1. The Majority of Older Canadian are not Receiving their Recommended Vaccinations
The vast majority of Canadians ensure that our children and young adults are getting the vaccinations recommended for them. What fewer Canadians appreciate is that there are recommended vaccinations specifically for older Canadians like the influenza, pneumonia (pneumococcal) and shingles (varicella/herpes zoster) vaccinations. Additionally, the tetanus vaccination is one we are recommended to take at regular intervals across the lifespan. As a result, overall vaccination rates among adults in Canada remain far lower (See Table 1) than the Public Health Agency of Canada’s (PHAC) previously set 80% target immunization rates for those 65 and older by 2010.7
With evidence showing the overall positive benefits of taking the annual influenza vaccination8 Canadian public health authorities have made the greatest progress in advancing the uptake of the influenza vaccine in particular among older adults, yet the uptake rate of other more efficacious vaccines such as the pneumonia, shingles and tetanus vaccinations have even lower rates of coverage amongst older Canadians (See Table 1).
|Risk Group||Seasonal Influenza||Pneumococcal||Varicella/Herpes Zoster||Tetanus
|65+ years of age 10||64.9%||38%||3.9%* 11||-
|Additional coverage needed to meet 80% target ||15.1%||42%||76.1%**||31%
Low vaccination rates among older Canadians is of concern since many preventable illnesses and their substantial associated costs could easily be avoided with better uptake of these vaccinations. With respect to influenza alone, between 4,000-8,000 Canadians are at risk of death annually due to influenza,14 with the vast majority being amongst individuals 65 years and older.15 Furthermore, costs related to the lost productivity costs due to influenza amount to over $1.5 billion annually.16
We also know that individuals over 65 years old make up one-third of all community acquired pneumonia cases;17 largely caused by one strain of pneumonia that the pneumonia vaccine specifically targets. Despite this, only 38% of older Canadians have received the pneumonia vaccination. Finally, 90% of Canadians are at risk of developing shingles because they have had chickenpox earlier in life,18 yet less than 5% of older Canadians have been vaccinated against shingles. This probably explains why 130,000 Canadians are still diagnosed with shingles each year, resulting in 252,000 physician consultations, 2,000 hospitalizations a year, and significant treatment-related costs.19
The opportunity to further advance the promotion of vaccinations among older adults through focused awareness campaigns and leveraging as many health care providers and points of care to offer this vaccination should be acted upon. Indeed, in a growing number of provinces, pharmacists are now being given training and support to deliver influenza vaccinations each year, while nearly all provinces have ensured that the vaccination can be provided at no cost to recipients. However, not all older Canadians have access to universal coverage for the influenza vaccine. In Quebec, for example, individuals 65 and over do not have access to publically funded influenza vaccinations.20 Where vaccines recommended for older Canadians by the Public Health Agency of Canada (PHAC) are provided at no out of pocket cost, identifying barriers to uptake is still required to address low vaccination rates.