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Canada still has too many unvaccinated people. And if the pandemic delivers an encore performance this winter, it will primarily be because of those 3.5 million Canadians who are eligible for their shots, but have yet to get even one.

The pandemic comes with many uncertainties, such as how far public-health measures can be eased without triggering an unsustainable rise in cases.

But the pandemic also has its certainties. The most incontrovertible has to do with vaccination. All else equal, the more Canadians are vaccinated, the fewer will get infected with COVID-19, and the fewer will end up in hospital. It’s that simple.

Approximately 3.5 million Canadians 12 years of age and over are still without so much as one shot. They are the main drivers of what’s left of the pandemic.

Ontario’s Science Table calculates that the unvaccinated in that province are currently five times more likely to be infected than the vaccinated, 11 times more likely to be hospitalized and 26 times more likely to end up intensive care. Quebec says the risk of infection for the unvaccinated is 4.7 times higher, and the risk of hospitalization is 16.2 times higher.

Over the past four months in Alberta, 262 people in their 50s ended up in the ICU because of COVID-19. Just 12 were fully vaccinated. For Albertans in their 30s, there were 121 ICU admissions; just four were vaccinated.

In the pandemic equation, vaccination is like a giant minus sign. It strongly subtracts from COVID-19′s ability to infect, to make severely ill and to damage the economy.

It’s not certain that vaccination alone can get Canada to the end of the pandemic, but it is by far the most effective tool available in pursuit of that goal. Each vaccination gets us closer to the pandemic finish line, and a high enough number of immunized people could get us across it.

So why is persuading 3.5 million unvaccinated holdouts not national priority No. 1?

Why aren’t the provinces, and the federal government, devoting more time, money and urgency to jump-starting a stalled campaign?

Earlier this year, we urged the kind of outreach measures that are the norm when something is urgent enough to matter. Consider the census: Every five years, Statistics Canada sends out millions of census forms and follows up – by mail, phone and even door-to-door visits – with every residential address that fails to complete their census. It hires tens of thousands of employees for the job. Its success rate is 98 per cent.

After a remarkable burst of vaccine enthusiasm in the spring, the vaccination campaign slowed and has now nearly stalled. The number of people coming forward to get a first shot dropped steadily through the summer. There was a temporary boost in September from the introduction of vaccine mandates and passports – and on the Prairies, the fear of the worst outbreak ever – but the number of daily new doses has since fallen to its lowest levels yet. The needle is barely moving.

Yes, 89.5 per cent of eligible Canadians have received at least a first shot. The glass is nine-tenths full. But that still leaves more than one in 10 Canadians aged 12 years and over who are entirely unvaccinated. It’s too many.

If you want to know what’s standing between Canada and a safe and enduring reopening, they’re it. Some are hostile, but many are merely hesitant, or afraid. Some are simply busy, and unaware of the risks they’re taking (and imposing on the rest of us). It’s why when shots are taken directly to people, such as walk-up clinics at subway stations in Toronto, they always discover unvaccinated folks willing to get a jab.

Canada is on the verge of approving vaccines for kids aged 5 to 11. If the right things are done to reassure parents, and make jabs conveniently available, then most of those nearly three million children will get their shots. And over the coming months, the provinces will be offering booster shots to everyone who got their second shot at least six months earlier. A major campaign will be needed to ensure that booster uptake is as close as possible to universal.

But lost in the shuffle is the biggest, toughest nut of all: Those 3.5 million eligible Canadians without a first shot. Unless we reach more of them, and soon, Canada’s pandemic is likely heading into overtime.

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