Toronto needs targeted incentives to reach vaccine goal

Big number: 336,000, the approximate number of unvaccinated or partially vaccinated people who need to get their shot to reach the citywide 90 per cent vaccination threshold set by Toronto Public Health.

Toronto Public Health has quantified Toronto’s remaining vaccine challenge. Our magic number? 336,000.

That’s the approximate number of remaining people who need to become fully vaccinated to push the city’s two-dose vaccination rate from its current level of about 78 per cent of the eligible population to the 90 per cent threshold the city’s public health agency has set as its new target.

The good news: Almost half of those 336,000 people are halfway there. 164,000 of them have already received their first dose. Some are just in the waiting period before their second jab. Others have, for whatever reason, become reluctant to go back for their second shot. Toronto Public Health can reach out to these people and figure out ways to make them feel more comfortable about coming back for round two.

More good news: The hardest of the hardcore anti-vaxxers — the kind of reprehensible yahoos who spend their days protesting at hospitals — are unlikely to stop the city from reaching the 90 per cent target.

A poll conducted by Ipsos for Toronto Public Health in August examined vaccine attitudes among Toronto residents. It found that just six per cent of us are in the “I have not received a COVID-19 vaccine and I definitely will not in the future” camp. That compares with eight per cent who haven’t been vaccinated yet but say they’re unsure about whether they might be in the future, and another five per cent who haven’t been dosed yet but say they would like to be.

Toronto can hit its 90 per cent target with those two groups alone — the hesitant types and those who just need some extra help finding their way into a clinic. They, along with those who already have their first dose, can be the 336,000.

So long as these people remain persuadable, we owe them patience. We owe them understanding.

But should we give them more than that? I was struck by another finding of Toronto Public Health’s poll that asked unvaccinated people about whether various policy measures would make them more likely to get vaccinated. The results found that 37 per cent of the unvaccinated would be more likely to get vaccinated if vaccinations were mandatory for travel, and 34 per cent said they would be more likely if shots were required for them to go to work.

That’s a sign that a vaccine passport system, like the one Premier Doug Ford’s government will belatedly begin to implement on Sept. 22, could move some needles.

But next highest on the list of factors that would make unvaccinated people more likely to get vaccinated? Getting paid. Thirty per cent of respondents said getting $100 would work as a motivator.

I asked Coun. Joe Cressy, chair of the board of health, if a cash-for-jabs scheme is something Toronto Public Health is actively considering. He told me they have no current plans, and that he thinks the poll result is more a reflection of the fact that a lot of the remaining unvaccinated population might be feeling financially squeezed and can’t easily get paid time off work. Breaking down those kinds of barriers remains a big priority.

Other jurisdictions have gone further with bigger vaccine incentives. The state of Ohio launched a lottery in the spring, where being vaccinated made you eligible for the prize. Alberta kicked off its own $3-million vaccine lottery program in July, and recently started distributing $100 debit cards to anyone who gets a dose. But the promise of cash hasn’t worked as well as those jurisdictions might have hoped. A study after the Ohio lottery found that it did not move vaccination rates when compared to the national average. And the Alberta experiment has shown shortterm bursts when prizes and payments are announced, but overall their provincial vaccination rate remains among the lowest in Canada for eligible people.

What could work better, though, are targeted incentives — and fun. Recently, pop-up vaccination clinics have started offering things like $25 gift cards redeemable at local malls. And Cressy says there’s a “vaccine fun committee” that regularly comes up with ways to make clinic sites more appealing, with DJs, basketball skills competitions and the opportunity to use a woodfired pizza oven offered at recent pop-ups. The successful attempt to break the one-day vaccination record at Scotiabank Arena this summer spun out of the idea that it was important to make the vaccination experience fun. With more than 25,000 doses administered, it did the job.

In the weeks and months ahead, the city will need more creative thinking like that. All options must remain on the table. The goal is clear, but the goal is big: 336,000. It’s time to pull out all the stops, and count it down.