Access to adult vaccines in Canada remains uneven as programs vary between provinces, leading to patchwork vaccination rates based on factors such as patients’ location, financial means and education.FatCamera/Getty Images
Ask a Doctor is a series of physician-authored columns offering insights and advice on common health topics. It is not a substitute for seeking medical care.
Continuing measles outbreaks across Canada have placed the importance of childhood vaccines back in the spotlight, illustrating what can happen when immunization rates fall.
Robust childhood vaccination programs have saved lives – and saved the health care system significant resources as well.
Adult vaccines have similar impacts. Last year, the Adult Vaccine Alliance, a pro-vaccine advocacy group, estimated that six common adult vaccines – COVID-19, seasonal influenza, shingles, respiratory syncytial virus (RSV), pneumococcal disease and human papillomavirus (HPV) – save the Canadian economy and health care system $2.5-billion in unnecessary illness and missed work days.
But access to adult vaccines remains uneven. While some provinces have COVID-19 immunization programs, which automatically recall high-risk patients when due for their boosters, other adult vaccines lack the same supports. This has led to patchwork vaccination rates based on factors such as patients’ location, financial means and education.
Here is a primer on four common adult vaccines (other than the COVID-19 and flu shot).
Shingles
Shingles is caused by the varicella-zoster virus, which also causes chicken pox. When you have chicken pox as a child, the virus stays in your body even after you get better and can be re-activated later in the form of shingles.
Shingles affects about one in three Canadians in their lifetime, especially those over age 50, often causing symptoms such as rash, blisters and pain. In some cases, it can cause serious complications such as debilitating long-term nerve pain.
The two-dose Shingrix vaccine protects against shingles and is approved by Health Canada for people over age 50. It costs about $300.
Ontario, Quebec, Prince Edward Island and Yukon cover the cost for eligible residents but people in other parts of the country must pay out of pocket. In many provinces, your pharmacist can both prescribe and administer the vaccine to you.
Human papillomavirus (HPV)
HPV is the most common sexually transmitted infection in Canada. It usually infects the genital area, mouth and throat, and can increase the risk of cancer in the affected areas.
HPV vaccination is the cornerstone of the Canadian Partnership Against Cancer’s lofty goal to eliminate cervical cancer by 2040.
There are two types of vaccines to protect against HPV infection authorized in Canada and recommended for individuals aged nine to 26.
While publicly-funded and school-based HPV vaccination programs are available across Canada, some adults may have never received the vaccine. The National Advisory Committee on Immunization says people age 27 and older who were not vaccinated may benefit from vaccination and should consult with their health care provider.
Eligibility for provincially-covered HPV vaccines outside of school-based programs varies across Canada. Individuals who don’t qualify for provincial coverage can pay up to roughly $600 for the recommended doses.
Respiratory syncytial virus (RSV)
RSV is a seasonal respiratory virus that often feels like a common cold but can cause serious illness and complications for some people, especially infants and older adults.
It is a leading cause of pediatric and older adult hospitalizations and emergency room visits.
There are three RSV vaccines currently approved in Canada. Health Canada recommends vaccination for adults age 75 and older, and adults age 60 and over who live in chronic care facilities or are considered high-risk. It also advises other adults who may be interested in the vaccine – including people over age 50 and pregnant people between 32-36 weeks gestation – to talk to their doctor to decide what is best for them.
Maximal efficacy occurs if it is received before the start of respiratory virus season in the fall.
Cost and provincial coverage varies across the country so speak with your primary care provider to learn more.
Pneumococcal disease
Pneumococcal infections can range from ear and sinus infections to more serious cases of pneumonia, also known as invasive pneumococcal disease.
Older adults are among the populations at higher risk of more severe health complications. Pneumonia vaccines have been around for a long time and many adults may have received the older versions, but the latest versions are more effective against multiple strains. Prevnar 20 is recommended by the National Advisory Committee on Immunization for adults aged 65 and over. It has set a goal that 80 per cent of adults age 65 and older be vaccinated.
Eligibility for provincial coverage varies across Canada.
Possible side-effects for all four of these vaccines include redness, soreness, mild swelling, low-grade fever, fatigue, headache and muscle aches. In most cases, these symptoms are mild and short-lived.
Dr. Tahmeena Ali is a family physician, medical director and co-owner of Catalyst Kinetics Medical in Surrey, British Columbia. She is also a hospitalist at Peace Arch Hospital in White Rock, B.C., a child and youth mental health consultant and clinical lecturer in the Department of Family Medicine at the University of British Columbia.
