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The shingles vaccine works (but only if people can get it)

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As Canada’s national seniors’ advocacy organization, CanAge released an election platform built around three core goals: fixing seniors’ care; protecting older adults’ financial well-being; and prioritizing vaccinations to keep older Canadians healthy.  

With variants of COVID-19 spreading aggressively in communities across Canada, it’s never been more important to protect seniors from the multiple infectious diseases we already know how to prevent. Vaccines save people, healthcare dollars, and economies.

Only 8-10% of older Canadians are up to date with the routine vaccinations they need to stay safe from the flu, shingles and pneumonia; due in part to a lack of funding and access in certain provinces. 

The pandemic has prevented many seniors from seeing their primary health care providers and getting vaccinated. In fact, the Canadian Institute for Health Information (CIHI), released a report this past July showing that, during the first wave of the pandemic in Nova Scotia, Ontario and Manitoba, the number of patient visits to physicians dropped by 13%.

CanAge has increasingly been fielding concerns from adults in their 50’s who can’t get to their GP to get vaccinated, including the expert-recommended newer shingles vaccine, Shingrix.

Shingles is a viral infection caused by the varicella-zoster virus — the same virus that causes chickenpox. Symptoms include a painful rash that can occur anywhere on your body, including in your eyes. Yet, in Ontario alone, initial data suggests a 35% decline in shingles vaccinations over the course of 2020, worsening to a 48% decline by January of 2021.

While the vaccine became publicly funded and readily available for those aged 65-70 in Ontario in 2020, it is available for purchase for those over the age of 50 who wish to obtain it.  

Except that they can’t.

The backlog for some offices is simply too great and people are waiting much longer than they may like, to get the protection they need. While shingles isn’t a life-threatening condition, the most common complication is postherpetic neuralgia, which causes pain for a long time after your blisters have cleared.

Ontario was the first jurisdiction in Canada to make the shingles vaccine part of its publicly-funded immunization program. Even now the province is one of only two jurisdictions that offer it for free to those aged 65 to 70 years old (the National Advisory Committee on Immunization recommends it for everyone over 50).

And yet, in CanAge’s annual vaccine report card, we gave Ontario an “F” for vaccine access due to the cumbersome nature of gaining access to those vaccines – including not having the vaccines be available in pharmacies. Pharmacies are the health care hub Canadians visit most frequently, and as we’ve seen during the COVID19 rollout, are the closest, most accessible, and convenient face-to-face health service we have. In short, when it comes to vaccines, pharmacies can reduce the disparities of access between rural and urban communities.  

The past 18 months have shown the importance of effective collaboration, communication and coordination between the federal government and its provincial and territorial counterparts. But healthcare is ultimately a provincial responsibility, which is why CanAge is equally focused on pushing provinces to step up and ensure they have the policies, the funding and the ability to deliver the vaccines required to help protect the health of millions of Canadian seniors.

We firmly believe that pharmacies across the country should be empowered to administer all publicly funded vaccines including influenza, pneumonia and shingles.

In fact, that’s precisely why on behalf of older adults in Canada, CanAge presented to the National Association of Pharmacy Regulatory Authorities (NAPRA) to reclassify the best-in-class shingles vaccine as a Schedule 2 vaccine –  which would allow pharmacist administration without a prescription from a physician. The NAPRA agreed completely and the scheduling has been effectively changed.

Throughout the pandemic, pharmacists have demonstrated that they have the skills, capacity and community reach that Canadians need to get the preventive healthcare they deserve. Governments across the country turned to pharmacies to play a fundamental role in the rollout of COVID-19 vaccines, and that’s why they should also become a cornerstone of a new pan-Canadian partnership to expand access to routine immunizations that will continue to keep older Canadians out of hospital, and healthy.

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Toronto, ON, M6R 1L5

Factor-Inwentash Faculty of Social Work
University of Toronto

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