Ensuring Equitable Access to Adult Vaccines across Canada

GSK is a global biopharma company with a purpose to unite science, technology and talent to get ahead of disease together. Our vaccines portfolio, the broadest in the industry, consists of more than 20 vaccines helping to protect people at all stages of life.

In April 2023, GSK engaged KPMG on an evidence-based report that provides an analysis of the gaps between Canada’s federal and provincial approaches to adult vaccination and potential approaches to address these gaps. This paper is based on information from publicly available sources and on insights from experts – public health leaders, researchers and policy makers – who generously contributed their time. This blog post is an excerpt from the executive summary of the report available here.

Vaccination has saved more lives than any other innovation in modern medicine,[1] but the benefits of disease-preventing vaccines are not equally accessible across Canada. Over the last two decades, the progress made in improving vaccine access and uptake in children has not been observed among adults.

Currently, there is no obligation for Canadian provinces, territories (P/Ts) nor the federal government, to allocate funding for adult vaccines that have been recommended by Canada’s National Advisory Committee on Immunization (NACI). Consequently, the availability of publicly funded immunizations across Canada is patchy and inconsistent for certain diseases, limiting access to those who are aware of the vaccine and can pay.

What stands between NACI recommendations and equitable access to vaccines across Canada is often the lack of public health funding to support vaccination programs. For most adult vaccines in Canada, the funding burden for vaccine purchasing and program implementation is the responsibility of each P/T. P/Ts are faced with complex decisions around allocation of their healthcare budgets and competing priorities that can impinge the decision to fund a vaccine.[2]This has created a patchwork approach to access across Canada.

Additionally, despite progress in the digitization of health and medical records, there are still significant gaps in the availability of consistent, accurate and real-time immunization data across Canada, especially for adults.[3] These gaps in data collection and harmonization make it difficult for public health teams to evaluate the effectiveness and benefits of vaccination programs.

Despite the efforts to improve equitable access to vaccines,[4] there is more work to do. As new innovative vaccines launch in Canada, there is an expected increase in the number of NACI-recommended vaccines for adults, and costs with implementing respective programs. These new vaccines, however, present opportunities to improve equity in access to reduce suffering and death while alleviating burden on our healthcare systems – governments have a primary responsibility to capitalize on these opportunities.

Without change, current inequities in vaccination access may persist and widen. Alongside increased funding, thoughtful consideration should be put into addressing additional barriers to access, including providing convenient immunization delivery locations, and improving education and awareness around vaccine preventable diseases.

The full position paper analyzes the gaps between NACI recommendations and provincial approaches to adult vaccination and potential opportunities to address these gaps. The purpose of this analysis is to help advance public policy discussion regarding equitable access to adult vaccines across the country so that the benefits of immunizations are spread equally across Canada. Access to vaccines should not depend on the postal code in which you live.

[1] Desai S, et al. (2015). Canada’s National Advisory Committee on Immunization. https://www.ncbi.nlm.nih.gov/ pmc/articles/PMC4507835/

[2] Scheifele DW & al. (2014), Approved but non-funded vaccines: Accessing individual protection. https://doi.org/10.1016/j.vaccine.2013.12.027

[3] Government of Canada (2019), Highlights from the 2017 childhood National Immunization Coverage Survey (cNICS) : 2019 update. https://www.canada.ca/en/services/health/publications/vaccines-immunization/vaccine-uptake-canadian-children-preliminary-results-2017-childhood-national-immunization-coverage-survey.html

[4] Government of Ontario (2020), Immunization 2020: Modernizing Ontario’s Publicly Funded Immunization Program. https://www.health.gov.on.ca/en/common/ministry/publications/reports/immunization_2020/immunization_2020_report.pdf