A Burning Issue: The Shingles Vaccine Debate
In a controversial move, the B.C. government has come under fire for its stance on the shingles vaccine. With a proven track record of preventing severe pain and even reducing dementia risk, a senior's advocacy group is questioning why B.C. is one of the few provinces denying universal coverage for those aged 50 and above.
Imagine you're a senior, aged 50 or older, and your doctor strongly recommends the shingles vaccine. Health authorities like Vancouver Coastal Health (VCH) also endorse it, but here's the catch: you might have to pay for it out of your own pocket.
Canada's National Advisory Committee on Immunization (NACI), a trusted panel of health experts, recommends the shingles vaccine for all adults aged 50 and older, as well as those with compromised immune systems. Shingles is essentially a reactivation of the chickenpox virus, and if you had chickenpox as a child, you're at risk.
The VCH website describes shingles as causing severe blisters, pain, and burning sensations on the torso, limbs, or face. For one in five people with shingles, the nerve pain can persist for months or years. Recent studies estimate that up to 30% of the general population will develop shingles at some point in their lives.
In Canada, this translates to approximately 130,000 cases of shingles annually. Of these, about 17,000 will result in persistent, severe nerve pain, and a further 2,000 will require hospitalization.
The vaccine, Shingrix, is highly effective, offering 97% protection for those aged 50 to 69, and 91% for those over 70, according to VCH. It lasts for around 12 years, but the cost is a significant barrier for many.
Eligible Indigenous people aged 60 and above can access the vaccine for free through the First Nations Health Authority's BC PharmaCare plan. Some employer health insurance plans may also cover the cost, but most seniors will have to pay.
The vaccine typically costs around $160 per dose, and it's given in two doses, spaced two to six months apart. That's a total of $320 - a hefty sum for many seniors on fixed incomes.
An Unfair Burden and a Missed Opportunity
Laura Tamblyn Watts, a corporate director and CEO of CanAge, a national seniors' advocacy organization, argues that making seniors pay for the shingles vaccine is an unfair burden. She believes it's also bad public health policy, especially when other regions have started providing coverage for seniors.
Nova Scotia, for example, began covering the vaccine in May of last year. Premier Tim Houston stated, "Across Canada, nearly one in three people develop shingles, despite the availability of the vaccine. That's why we are delivering on our promise of removing barriers to access and making the shingles vaccine free."
New Brunswick is the only Atlantic province that doesn't cover the shingles vaccine, but Ontario, the Yukon, and Quebec all have free programs in place.
With the aging population on the rise - people aged 65 and over are projected to make up about 23% of Canada's population by 2040 - the need for accessible vaccines is only going to increase.
The International Federation on Ageing's policy brief, "Shingles Matters Driving Provincial Policy in Canada," highlights the significant pain, complications, and healthcare costs associated with shingles. It emphasizes the need for urgent action, given the economic impact, which is already estimated at millions of dollars annually.
Tamblyn Watts points out that the cost of the vaccine is a significant burden for seniors in the Lower Mainland and Sea to Sky regions, where the cost of living is already high. She argues that vaccines are a fundamental part of our healthcare system and vital for preventing illness.
"Think about two seniors on fixed incomes in the Pacific Northwest trying to find where $800 is going to come from out of their already stretched pockets. The single most problematic part of getting people to take vaccines is having to pay for them privately. It's not that people don't want the vaccines; it's that they should be covered, and in B.C., they're not," she said.
The Economic Argument
Tamblyn Watts also makes a strong economic case for funding the vaccine. She argues that it makes no sense for the province to deny funding when the cost of treating sick people is so high.
"The amount we save by preventing shingles is significant, even if you don't consider the human cost of blindness, opioid use, pain, and suffering. The economies are so profound, it makes absolutely no sense, especially in our stretched healthcare system. We should be prioritizing the most effective measures to keep people out of hospitals," she said.
Dementia Reduction and a Missed Opportunity
A 2024 study revealed another compelling reason to fund the shingles vaccine: it lowers new dementia diagnoses by about 20%.
"Even if this was just a dementia vaccine with a side effect of preventing shingles, it would still be the most effective tool we have, aside from lifestyle choices, for dementia prevention. The impact of dementia on people's lives is immense. What wouldn't we do to prevent it?" Tamblyn Watts said.
The Government's Response
The Ministry of Health, when approached for comment, stated that "at this time, the province is not considering the implementation of a publicly funded shingles vaccine program."
The ministry reviews B.C.'s immunization program regularly and consults with provincial public health and immunization experts to assess and advise on adding vaccines to the publicly funded list.
"The ministry then reviews their recommendations in the context of other health system priorities," a spokesperson said.
When the time comes to review the potential inclusion of the shingles vaccine, the ministry will consider national and provincial guidance, emerging scientific evidence, and their responsibility to manage public resources prudently.
The Ministry of Health encourages those with private health insurance to reach out to their providers to determine their eligibility and coverage for the shingles vaccine.
Tamblyn Watts agrees that private insurance can help, but emphasizes that it's the government's responsibility to ensure coverage for recommended vaccines.
"If you have an employer, whether union or non-union, you can lobby them to cover all NACI-recommended vaccines. But ultimately, this is the government's job. Governments should be doing this," she said.
And this is the part most people miss...
The shingles vaccine debate is a complex issue, with strong arguments on both sides. It raises questions about the role of government in healthcare, the economics of prevention versus treatment, and the value we place on public health.
What do you think? Should the B.C. government fund the shingles vaccine? Is it a matter of public health or personal responsibility? We'd love to hear your thoughts in the comments below!
