In the early days of Newfoundland and Labrador's COVID-19 vaccine roll out, plenty of people wanted to get their shot — and there were a lot more arms than there were doses to go around.
Now, as vaccinations progress, the problem is the opposite: the province has more than 150,000 doses ready to go, but it doesn't have a lot of new people stepping up to get their first shots.
Newfoundland and Labrador has one of the best vaccination records in North America. Almost 77 per cent of the whole population has had a shot.
When you look at just the eligible population, it's 82 per cent, but what the number hides is that some people aren't stepping up to get vaccinated.
As most people worry about booking their second, the province has been handing out very few new first doses. There are an estimated 85,000 people who could get vaccinated, most of which are young people, and experts are starting to get worried.
The lowest rates of vaccination are among 18 to 29 year olds — particularly men, with just 66 per cent of them getting at least one shot, leaving one in three unprotected.
The best rate is people in their 70s. Of that age group, 97 per cent have gotten their shot.
Rate of COVID-19 vaccination in N.L. by age and gender
Rod Russell, a professor of immunology and virology at Memorial University, says the lower uptake in younger people will be a concern as classes resume in the fall.
"That's a group that has the potential to spread virus if it's in the community, and if they are not vaccinated, then it will spread fast," he said.
That's exactly what happened in Yukon, where the territory was hit with its biggest outbreak of the pandemic earlier this month, even with more than 70 per cent of its population fully vaccinated.
There were gatherings of young people who were unvaccinated, where one of the new variants of concern spread quickly. That same thing could happen in Newfoundland and Labrador.
"We would like to see an increase in the number of first doses," said Dr. Janice Fitzgerald, the province's chief medical officer of health.
"There is certainly a little bit of concern with that, for sure."
Why aren't young people stepping up?
Russell said there are fewer anti-vaxxers in the province than in the U.S., where misinformation has led large groups to refuse the vaccine.
Younger people were some of the last to be eligible to get the shot, however, and he said some just don't see the urgency.
"They've heard for a long time that it's the vulnerable populations, the elderly populations, the immunocompromised, so young people with healthy immune systems don't think they need it," he said.
But they do need the vaccine, and everyone else needs them to get it to reduce the chance of the disease spreading.
Incentives could work
So what will it take to get them get a shot?
Neither the premier nor Russell think a lottery is a good idea, like the ones Alberta and Manitoba have brought in, hoping the prospect of a big payout will get a big turnout at vaccination clinics.
But Russell thinks other incentives could work.
"What we miss the most, all of us, is normal life. So I think anything that gives you a little bit more normal life, so perhaps access to social activity, access to social gathering, access to all the things we've missed over the last year, if we can somehow incentivize access to things we've been missing, that might do it," he said.
It worked in France. When the goverment there announced you'd need to be vaccinated to get into a bar or cafe, there was a surge in people booking COVID-19 vaccines.
Right now in Newfoundland and Labrador, if you want to travel, being vaccinated lets you skip quarantine. But if you don't plan to leave the province, there is no special treatment.
Allowing large concerts, for example — but only for those who are vaccinated — could push the reluctant to book their shot.
That's not the direction the province is going in, however.
"We are not going to require anyone to release health information," Fitzgerald said during this week's briefing.
Barriers remain to getting a first dose
What Fitzgerald and Russell do agree on, though, is that easier access will help.
On the west coast of Newfoundland and in Labrador, you don't need an appointment, anyone can walk in and get their shot.
But other places, it's more difficult. For example, there were no first dose appointments available at any of the clinics in St. John's or Mount Pearl on Friday afternoon.
When the lack of appointments was a problem in the past, Eastern Health said people should check back later, but the harder you make it to get a shot, the less likely people will follow through.
Fitzgerald is promising pop-up clinics in Eastern Health, and they're figuring out the best spots to put them to get as many young people as possible.
"We're going to be continuing to vaccinate throughout the summer and into the fall," she said.
"Just because we get to a point where we hit 80 per cent, we're not going to stop."