Vaccines: To fund or not to fund?

CARP calls on federal government to renew National Immunization Strategy but acknowledges that governments must deliberate carefully when making vaccination funding decisions.

While immunization has received numerous stamps of approval as one of the most beneficial medial interventions of modern times, the question of whether or not certain vaccinations should be publicly funded remains a murkier issue. Before any vaccine is authorized for sale in Canada, it is reviewed by Health Canada to assess its safety, efficacy and quality. Once a vaccine is approved by Health Canada, the National Committee on Immunization (NACI) – an advisory body made up of recognized experts that reports to the Chief Public Health Officer of Canada – issues recommendations on the appropriate use of vaccines by Canadians. NACI’s recommendations include the identification of groups at risk for vaccine-preventable disease for whom vaccine programs should be targeted. Recently, NACI issued its recommendation on the Herpes Zoster Vaccine for shingles, a painful condition linked to the same virus that causes chickenpox. In its recommendation NACI found that, “in those aged 60 and older, vaccination with the Herpes Zoster Vaccine reduces the occurrence of (shingles) and its complications by approximately 60%.” Click here to read the full recommendation

According to industry experts, NACI’s recommendation is now a required standard of practice and physicians are obliged to prescribe the vaccine. However, it still remains to be seen which provinces will fund the vaccine. At the moment, the Herpes Zoster Vaccine is available for purchase at a cost of no less than $150. Prompted by the recent NACI recommendation on the shingles vaccine, CARP wrote to the federal Ministers of Finance and Health to request renewed funding for the National Immunization Strategy, a plan launched in 2003 to meet the current and future immunization needs of all Canadians. To read CARP’s letter click here. To learn more about the National Immunization Strategy click here.(

The preventative and therefore cost-effective benefits of immunization are extremely important when considered against Canada’s mounting health care costs. In 2005, the Public Health Agency found that immunization saves more lives and prevents more suffering than any other medical intervention. In 2004, Recognizing the merits of immunization, the federal government committed itself to ongoing investments for needed vaccines through the National Immunization strategy.

But while the benefits of immunization are clear, it does not follow that universal public funding is necessary for all vaccines. When determining which vaccines are publicly funded, governments must contend with important qualifying factors associated with vaccines. For example, while NACI found the shingles vaccine to be effective in reducing the occurrence of the disease, it also concluded that that “the decision to include Zostavax™ in universal, publicly funded provincial and territorial programs will depend upon a number of other factors, such as detailed cost-benefit evaluation.”

In other words, a number of factors related to the efficacy of vaccines may give governments good reasons not to extend universal funding for a particular vaccine. For example, in the case of the Herpes Zoster vaccine, NACI made note of the fact that “studies evaluating the immunogenicity of zoster vaccination should be interpreted with caution.” All of this to say that while immunization has been proven as an effective means of attenuating disease, public officials must weigh and balance a number of considerations in order to lever the preventative and thus cost-effective benefits of publicly funded immunization.

Keywords: immunization, healthcare, finances