Vaccinations are essential in protecting older adults from serious illness and complications. As people age, their immune systems weaken, increasing the risk of severe outcomes from infectious diseases such as COVID-19, influenza, pneumococcal disease, shingles, and respiratory syncytial virus (RSV). In Canada, seniors account for the majority of hospitalizations and deaths related to these diseases, highlighting the importance of staying up-to-date with recommended immunizations. Ontario needs to lead the way in making free vaccines available for all seniors in the province. Whether it’s for influenza, shingles, COVID-19, or pneumococcal diseases. Adult immunization of the best possible medications should be a right for all older Ontarians. 

It’s tempting to think everything is fine. After all, Ontario is a national leader in the availability of vaccinations for older adults. But there is still more work to do and leadership to be shown.  The Ontario government (2022-2024) has made progress in vaccination programs, but seniors still face financial barriers to some expert-recommended vaccines. Expanded access would improve health outcomes and reduce strain on the healthcare system. Ontario needs to do more to make the expert-recommended vaccines for seniors free in the province and ensure easy access. Deaths due to preventable diseases is not a trend we want to see in 2025. 

It is undeniable that Ontario is the leading province in Canada in terms of vaccination coverage and eligibility. We hope other provinces will follow in Ontario’s footsteps regarding vaccines for seniors. However, CARP’s stance has always been that seniors should have access at no cost to the expert-recommended vaccines. Ontario needs to do more in making the expert-recommended vaccines for seniors free in the province and ensure easy access whether that be for influenza, shingles, COVID-19, RSV or pneumococcal. 

CARP advocates for:

• Better accessibility through wider availability of the NACI-recommended high-dose flu vaccines.
• Increased availability of the shingles vaccines for all seniors at no cost.
• Streamlined access and more funding for the pneumonia and RSV vaccines.

Government response to the ‘CARP 5’

COVID-19 

• The National Advisory Committee on Immunization (NACI) recommends 2 doses of vaccine for older adults.
• Vaccines are currently free for everyone 6 months and older, regardless of health coverage or immigration status. 

Pneumococcal Disease 

• NACI recommends pneumococcal vaccination for all adults 65+. Ontario offers the Pneu-C-20 vaccine for free to adults 65+ only. 
• Other pneumococcal vaccines or additional doses require out-of-pocket payment. 
• There have been no updates on eligibility and changes for seniors for this vaccine in Ontario. 

Shingles

• The shingles vaccine is available for adults 50+ but is only covered by the Ontario Health Plan (OHIP) for those aged 65-70. Other age groups must pay out of pocket.
• NACI recommends all aged 50+ get the shingles vaccine
• No advance on Ontario government funding for additional qualified age groups.

Influenza 

• NACI recommends annual influenza vaccination, as strains change yearly. 
• Seniors are advised to get Fluzone High-Dose Quadrivalent, Fluad, or Supemtek vaccines.
• Flu vaccines are free and available at pharmacies, clinics, and public health centers and some family doctor’s offices.

RSV

• In Ontario, the RSV vaccine is only publicly funded for those aged 60+ in long-term care (LTC), retirement homes, Elder Care Lodges, and First Nations, Inuit, or Metis; otherwise, it is an out-of-pocket expense.
• In Ontario, no new updates on broader coverage have been announced.

Full Brief

COVID-19 

COVID-19 is an infectious disease with symptoms including runny nose, sneezing, sore throat, headache, difficulty breathing, severe shortness of breath, fever, vomiting, and diarrhea. The risk of hospitalization from COVID-19 is significantly higher among those aged 60+, accounting for 92% of Canada’s COVID-19 deaths as of Winter 2024. 

NACI recommends that older Canadians receive 2 doses of the new COVID-19 vaccine. 

The current COVID-19 vaccine program offers vaccines free of charge to all individuals 6 months and older, even if you do not have an Ontario Health Plan (OHIP). Vaccines are available at select pharmacies and primary care providers. The 2024/2025 updated COVID-19 vaccines made by Moderna, Pfizer-BioNtech and Novavax provide a high level of protection against the virus. As of October 2024, seniors may be eligible for a second dose 6 months after their first dose. 

PNEUMOCOCCAL (Pneumonia)

Pneumococcal diseases may cause infection in the lungs, ears, sinuses, and, more rarely, the bloodstream or central nervous system. Pneumonia, a lung infection, is the most common form of this disease. Symptoms include difficulty breathing, coughing, fever, sweating, chills, fatigue, nausea and vomiting, chest pain, and diarrhea. Older Canadians experience more serious outcomes as they make up the majority of pneumonia-related hospitalizations and deaths each year. Together with influenza, pneumonia is ranked the 8th leading cause of death, with 90% of these deaths occurring among approximately 5,375 older Canadians in 2022. 

The NACI recommends that all adults aged 65+ get the pneumococcal vaccine. Ontario’s publicly funded pneumococcal vaccine program has recently transitioned to two new vaccines—Pneu-C-15 and Pneu-C-20.

Currently, only the Pneu-C-20 vaccine is publicly funded (free) for adults aged 65+ and for those 18+ with certain underlying medical conditions. Adults who do not meet these criteria must pay out-of-pocket. Other pneumococcal vaccines or additional doses are not covered for seniors and would require out-of-pocket payment. 

As of January 2025, there has been no new announcement by the Ontario government regarding the pneumococcal vaccine or changes to existing eligibility coverage for seniors. 

SHINGLES 

Shingles is an infection caused when the chickenpox virus is reactivated and can present as a painful, blistering rash accompanied by headache and fever. Other more serious symptoms include prolonged severe pain, nerve paralysis, vision loss, and problems with hearing or balance. Most cases occur for those aged 50+ and present most severely in seniors.  

The NACI recommends that everyone aged 50+ get the shingles vaccine. 

The shingles vaccine (Shingrix) is available to adults aged 50. However, the vaccine is covered by OHIP only for those aged 65-70. For other age groups, there is an out-of-pocket cost. As of January 2025, there has been no new announcement by the Ontario government regarding the shingles vaccine or changes to existing eligibility coverage for seniors. 

INFLUENZA 

Influenza infections can occur throughout the year but are more common during “flu season” from fall and winter. Symptoms include fever, headache, muscle aches, fatigue, sore throat, chills, coughing, and loss of appetite. Older Canadians are more likely to experience serious outcomes such as pneumonia, heart attack, and death. Together with pneumonia, influenza is ranked the 8th leading cause of death in Canada, with 90% of these deaths in older Canadians in 2022.

There are 8 influenza vaccines available for older Canadians, each protecting different strains of influenza. NACI recommends Canadians get an influenza vaccine each year as the strains in the vaccines change each year to better protect against the current influenza viruses. NACI recommends that older adults should receive one of three influenza vaccines: Fluzone High-Dose Quadrivalent, Fluad or Supemtek.

In Ontario, the influenza vaccines are provided free of charge to all seniors. Flu shots are available at primary care and some specialty care clinics, pharmacies, or public health clinics. 

RESPIRATORY SYNCYTIAL VIRUS 

RSV infects the airways and lungs. Symptoms include runny nose, coughing, sneezing, wheezing, fever, and decreased appetite. Seniors have the highest mortality rate from RSV infections, more than 6 times than the overall mortality rate – 85% of deaths among hospitalized patients with RSV were older adults. 

NACI recommends that adults 60+ get the RSV vaccine. Abrysvo and Arexvy vaccines are available in Ontario for seniors.  

However, these vaccines are not covered by OHIP. It will be an out-of-pocket expense for most senior Ontarians. Publicly funded RSV vaccines are only available for people 60+ in LTC homes, retirement homes, or Elder Care Lodges and First Nations, Inuit, or Metis.  

As of January 2025, there has been no new announcement by the Ontario government regarding the RSV vaccine or changes to existing eligibility coverage for seniors.