaccines — a reality that would have impacted how many are fully vaccinated today — younger Canadians are also less likely to be worried about an adverse outcome from the virus. That’s because the vast majority of COVID-19 deaths have been among older populations in Canada.
According to the experts, this could have made young adults feel less urgency when it came to getting their COVID-19 vaccine.
“That’s called threat perception,” Evans said.
“So if your perception is that you are in a high-risk group, you are going to do something about (it, like) getting vaccinated to protect yourself.”
On top of that, Canadians are less likely to perceive the threat of something if it’s happening to someone they don’t know, Evans said. Very few teenage Canadians are spending their weekends and evenings hanging out with those in their 80s, and therefore might feel more disconnected from the threat COVID-19 can pose.
“If it’s happening to someone you don’t know, it doesn’t carry a lot of seriousness to you. But all of a sudden, if you know someone who actually had COVID and were unvaccinated, that increases your threat perception,” Evans said.
“You’re now saying, ‘Well, this is so close to me. Someone I know, a family member, a friend has suffered from not being vaccinated.’ So that threat perception increases and now you can really bring it closer to home to your own personal, individual interest.”
And even if young adults might feel safer from COVID-19, experts say it’s still incredibly important that they get a vaccine.
“It’s true that if you’re older, you’re more susceptible to get severe disease. Some younger people may not get as sick, but it’s important to understand that you can still get sick, and we don’t know if you’re one of the people who will get really sick or just a little bit sick,” Khan said.
“That’s why it’s still important to get vaccinated.”
Larger unvaccinated populations also provide more opportunities for COVID-19 to spread. That means more opportunities for the virus to make a mistake as it replicates — and if that mistake leads to faster transmission or causes it to become deadlier, it can give birth to new variants of concern, Khan warned.
“We are very fortunate that our vaccines have remained effective against the variants. This has been fantastic,” Khan said.
“But every time the virus replicates, there’s an opportunity to mutate and form a variant of concern that is just different enough so our current vaccines don’t work and we really want to avoid that. So it’s actually important to prevent viral evolution.”
You are what you read
Canadians’ opinions on vaccines can also be swayed by the information they’re taking in online, whether they’re posts on Facebook or videos on YouTube.
And there are lots of posts out there that make unverified or inaccurate claims about COVID-19.
Facebook and Instagram have had to remove over 18 million pieces of COVID-19-related misinformation since the start of the pandemic, according to a new report the company released on May 19. The figures were released as part of Facebook’s Community Standards Enforcement Report, which covered the enforcement of the policies from January through March.
“From the start of the pandemic to April 2021, we removed more than 18 million pieces of content from Facebook and Instagram globally for violating our policies on COVID-19-related misinformation and harm,” read the report.
Evans said somewhere between 10 and 20 per cent of the population has proven to be vaccine-hesitant, but many of these folks are just waiting to learn more about the vaccines — whether it’s by watching their friends get a shot, learning more about the technology, or getting answers to their questions about vaccine safety.
Depending on the sources they consult, their decision could be swayed.
“That misinformation that exists out in social media has had a negative impact on getting some adults, certainly those with less of a threat perception like a young adult, … to get themselves vaccinated. We’ve seen a lot of that,” Evans said.
Add to that the fact that some celebrities and influencers have added their voices to the anti-vaccine chorus, and it can spell a recipe for vaccine hesitancy, Evans warned.
“We’re very much influenced, in the setting of stress and anxiety of a pandemic, about what other people think,” Evans said.
“Especially people who you might say you admire, like I used to for Eric Clapton, and friends and family and other people who have had some experience. … If their experience was a little off, that seems to be influencing people’s reluctance or lack of vaccine confidence in getting the vaccine for themselves.”
Building vaccine confidence
As vaccination rates have increased across Canada and provinces have started to lift their restrictions, the efficacy of vaccines has become even more apparent.
Since June 1, 91 per cent of Alberta’s COVID-19 deaths and 95 per cent of hospital and ICU admissions came from unvaccinated populations, according to the province’s top doctor Deena Hinshaw. The United States has seen similar results. At the start of the month, about 99.2 per cent of recent COVID-19 deaths in the U.S. had involved unvaccinated people, according to Dr. Anthony Fauci.
But as vaccine hesitant-Canadians still grapple with all the factors fueling their decisions to get a shot, experts say it all boils down to one main thing: talking.
“I think really it comes down to communication of the science behind it and the benefits,” Khan said.
He said if we “tie the benefits to certain metrics,” such as being able to reopen businesses, or opening schools, that could “really help.”
If Canadians don’t achieve a high enough level of vaccination, Khan warned, we’d be less likely to withstand any transmission in schools. Kids are unlikely to face severe cases of COVID-19, but they can bring it home to their families — where unvaccinated parents might get sick enough to end up in a hospital.
Khan said communicating things like the linkage between high vaccination rates and school reopenings can motivate those who otherwise don’t feel particularly excited about the idea of getting a vaccine.
We can also explain to people how their actions impact others, Evans added.
“‘I’m not worried about myself. I’m going to be fine,’ you might say. But really, what about family? What about friends? What about society in general? What about your interest in having us go back to having a sort of normal social environment to work in that we had before the pandemic?” Evans asked.
“So we really need to push those messages that (there are) huge benefits to being vaccinated, not just for yourself (but for) family, friends, others around you and society in general.”
It’s also important to share factual information about the safety and effectiveness of vaccines — but it needs to be done in a way people understand, Evans said. Scientists and doctors can tweet out graphs and charts all day long, but that doesn’t mean the message won’t land on deaf ears.
“Humans are very much tied to anecdotal things and less so to deep data and things like that,” he said.
Some provinces have even tried to incentivize vaccinations, with Alberta and Quebec both launching a vaccine lottery with a cash prize at the finish line for a lucky vaccine recipient.
“Things that incentivize people are good,” Evans said.
But, he warned, it’s important to make sure these incentives don’t cross the line into coercion.
“Whether it’s a year’s supply of Tim Hortons coffee or a couple of hundred thousand dollars, you have to be a little bit careful that when you make some of these incentives very, very lucrative, that can almost be perceived to be some form of coercion,” he said.
“We don’t really want to coerce people. We want people to be incentivized to get the vaccine.”
But he’s not opposed to these creative efforts, because the more Canadians get vaccinated, the closer we are to back to normal, Evans said.
“It’s clear and unequivocal that we’ll all benefit, the higher the rates of vaccination are in the country.”
— with files from Global News’ Eric Sorenson and Katherine Aylesworth