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Good morning. It’s James Keller in Calgary.

As Alberta looked for ways to increase its COVID-19 vaccination rates – which are currently the lowest in the country – the government started out with a carrot.

Premier Jason Kenney announced a lottery in June that would pay out three $1-million jackpots and a host of other prizes. When that didn’t move the needle, the government turned to gift cards earlier this month, paying people $100 to get a shot, which was followed by a slight increase in appointments but the effect was fairly modest.

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It wasn’t until Alberta resorted to the stick of a vaccine passport – which the government had been promising for months never to do – that there was finally a significant increase in appointments. Vaccinations tripled on Thursday, the day after the policy was announced, with nearly 25,000 people getting their first or second doses.

It shouldn’t have come as a surprise. Time and again, provinces that have introduced vaccine passport systems, which demand proof of vaccination to access non-essential services such as pubs and movie theatres, have recorded sudden spikes in demand from the unvaccinated.

Quebec and Ontario said vaccine appointments doubled after they unveiled their programs.

In B.C., appointments tripled in the days following the program’s announcement in August. But perhaps more important, as Justine Hunter reports this weekend, that effect was strongest among a group with typically low vaccination rates: young adults.

More than 20,000 British Columbians between the ages of 18 and 24 had their first shot of the vaccine in the three weeks after the policy’s announcement – a significant jump in turnout from the trend over the summer. Just 351 people in that age group had registered for a vaccine the day before the announcement; the day after, registrations jumped to 2,030, and an average of 1,000 people have signed up every day for the past three weeks.

The early success of B.C.’s program – and the weak performance of Alberta’s lotteries and gift cards – underscore what public health experts have been arguing for some time: tying vaccines to freedoms and privileges can be a powerful incentive to convince people on the fence to get a shot.

Alberta announced its passport program as a punishing fourth wave threatens to overwhelm the health care system, with more people in intensive care with COVID-19 than at any other point in the pandemic. Health officials have issued dire warnings that the system could be beyond capacity by next weekend if they can’t create additional beds or secure help from other provinces.

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Alberta’s proof-of-vaccination system works differently than in other provinces. Instead of creating a blanket set of rules for where proof of vaccination is required, the government has given businesses a choice: implement the vaccine passport, or face restrictions, such as no indoor dining for restaurants. Critics have said the system is overly complicated but the government argues it tried to strike a balance.

Mr. Kenney acknowledged that he was reversing a significant promise, but he said the situation in the province left him with no choice. He said the province needs to increase its vaccination rates, and the government had a moral, ethical and legal obligation to intervene to protect the health care system. He also blamed unvaccinated people for threatening the hospital system and urged them to finally get the shot.

He also apologized for the province’s announcement in late July that COVID-19 could be treated like any other respiratory illness, and for what he described as his “enthusiasm” as he promised that the province was “open for good.” He made it clear, however, that he was not apologizing for lifting all public health measures in July, which his Chief Medical Officer of Health, Deena Hinshaw, said set the province on the trajectory for its fourth wave.

Saskatchewan, where the COVID-19 situation is as bad as Alberta in terms of infections, deaths and hospital admissions, also implemented its own vaccine passport system – reversing an earlier promise from Premier Scott Moe – as ICU admissions forced the cancellation of surgeries and warnings that the situation is expected to get worse.

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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