The Current

New shingles vaccine should be free, argues seniors advocate

As the cases of shingles rise, especially among seniors, advocates are pushing for provincial governments to cover the cost of a new and effective vaccine.
A new vaccine to keep shingles away from older Canadians costs about $400. Advocates are calling for provincial health care plans to cover it. (Eloy Alonso/Reuters)

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It's a painful viral infection that strikes 130,000 Canadians every year, mostly over the age of 60. 

The symptoms of shingles have been described as a searing combination of burning electrical shocks and needle pricks against your skin. 

All this can be avoided with a new vaccine that is now available in Canada. The catch is, it's not cheap — and not covered. Patients require two separate shots of the vaccine Shingrix, costing about $400 in total.

Many seniors advocates are calling on provinces to take on the cost of this vaccine in their health-care plans.

"Governments owe Canadians to invest up front because Canadians are asked to look after themselves and contribute to society," argues Jane Barratt, the secretary general of the International Federation on Ageing

Vaccination can help prevent shingles, which is caused by the varicella-zoster virus — the same virus that causes chickenpox. (Centres for Disease Control and Prevention)

"By 2031 one in four of us in Canada are going to be over the age of 65. So we should understand this is a short-term investment for long-term contributions that all Canadians will make."

Barratt says Ontario is the only province she knows of that covers the older, less-effective vaccine Zostavax, but it is only available for people between the ages of 65 to 70 years old. 

What is shingles?

According to Health Canada, the shingles infection presents itself as a painful skin rash with blisters on one side of the body (left or right.)

How do you get shingles?

Shingles is caused by the varicella-zoster virus, the same virus that causes chickenpox.  Even after recovering from the chickenpox, this virus does not leave the body. It tends to re-activate when the immune system is compromised by another health problem.

Risks associated with shingles

The severity and complications derived from shingles increase with age.

Pain from shingles can interfere with daily activities. Scratching the rash area can also result in a secondary infection when the sore is exposed to harmful bacteria.

If shingles occurs on the face involving the eyes, there is a possibility of scarring and blindness.

The number of shingles cases over the age of 50, according to Barratt, is two out of three. With people working longer, volunteering and taking on caregiving duties as grandparents, she recommends the vaccine should be considered from the age of 50 and over.

​Why is this new vaccine more effective?

Infectious disease specialist Dr. Lynora Saxinger says after reading preliminary papers on the Shingrix vaccine, she was very impressed.

"It genuinely is a big step up in vaccinating against varicella-zoster virus (which causes shingles). It has much higher rates of protection that seems to not matter how old you are," Saxinger tells The Current's Anna Maria Tremonti.

That is not the case with the older shingles vaccine Zostavax, she argues. While it is decent at reducing risk, it would depend on age on how well a patient would be protected. The vaccine does not respond well to an older immune system, says Dr. Saxinger, highlighting this as a real problem given the elderly are at a higher risk of contracting shingles. 

"This [Shingrix vaccine] actually kind of gives the 80-year-old the immune system of a 20-year-old," says Dr. Saxinger. 

"It seems to provide potentially long-lasting immunity, at least so far it doesn't seem to decline over the first few years the way the other vaccine did."

Government funding of a vaccine is complicated

It's no surprise to microbiologist Dr. Allison McGeer that the Shingrix vaccine not being covered because it's a process that involves many variables. 

"There's a whole lot of complicated logistical planning that goes into how a government would decide to fund and deliver a vaccine — it feels like something really simple but it's actually not," Dr. McGeer says.

She lists some of the factors that government needs to consider when funding a vaccine.

"A piece of it is about how cost effective it is, so what is the actual benefit? Is there a savings in medical care? A piece of it is about how we perceive the illness.  It's much easier to fund a vaccine against meningitis than it is to fund a vaccine against influenza," Dr. McGreer explains.

A province-wide vaccination program takes a very long time to consider, says Dr. Allison McGeer. (Ryan Remiorz/Canadian Press)

She adds that another piece to this puzzle is how to integrate a provincial program providing the vaccine.

"It's not as simple as saying: 'We'll just give everybody the vaccine.' We have to have a stable supply and we have to know how much is going to be used so we're not wasting money on a vaccine that's not going to be given, or running out of vaccine when we need it."

The government just doesn't spend money on prevention, says Dr. McGreer 

"I think there need to be people who are advocating for prevention, so it's hard to argue when people are advocating for effective vaccines," she tells Tremonti.

"At the same time it's really important that the government looks carefully at what they're doing and negotiates hard to get the best price for vaccines, and sometimes that takes time."

Listen to the full audio near the top of this page.

This segment was produced by The Current's Samria Mohyeddin and Calgary Network's Michael O'Halloran.