How Canadians Are Paying The Price For Incomplete Vaccine Funding
Patient Perspective Understanding the impact of recommended, but unfunded vaccines.
Not everyone needs to receive every vaccine available, which is why the National Advisory Committee on Immunization (NACI) has created their recommendations outlining which vaccines are recommended for people in certain high-risk groups.
Though these recommendations are in place nation-wide, funding for vaccination takes place on a provincial level and, depending on where you live, recommended vaccines are not always funded by provincial public health agencies. “For the most part these vaccines are unfunded simply due to budgetary priorities,” explains Ian Culbert, Executive Director of the Canadian Public Health Association. “The ministers of health in each province have set budgets for vaccination programs and, as new vaccines get approved, they just don’t have the money to fund them.”
Without funding, vaccines fade from view
When people become aware of these unfunded ‘orphan’ vaccines, there is a reluctance to pay out of pocket for them, not only because of the cost, but because many feel that, if the vaccines are unfunded, they must not be important. “There is a belief that, if it’s good, governments will supply it,” says Dr. David Scheifele, Director of the Vaccine Evaluation Center at BC Children’s Hospital. “Unfortunately, we’re at a point where not everything that’s good is necessarily affordable by governments. It’s becoming necessary to pick and choose rather than fund everything.”
Perhaps the most prominent example of an orphan vaccine is the herpes zoster (shingles) vaccine, which is recommended for all Canadians over the age of 60. Thirty to 40 percent of Canadians will experience a shingles episode in their old age and the condition can be extremely painful, resulting in permanent chronic pain and even blindness. And yet, despite the existence of an approved and recommended vaccine, it remains unfunded and most Canadians go unvaccinated.
The human cost of unfunded vaccines
Elaine and Larry Gareau, of Eastern Ontario, have direct experience with the fallout from a lack of shingles vaccination. Larry came down with the disease in the early 2000s and then, ten years later, Elaine also contracted it, at the age of 65. “I still thought I was invincible, even at my age,” Elaine says. “I thought that if I’d had chickenpox I would not get shingles, when in fact the opposite is true.”
“There is a belief that, if it’s good, governments will supply it. Unfortunately, we’re at a point where not everything that’s good is necessarily affordable by governments. It’s becoming necessary to pick and choose rather than fund everything.”
Elaine’s case was particularly bad. The blisters spread across her body, causing excruciating pain that continues to this day in the form of postherpetic neuralgia, more than a year after the episode. Elaine and Larry are fortunate enough to have been able to afford to get vaccinated following their episodes (for shingles is a disease that can reoccur, and post-facto vaccination reduces both the likelihood and severity), but for those on a fixed income that is not an easy option when the vaccine costs over $200 out of pocket. “For many people over 65, who are living on Old Age Security (OAS), they would not have the money for the vaccine,” says Elaine. “They barely have the money to survive.”
In order to bridge the gap between what is recommended and what is available, awareness of these vaccine-preventable diseases must grow and people must insist that their provincial public health organizations promote and fund them for the good of all Canadians. “There needs to be a public demand as well as a political solution,” says Dr. Scheifele.