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Good morning. it’s James Keller in Calgary.

As provinces across the country implement their respective plans to lift COVID-19 restrictions, they point to this country’s vaccination rates – among the highest in the world – to argue that they can re-open safely.

But those seemingly robust national or even provincial rates hide pockets where small numbers of people have been vaccinated, as predominantly rural or remote regions lag behind the rest of the country.

The most extreme examples are on the Prairies: the northwestern corner of Alberta in and around High Level, and the southern tip of Manitoba in the Rural Municipality of Stanley. In both places, just 16 per cent of the population have had their first doses, which is just a fraction of places like Calgary and Winnipeg.

Those low vaccination rates are leaving residents vulnerable to the fast-spreading Delta variant and put those areas at risk of never having the level of protection public-health experts argue is needed to keep COVID-19 under control.

In the High Level region – which includes the 3,000 residents of the town of High Level as well as more than 20,000 residents in nearby communities, First Nations reserves and rural areas – the uptake is spread across age groups, including seniors. Just 30 per cent of people over 75 have received at least one dose; for teenagers, the coverage is about 12 per cent.

High Level Mayor Crystal McAteer, who has had two doses herself, told me that she believes the rates in her town are not too far off from the provincial average, but that the surrounding areas, where people are spread out and where some religious communities are especially resistant, help to explain the numbers.

Ms. McAteer also suspects the official rate is low due to the number of First Nations reserves in the High Level health area, which are often not included in the regional vaccination numbers, even though many of them have had very successful vaccination campaigns. About 29 per cent of the area identified as Indigenous, compared with less than 3 per cent across the province.

But she also acknowledges that some people have been taken in by misinformation online and she’s skeptical that things like the Alberta government’s vaccine lottery will do much to change that.

“We have horrible internet up here, we have horrible newspaper reporting, and people just are not getting the right information. They’re getting all their information from social media,” she said.

Norman Bueckert, a pastor at the High Level Christian Fellowship, said many people in his congregation have dutifully followed the COVID-19 rules, but many – including him – remain unconvinced about the vaccines.

He said there has been so much conflicting information floating around about vaccines that people just don’t trust public-health officials insisting the vaccine is safe. The provincial government’s decision to fence off a handful of churches and jail pastors who refused to abide by pandemic capacity limits has only bred more suspicion, he added.

Mr. Bueckert said he hasn’t closed the door permanently on the vaccine, and he doesn’t think all of the holdouts in his church have, either. He said people in his church believe COVID-19 is real – some have gotten sick and there are people in the community who have ended up in intensive care

“I’m not an anti-vaxxer, because I have all the other vaccines,” he said, “I’m personally not ready yet and don’t trust the vaccines.”

Data from Alberta Health shows that the region had lower vaccination rates than the rest of the province even before the pandemic. For example, by age two, about 26 per cent of children in the High Level health area had received the DTaP-HB-IPV-Hib vaccine – a standard infant shot that protects against several diseases including diphtheria, hepatitis B and polio – compared with about 77 per cent across the province as of 2017. The rate for the measles, mumps and rubella vaccine was 44 per cent, compared with 87 per cent across Alberta.

Alberta also lags behind the rest of the country for vaccine coverage; the province is near the bottom when it comes to first doses and is behind most other provinces for second doses, as well, despite leading on that metric early on. And like many places in the country, Alberta’s rural areas generally have lower vaccine uptake than the larger cities.

In Manitoba, it’s not just the Stanley area that has low rates. About 30 per cent of the total population in Winkler has received at least one dose of a COVID-19 vaccine – well below the 69-per-cent average across the province. The rate for the Rural Municipality of Stanley surrounds Winkler and extends south to the U.S. border.

Stanley Reeve Morris Olafson said access has been an issue that has discouraged some from getting vaccinated when they realize the “rigmarole” involved in waiting weeks for scarce appointments. He said that has gotten a lot better and he expects the numbers to improve.

He also noted that Stanley’s population is young – the median age is 23 compared with 41 in Canada – which has also pushed down rates.

Mr. Morris agreed that misinformation and conspiracies are a problem but he doesn’t think that’s the main issue.

“I think it’s more hesitancy than it is anything else,” he said.

Health officials in both provinces have pointed to a number of factors keeping people from getting vaccinated, from continued difficulty accessing vaccines in rural areas, distrust of the medical system, religious beliefs, and misinformation.

They say they are working with community leaders, churches, and others to slowly push up those numbers. Manitoba was the first province in Canada to introduce a lottery to entice people to get the COVID-19 vaccine. Alberta was the second.

This is the weekly Western Canada newsletter written by B.C. Editor Wendy Cox and Alberta Bureau Chief James Keller. If you’re reading this on the web, or it was forwarded to you from someone else, you can sign up for it and all Globe newsletters here.

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