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Good morning. It’s James Keller in Calgary.

Just as it did in the second and third waves of the COVID-19 pandemic, Alberta has the highest infection rates of any province. Hospital admissions are soaring and are projected to surpass any of the previous waves. And despite pleas from Premier Jason Kenney, Albertans have the lowest vaccination rates in the country.

Mr. Kenney and his government have been relatively silent in recent weeks as the situation worsened, after playing down the potential for a severe fourth wave and resisting any additional measures to curb the spread of the virus.

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That changed on Friday, when Mr. Kenney surfaced to announce several new measures, including the return of mandatory masks, a curfew on liquor sales at bars, and a new strategy designed to entice the unvaccinated: cash payments of $100. The province is willing to try anything, Mr. Kenney said, as he accused people who have refused to get vaccinated of endangering the health care system and told them: “For the love of God, please get vaccinated now.”

Any adult who gets their first or second shot before Oct. 14 will receive a preloaded $100 debit card. People who were vaccinated before Friday don’t qualify.

The new incentive follows the province’s vaccine lottery, which recently awarded the second of three $1-million prizes. Mr. Kenney says the lottery helped drive vaccine demand “a bit” but appointments have since slowed to a crawl. The province is administering just a few thousand first doses per day and demand for second shots has also dropped off considerably. About 300,000 people have received a first shot but have yet to get their second.

And while the government appears firm on rejecting a mandatory vaccine passport, similar to what has been introduced in other provinces, Mr. Kenney said the government is developing an electronic vaccine certificate to help Albertans who want to prove their vaccine status if a business requires it. The NHL and CFL teams in Calgary and Edmonton have announced vaccine requirements, as have several restaurants and other businesses.

Mr. Kenney pointed to jurisdictions in the United States that have turned to cash payments, such as Colorado. That state’s government has introduced both a lottery and a gift-card program; its vaccine rates are slightly lower than in Alberta.

Academic research that has looked at the effectiveness of such programs has had mixed results.

Arash Naeim, a professor at UCLA who has researched incentives with the school’s COVID-19 Health and Politics Project, said surveys have shown there are still people who are willing to be vaccinated but haven’t got their shot yet. He said as long as that gap remains, governments can boost their vaccine numbers through a variety of strategies, including cash incentives.

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The UCLA research group has conducted surveys that found people would be more willing to get vaccinated in exchange for cash, and that the benefit increases as the amount of money grows.

“I think as long as there’s a gap between the people that say that they are willing to get vaccinated and then do, there’s opportunity,” he said.

The same surveys have also shown that some people are actually less likely to get vaccinated in the face of an incentive program, possibly because they are already distrustful of government, but the potential benefit outweighed that problem.

Dr. Naeim said it makes sense to use a combination of strategies, including incentives such as lotteries as well as tying vaccination to increased freedoms.

Andrew Barber, an economist at the University of California Santa Cruz, co-authored a study about a lottery program in Ohio. The paper concluded that the lottery increased vaccine uptake by 1.5 per cent, though the effect only lasted a few weeks. Still, Prof. Barber said even that small effect can have a noticeable impact on hospital admissions; the study concluded the lottery saved US$66-million in health care costs.

“It doesn’t seem deniable or debatable to me that it’s effective,” he said.

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“You want to exhaust the number of people who are going to get it without any incentive whatsoever. And once you have exhausted that pool of people, then you want to start thinking about incentive structures.”

Prof. Barber cautioned that the study did not look at cash payments and that the benefit might not be as clear-cut, because a lottery costs significantly less per person.

This is the weekly Western Canada newsletter written by B.C. Editor Wendy Cox and Alberta Bureau Chief James Keller. If you’re reading this on the web, or it was forwarded to you from someone else, you can sign up for it and all Globe newsletters here.

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