Skip to main content
Opinion editorial
September 01, 2021
Adam Kassam

Vaccinating the ‘movable middle’ is key to fighting the Delta variant

Here’s what we know: six to nine per cent of Canadians are digging in their heels and will resist getting vaccinated against COVID-19 at any cost.

But new analysis of vaccine hesitancy by the Public Health Agency of Canada also tells us there is a sizeable chunk of our unvaccinated population — the so-called movable middle — who can be motivated.

Restarting our lives and our livelihoods as the fourth wave picks up steam depends on our ability to get shots into these arms.

In Ontario, for example, new modelling shows that if we don’t move the dial from 75 to 90 per cent fully vaccinated soon, Ontarians are headed for many months of riding those brutal waves of infection.

As we plan strategies to reach this last cohort, it’s helpful to understand why — through 18 months of restrictions on their freedoms, 1.5 million infections across the country, and almost 27,000 deaths — they have yet to roll up their sleeves.

We have some understanding of this too.

Some young adults believe they don’t need vaccines because they are at lower risk of serious complications from the virus. There are parents who question the safety of COVID-19 vaccines for their young children. Those with lower incomes are more likely to face access-related barriers to vaccination, including transportation challenges, limited access to Internet or mobile booking systems, and no paid time off work to get their shots. Some ethnic groups may distrust the medical profession.

So, if true vaccine hesitancy stems from a sense of complacency, a lack of convenience, and a lack of confidence, the central question then becomes how to turn these obstacles into action.

Public health units have been working to improve convenience. Across Canada, for example, provincial and territorial support for Indigenous-run vaccination clinics has boosted vaccines in these communities by providing culturally safe spaces. Ontario has also had success with facilitated employer-based and community-run clinics and even door-to-door service in targeted communities.

Physicians, who hold the trust of patients, are stepping up their efforts to build confidence in vaccines and dispel any lingering doubts about whether they are necessary.

Many are reaching out to unvaccinated patients to invite conversations about what’s holding them back. Patients at the Scarborough Health Network can call the Vax Facts hotline for anonymous one-on-one conversations with doctors as they seek answers to their particular concerns.

We encourage all health-care workers to proactively ask patients about their vaccine status, share their experience and connect patients with vaccination opportunities. These measures are most likely to move those who are hesitant because of complacency.

Building confidence in populations where there may be distrust of the health-care system is best done within the community. Engaging elders or other respected leaders can help community members understand the benefits of vaccines, as can offering clinics in places that are familiar and staffed by people who look like those they are trying to reach.

These confidence-building strategies are effective. But they take time and they must be used in conjunction with mandatory vaccines for all health-care and education workers and proof-of-vaccine certificates that could be used by employers and private businesses such as restaurants and in crowded settings.

Addressing vaccine hesitancy will take a number of creative solutions all targeted to this movable middle, with physicians, public health and governments working together to get our vaccination rates to where they need to be to protect us all.

If we want to get ahead of Delta, we need to pull out all these stops and nothing less.

Used with permission from the Toronto Star: Copyright Toronto Star. All rights reserved.