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Alberta has administered an average of about 9,400 first doses per day over the past week, compared with a single-day record of 75,000 shots three weeks ago.JASON FRANSON/The Canadian Press

Demand for first doses of COVID-19 vaccines has plummeted in Alberta, raising the possibility that the province, which already has among the lowest rates in the country, could become stuck with significant segments of the population with no protection for the virus.

The government has launched a multimillion-dollar lottery to entice holdouts to book their first shots and is increasing the use of pop-up clinics and other programs designed to reach into the community rather than waiting for people to show up to mass vaccination sites. Premier Jason Kennedy describes the province’s next phase of its vaccine program as a “game of inches” now that the most of those keen to book their shots have already done so.

Alberta has administered an average of about 9,400 first doses per day over the past week, compared with a single-day record of 75,000 shots three weeks ago. First doses now account for about 22 per cent of shots administered every day, and that share is falling quickly.

The province expects to have given first doses to 70 per cent of people aged 12 and older by the end of the week, which would meet the government’s self-imposed threshold for lifting all public-health restrictions two weeks later. But there are concerns that number may not climb much higher than that.

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Alberta is also lagging behind the rest of Canada for first doses. Across the country, about 74 per cent of eligible people have at least one dose, according to the COVID-19 Tracker Canada website, and only Prince Edward Island and Nunavut have lower rates for first doses than Alberta.

Cheri Nijssen-Jordan, the co-lead of Alberta’s vaccine task force, said she wants to see vaccine coverage hit 80 per cent, though that next 10 per cent will be the most difficult.

“We’ve definitely gotten to the point where we’ve handled all of the people who are very eager – the early adopters,” she said in an interview.

Dr. Nijssen-Jordan said the reasons for the lag vary, from difficulties accessing vaccine clinics or lingering questions about the safety or effectiveness of vaccines. She also acknowledged that there is a smaller group of people who will refuse vaccines no matter what.

For those who can be convinced, she said, the strategies depend on what’s holding them back. Alberta Health Services is stepping up outreach and public messaging, while also enlisting community leaders to get the message out.

If people are still having trouble accessing vaccines despite wanting to get a shot, AHS is trying to ease those burdens as well. For example, the agency held a pop-up clinic last weekend in northeast Calgary, where vaccine rates have been lower than the rest of the city and where transportation and work schedules could be a barrier.

Dr. Nijssen-Jordan said she and her colleagues are particularly worried about the northwest corner of Alberta, where just 14 per cent of people have had at least one dose. She said her team is trying to figure out what is preventing people from getting vaccinated, while working with local health officials, community leaders and media to reach people who remain unconvinced.

“There are likely going to be some additional places that will be harder to get to than others, that may not have the coverage that we desire,” she said.

Public opinion surveys have shown higher rates of resistance to COVID-19 vaccines in Alberta than elsewhere in Canada, but recent polls have suggested that has dropped considerably, with more than 80 per cent saying they would be willing to get vaccinated.

Shannon MacDonald, a University of Alberta professor who studies immunization campaigns, said the province needs to focus more on “active” strategies to reach unvaccinated people, as health officials are already starting to do.

She also said that as people who may have been on the fence hear more about friends and relatives who’ve been vaccinated, that can also help. She said health officials should be encouraging the public to be as vocal as possible when they get vaccinated.

“I’m not convinced that vaccination is going to totally level off,” she said. “I think as unvaccinated people start to recognize that the people around them got vaccinated, I’d say there will be a substantial number of people who think, ‘Maybe I should just do this.’”

Jim Kellner, a pediatrician and infectious-disease specialist at Alberta Children’s Hospital in Calgary, said it’s no surprise that demand is waning. He said having significant pockets of the population who aren’t vaccinated will ensure COVID-19 continues to pose a threat.

“If we have areas in our cities and our provinces across Canada that are still hot spots, then it puts the whole country at risk,” he said. “We’re not so isolated from each other that you can say you’re sitting pretty if you live in a part of town where there’s low rates of disease and a high rate of vaccination.”

Dr. Kellner noted there is a debate about the level of vaccination required for herd immunity, but some models suggest it is 80 per cent or higher.

Ilan Schwartz, an infectious-disease specialist at the University of Alberta, said having COVID-19 spreading widely through unvaccinated people also increases the risk of new variants of concern emerging.

Still, Dr. Schwartz said the prevalence of vaccines, even if not high enough to achieve true herd immunity, would likely mean fewer hospitalizations and deaths, which would lessen the need for strict public-health measures and lockdowns.

“There are likely still going to be cases; there are still going to be people who have very severe outcomes, including death,” he said. “But it’s not going to threaten society being able to function day-to-day in the way that we have seen over the last 15 months.”

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