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Dr. Janice Fitzgerald, Chief Medical Officer of Health for Newfoundland and Labrador, administers the COVID-19 vaccine to 11-year-old Keira O'Keefe in St. John's, N.L., on Nov. 25, 2021.Paul Daly/The Canadian Press

In Bonavista, a town of about 3,500 huddled on a flat, rocky plain on Newfoundland’s northeast coast, people used to pack into the Lions Club for the bingo tournaments. Lately, they’ve been lining up to get into the building for something else – COVID-19 vaccinations.

Nicole Abbott, a local mother of two boys, says openings for children’s doses inside the hall’s mass vaccination clinic are the hottest ticket in town.

“As soon as an appointment goes up, they’re getting booked right away,” she said. “And when there’s an extra spot, they let you know immediately, so you can grab it.”

When it comes to vaccinating children against the coronavirus, no province comes close to Newfoundland and Labrador. It leads the country, with nearly 75 per cent of kids aged 5 to 11 at least partly vaccinated, well above the national average, and nearly twice the rate of provinces such as Alberta.

Even in Bonavista, where the worst of COVID-19 feels a long way away, people are doing their duty to vaccinate their children. Ms. Abbott says that has a lot to do with trust. In the small towns that dot this province, parents have a lot of faith in the public health experts, and are more likely to follow their advice, she said.

With the oldest population in Canada, Newfoundland’s public health leaders have also focused their campaign for pediatric vaccines around protecting grandparents – something that resonates deeply. One popular ad for kids’ vaccination featured a little girl licking a wooden spoon, with the message, “Because my nan needs help with her cookies.”

“My oldest son was very concerned about his grandparents. He doesn’t want to get sick and pass it on to them,” said Ms. Abbott, a teacher in the local elementary school. “I think we have a close connection with that older generation, and we want to protect them.”

Opinion: Newfoundland and Labrador’s culture has helped it achieve Canada’s highest vaccination rate

Long before COVID-19, Newfoundlanders were already more pro-vaccine than most other Canadian provinces, and had a well-oiled childhood vaccination program that consistently beats national rates. Part of that can be explained by history, and a devastating problem with tuberculosis that persisted here until the early 1970s, long after the disease was under control elsewhere.

Many families in the province have relatives who still share those stories, and that’s helped build a collective understanding of the importance of vaccination.

“Vaccine-preventable diseases were a very real part of the lives of Newfoundlanders and Labradorians not that long ago,” said Natalie Bridger, a pediatric physician in St. John’s. “With better water, sanitation and food security, we’ve become a much more resilient province against infectious diseases, but vaccines were a major part of that.”

Her father grew up in the 1950s and 1960s in Brighton, a small fishing community in northern Newfoundland, and still talks about how children couldn’t play outside in the summer because of the polio virus, and how neighbours lost babies to whooping cough, she said.

The isolation of many Newfoundland and Labrador communities was a major reason some preventable diseases were difficult to detect and treat. Without access to X-rays and proper treatment, tuberculosis ran rampant through the outports. Until the mid-1950s, it was a leading cause of death in the province, killing tens of thousands in the first half of that century.

“I think those memories in Newfoundland of rampant TB from the 1940s, ‘50s and ‘60s are still very much alive,” Premier Andrew Furey said.

“For historical reasons, Newfoundlanders and Labradorians have been very compliant with respect to vaccines. In general, we have a very engaged population who recognizes the value of vaccines and the importance of following science and public health measures. That’s not to be underestimated.”

Less effort has been required to persuade people to get vaccinated. Instead, the focus has been on accessibility over acceptability, getting as many mass vaccination clinics into local Legion clubs, church and fisherman’s halls and community centres as possible. Giving parents the option of vaccinating their kids at school or a clinic seems to have helped.

“Instead of picking one or the other, I think we recognized the biggest barrier in our population is accessibility and convenience,” Mr. Furey said. “For this age group, I think providing vaccines in schools was really the key to driving those numbers.”

Early on, the pediatric campaign had a lot of success getting parents to sign consent forms for their children to be vaccinated at school during class time, much like previous programs for diseases such as meningitis.

The vaccination rate slowed while schools were closed for more than a month, but Dr. Bridger expects it to begin climbing again on Tuesday, when in-person classes resume, along with those in-school clinics.

Much of the credit for the pediatric campaign should also go to Janice Fitzgerald, the province’s Chief Medical Officer of Health, Dr. Bridger said. She’s a clear communicator, and had an easy-to-follow plan that allowed parents to book kids’ appointments as soon as the vaccines were approved in November, she said.

“Parents were able to sign up, online, that same day. There were a lot of things that were already done ahead of time that I believe helped get the momentum going,” Dr. Bridger said. “Newfoundlanders may get called out for having some of the worst health outcomes in the country, but vaccines are one area, at least, that we can be proud of.”

In many small communities in the province, getting vaccinated is seen as just another way to co-operate and look out for one another, she said.

“We’re quite socially connected, and I think some of our success is due to that,” she said. “We’re on a freezing cold rock in the middle of the Atlantic, so people have had to work together for a very long time.”

The Premier said geography plays a role, too. Newfoundland’s settlement, around the island and in remote settlements in Labrador, helped develop a culture in which community is central to people’s lives.

“There’s a culture here of being altruistic, of helping your neighbour, that I think is based on the historical context of being isolated,” Mr. Furey said. “People recognize that they have to do their part to help that community, in order to survive.”

Newfoundland has brought in some of the strictest public health measures in the country to combat COVID-19, including new restrictions introduced in December that require all travellers coming in from outside the province to self-isolate for five days. These measures have largely been accepted without protest. Instead, you’re likely to hear pride, rather than complaints, about how the province has responded to the challenge.

While few children have been hospitalized in Newfoundland by COVID-19, the province managed to persuade thousands of parents that getting their kids vaccinated was just something that needed to be done to protect more vulnerable and older members of their communities.

“That’s how we’re going to get through this pandemic,” Mr. Furey said. “Ignoring a particular demographic will only prolong the pandemic, and that’s something none of us wants.”

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