Advocating for Universal Free Vaccinations in Canada

A growing movement in Canada is calling for the government to provide free vaccinations for all citizens, particularly seniors. Advocates argue that eliminating the cost of vaccines would significantly reduce healthcare expenses and improve health outcomes, especially among older adults who are at a higher risk for serious complications from diseases.

Recent visits to pharmacies reveal a stark reality for many residents in British Columbia. While vaccines for influenza and COVID-19 are provided at no charge, others come with hefty price tags. For instance, the vaccination for respiratory syncytial virus (RSV) costs approximately $300, while the shingles vaccine can reach around $160 per dose. These costs prompt many seniors to reconsider their choices, despite the potential health risks associated with forgoing vaccinations.

Data from the Canadian Institute for Health Information indicates that health spending in British Columbia (B.C.) has not been evenly distributed among age groups. In 2022, B.C. spent an average of $16,583 per capita for infants under one year old, compared to $14,042 for those aged 65 and older. This discrepancy highlights the significant healthcare burden faced by older adults, who account for approximately 45 to 50 percent of health expenditures.

According to the B.C. Office of the Seniors Advocate, seniors represent about a quarter of all emergency visits and 47 percent of hospitalizations. They also spend an average of 8.6 days in hospital, nearly four days longer than younger patients. The costs associated with these hospital stays are considerable, averaging $8,321 per stay in the 2022-23 reporting period.

The implications of these figures are stark. While many individuals suffering from shingles or RSV do not require hospital care, the lack of vaccination leads to significant health complications. The “Shingles Matters” policy brief notes that the lifetime risk of developing shingles significantly increases after age 50, with approximately 130,000 cases occurring annually in Canada. In B.C. alone, an estimated 150 to 200 individuals are hospitalized each year due to shingles, with numbers potentially reaching 1,000 when accounting for secondary infections and complications.

RSV poses a similar threat, particularly among seniors, with annual hospitalizations in B.C. ranging from 900 to 1,200. The average cost for a hospital stay for RSV is estimated at $5,000 for a five to six-day duration, with costs escalating to $20,000 for intensive care. The case fatality rates for severe RSV infections average between 5 to 10 percent.

Despite the proven efficacy of vaccines, uptake remains low among seniors, primarily due to costs. For instance, the RSV vaccine, Arexvy, has shown to be 82.6 percent effective against RSV-associated lower respiratory diseases, yet only 12 to 15 percent of B.C. seniors have received the vaccination. Comparatively, the Shingrix vaccine is publicly funded in regions such as Ontario, leading to significantly higher uptake rates of 47 to 57 percent.

Advocates for universal free vaccinations argue that increased access would lead to healthier seniors, ultimately reducing demand for emergency and primary care services. An editorial in the November issue of The Lancet Infectious Diseases highlighted that adult vaccination has historically been neglected, even though it is crucial for promoting healthy aging and reducing healthcare costs.

The editorial emphasized that expanding adult vaccination could also alleviate the burden of antimicrobial resistance, potentially reducing antibiotic use significantly.

The current approach taken by health ministries, including that of B.C., may prove to be counterproductive. By imposing costs on necessary vaccinations, they may save a small amount in the short term but risk incurring larger expenses due to increased hospitalizations and emergency care among older populations.

The proposition for universal free vaccinations is gaining traction, with advocates likening it to the provision of safe drinking water—a fundamental right in a civilized society. Making vaccinations freely accessible could not only improve public health outcomes but also enhance the quality of life for many Canadians. The majority of seniors would likely embrace such an initiative, recognizing the long-term benefits of vaccination.