Quebec, Canada's second most populous province, is planning to force adults who refuse to get the Covid-19 vaccine to pay a "health contribution" in a move likely to spur a debate about individual rights and social responsibility.
The province's premier, Francois Legault said the proposal, details of which were still being finalised, would not apply to those who cannot get vaccinated for medical reasons.
Unvaccinated people put a financial burden on others and the provincial finance ministry is determining a "significant" amount that unvaccinated residents would be required to pay, Mr Legault said, adding that such an amount would not be less than 100 Canadian dollars (€70).
Governments globally have imposed movement restrictions on the unvaccinated and few have levied fines on the elderly, but a sweeping tax on all unvaccinated adults could be a rare and controversial move.
While such a tax could be justified in the context of a health emergency, McGill University medicine and health sciences professor Carolyn Ells said, whether it survives a court challenge would depend on the details.
But Ms Ells expressed surprise that the government was taking such a "dramatic" step now, when options such as further expanding vaccine mandates remain.
Provinces across Canada are tackling an exponential rise in Covid cases which has forced tens of thousands of people into isolation and burdened the healthcare sector.
The highly transmissible Omicron variant has made it difficult for restrictive measures to curb the spread and health experts have stressed the importance of getting double and tripled vaccinated.
Quebec has been one of the worst-hit, regularly recording the highest daily count of Covid cases of all provinces and having several thousand healthcare workers off their jobs.
"The vaccine is the key to fight the virus. This is why we're looking for a health contribution for adults who refuse to be vaccinated for non-medical reasons," Mr Legault said.
He added that even though the province has about 10 per cent unvaccinated people, they account for about 50 per cent of those in intensive care units.
This comes after Canadian prime minister Justin Trudeau confirmed the federal government has secured enough Covid vaccine doses for all eligible Canadians to receive a booster as well as a fourth dose.
Last month, Quebec said it had "no choice" but to allow some essential workers to continue working even after testing positive for the virus to prevent staff shortages from impeding its healthcare services.