Shingles vaccine should be provided for free to all Albertans 50-plus, doctors say

There are new calls for the provincial government to publicly fund the shingles vaccine for all older Albertans.

Shingles is triggered when the dormant chickenpox virus is reactivated, causing a blistering rash and nerve pain. It can lead to hearing and vision loss, and in rare cases it can be deadly.

The province provides the shingles vaccine, free of charge, to solid organ transplant patients over the age of 18. But doctors say everyone over 50 should have access publicly funded shots.

"Shingles is quite common. We estimate that about one in three Canadians get it over the course of their lifetime," said Calgary-based public health physician, Dr. Jia Hu. "It can be quite serious."

What many people don't realize, according to Hu, is that shingles can cause nerve damage and pain that can last for years. This complication is known as "post-herpetic neuralgia."

"Shingles is not a benign disease and anybody who's had shingles — and I'm glad I haven't — can tell you how nasty it was for them."

Alberta public health disease management guidelines reveal there are approximately 130,000 new cases of shingles, 17,000 cases of post-herpetic neuralgia and 20 shingles-related deaths in Canada each year.

"Something like the shingles vaccine is a no-brainer," said Hu.

The National Advisory Committee on Immunization recommends the Shingrix vaccine for Canadians over 50.

At Cambrian Pharmacy, in northwest Calgary, pharmacist David Kovacik brings up the vaccine with patients whenever he can.

"It's definitely something that we definitely talk about or discuss with our patients, that's for sure," he said.

"I think probably awareness, knowing about the shingles vaccine is probably the biggest barrier."

And Shingrix is expensive.  At Cambrian Pharmacy, the two required doses cost a total of $360.

"That is definitely a barrier to uptake," said Hu.

"The vaccine is highly effective. And we really just need to make it more accessible for more Albertans by making it free for more Albertans," said Hu.

Patchwork of coverage

The Toronto-based National Institute on Ageing (NIA) is calling for all provinces, including Alberta, to publicly fund the vaccine for everyone 50 and up, as part of Shingles Awareness Week, which runs until March 5.

"We are seeing other provinces in Canada who are covering all older people who we know are at an increased risk," said Dr. Samir Sinha, director of geriatrics at the University Health Network and director of health policy research at the National Institute on Ageing.

"What I'd like to see is across the country, across Alberta, that we actually provide universal coverage, free access for this vaccine, because we know that right now only 27 per cent of older Canadians have received a shingles vaccine.'" 

According to a report by the NIA, Ontario, Yukon and Prince Edward Island provide free shingle vaccines for older adults of varying age ranges. P.E.I's publicly funded immunization program covers the shots for people 60 and up.

"The key reason that I recommend it to all my patients is that it actually can reduce your chance of developing a case of shingles by 90 per cent," Sinha said.

The report estimates shingles cost the Canadian health-care system between $67 million to $82 million a year.

"Why wouldn't we make this investment in the health and well-being of older Canadians," said Sinha.

A spokesperson for Alberta Health said the minister approved plans to offer Shingrix to solid organ transplant patients, 18 and older, in February of 2021.

"Alberta Health reviews the provincially-funded vaccine program on a regular basis to determine if additional vaccines should be added," Andrew Livingstone said in an email.

The varicella-zoster virus, which leads to both chickenpox and shingles, is monitored in Alberta.

According to provincial data, an average of 11 Albertans are hospitalized for varicella every year. Most of them are not immunized.