Why are COVID-19 vaccine rates lower in some parts of rural Alberta?

Lower uptake of COVID-19 vaccines in pockets of rural Alberta is likely the result of compounding factors — not just vaccine hesitancy, experts say.

Rural areas face longstanding barriers to health-care access

Some areas of rural Alberta have the lowest COVID-19 vaccine rates in the province, according to data provided by Alberta Health. (Dave Gilson/CBC)

Lower uptake of COVID-19 vaccines in pockets of rural Alberta is likely the result of many factors — not just hesitancy, experts say.

Many Albertans — in both rural communities and cities — have been keen to get shots, and overall vaccine hesitancy is dropping. By Tuesday, more than 50 per cent of Albertans aged 12 and older had been given at least one dose.

But the shots aren't going into arms at the same rate in all parts of the province.

The province's data breaks down Alberta into 132 local geographic areas.

In most areas, between 30 to 49 per cent of the population has had a first dose. The areas with more than 50 per cent were parts of Edmonton and its surrounding communities, along with Calgary and Lethbridge.

All the areas with less than 30 per cent were smaller or rural communities, with the exception of the city of Grande Prairie. Those pockets were spread across different regions, but the lowest by far was 9.9 per cent in northwest Alberta, including the community of La Crete, which has made headlines for resistance to public-health measures.

A different cultural lens

For communities like that, vaccine hesitancy has an ideological component, said University of Lethbridge political science professor Lars Hallstrom. But there are also historical and cultural elements, as well as perspectives shaped by the remoteness of some of these places.

"The challenge in terms of overcoming different forms of vaccine hesitancy, which may significantly precede COVID-19, are really complex questions of science communication," he said. "It's really about dealing with a different cultural and psychological orientation to risk, to health, and to individuality and freedom."

When the illness was slow to spread to rural communities early in the pandemic, Hallstrom said, it fed beliefs that the coronavirus wasn't a major threat, which has led some people to wonder if vaccines are necessary.

While vaccines can be a hard sell in certain pockets where distrust of politicians, governments, academics, and urbanites run deep, he said, many rural communities face major health-care access issues that urban centres don't.

"This isn't all about attitude and vaccine hesitancy," he said. "There are broader structural issues about not just access to primary health care, but access to comprehensive health services in rural communities more broadly."

Do politics come into it?

There is some research that people more inclined to populist or conservative politics are more likely to be vaccine hesitant, and rural Albertans do skew to the political right, said University of Alberta assistant professor Roman Pabayo. 

Pabayo specializes in social epidemiology and has done research in the United States focused on the effects that political party affiliation and ideology can have on long-term health outcomes.

There has been some mixed messaging on COVID-19 from some conservative Alberta politicians throughout the pandemic, including criticism of public-health restrictions. Pabayo said that could be influencing vaccine hesitant attitudes, or could just be a reflection of already existing sentiments in those communities. 

"We have these political beliefs as we age, but at the same time they're reinforced by our political leaders." he said. "I do think there's a mixture of both going on here."

He agreed with Hallstrom that a lack of access to health care in rural communities is likely a compounding factor, as are education levels.

Pabayo said there is work public-health officials can do to address vaccine hesitancy among rural populations and other groups, but an effective strategy has been to get people in those communities to champion vaccines and public-health guidelines.

He said his own parents were vaccine hesitant, and he encouraged them to talk to friends and family who'd gotten their shots, which worked. 

"That sort of made them a bit more comfortable," he said.


Paige Parsons is a reporter with CBC Edmonton. She has specialized in justice issues and city hall, but now covers anything from politics to rural culture. She previously worked for the Edmonton Journal. She can be reached at paige.parsons@cbc.ca.


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