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People line up outside an immunization clinic to get their Oxford-AstraZeneca COVID-19 vaccine in Edmonton on April 20, 2021.JASON FRANSON/The Canadian Press

Alberta is set to become the first province to offer COVID-19 vaccinations to all teenagers, opening up eligibility to an additional 1.3 million people in a crucial step toward raising the level of immunity in the hard-hit province.

All Albertans 12 and up will be eligible for a vaccine beginning Monday, Premier Jason Kenney said on Wednesday. The announcement came hours after Health Canada authorized use of the Pfizer-BioNTech vaccine for adolescents ages 12 to 15. The shot had previously been approved only for those 16 and up.

“This is a major milestone in our vaccine rollout and it comes right when we need it most,” Mr. Kenney said. “When vaccines started trickling into Alberta just before Christmas, we had this day in mind: the day that we knew we could begin vaccinating pretty much everyone.”

The expansion means that 3.7 million Albertans will be eligible for the vaccine. People 30 or older can book appointments through Alberta Health Services or a participating pharmacy beginning on Thursday, while those aged 12 to 29 can book starting on Monday.

Manitoba also signalled on Wednesday that it would expand eligibility to those 12 and up by May 21. However, the medical lead for the province’s vaccine implementation task force said the team is still working on recommendations about how that will proceed.

Alberta is grappling with the highest rate of COVID-19 transmission in the country. As of Tuesday, the province had 534 active cases per 100,000 people. Ontario, which has the second highest rate, had 247 cases per 100,000, while the national rate was 218 per 100,000.

Mr. Kenney said he hopes restrictions announced on Tuesday – which include moving grade-school classes online and closing or limiting many businesses – and nearly one million vaccine doses expected this month can turn things around by summer.

“We do hope that in three weeks, if the measures and the behaviour can begin to move the numbers down, then the vaccines start to make the decisive difference, as they have done in many U.S. states and European countries,” he said.

The Premier noted that 30 per cent of Albertans had received their first dose, and that about 12 per cent had “natural immunity” from prior infection.

Chris Mody, head of the Department of Microbiology, Immunology and Infectious Diseases at the University of Calgary, said natural immunity is likely to provide some protection, but it may be relatively short-lived, given what is known about coronaviruses.

He also cautioned that the mutating virus will necessitate robust testing and quarantining, and a program to develop second-generation vaccines.

“Viruses that are able to mutate, like coronavirus, are pretty adept at overcoming the barriers that are presented to them,” he said.

Studies from Iceland and the United States found antibodies against SARS-CoV-2, the virus that causes COVID-19, did not decline within four months of diagnosis. A separate study of health care workers in England found that a previous infection was associated with an 84-per-cent lower risk of infection, with median protective effect observed seven months after primary infection.

Another study found that, after a single dose of the Pfizer vaccine, people with a prior COVID-19 infection had antibody levels similar to those of people without prior infection after two vaccine doses. However, the authors cautioned that additional research is needed.

A national poll by the Angus Reid Institute released in April found that vaccine hesitancy remains highest in Alberta, where 28 per cent of respondents said they were unwilling or unsure about getting vaccinated. Saskatchewan and Manitoba followed, with 22 and 20 per cent, respectively. The national average was 16 per cent.

Public health physician Jia Hu, a clinical assistant professor at the University of Calgary and chair of a coalition working to shift public perceptions around COVID-19 behaviours and vaccination, said such hesitancy is often associated with a distrust of government. He said his group is attempting to build trust through community outreach, media interviews and other awareness campaigns.

“It’s all trust-building. It sounds so bloody kitschy, but it really is,” Dr. Hu said. “There are plenty of people who are hesitant about the vaccine who aren’t conspiratorial about the vaccine.”

Ontario health officials said they are reviewing the approval of Pfizer for children 12 and up, but would continue for now vaccinating adults 18 and over. The province plans to offer first doses to everyone 18 and over by the week of May 24.

Ontario Health Minister Christine Elliott called the Pfizer approval “wonderful news” and said she is working with the Education Minister to get younger people vaccinated. Ms. Elliott said the plan would be to start vaccinations in schools – although in-person classes are suspended – and administer a second dose before September.

B.C. also expects to immunize adolescents before the school year ends in June. Provincial Health Officer Bonnie Henry on Wednesday said the province is working out how to fit an extra 300,000 people into its plans, but that it should still be able to provide the first dose to everyone eligible before July 1.

It is not clear if students will be vaccinated at school.

With reports from Laura Stone and Justine Hunter

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