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What charging for COVID-19 vaccines means for Albertans going forward
When the province announced that most Albertans will have to pay for COVID-19 vaccines themselves going forward, the phones at Mohamed Elfishawi's two Edmonton pharmacies started ringing.
"People are scared," Elfishawi said during an interview at his south Edmonton location, describing the calls he's had from clients – especially seniors.
Earlier this month, the province announced it would only cover vaccines for particular high-risk groups: people living in care homes and group settings, those receiving home care, people on social programs such as AISH, and immunocompromised individuals.
Everyone else will have to pay an estimated $110 if they want the vaccine.
Accessing the shot will also be more limited: in the near future, pharmacists like Elfishawi will no longer be allowed to administer them, they will only be available at health clinics.
Alberta's new path makes it an outlier in Canada, prompting questions about why the province has diverged from national recommendations on vaccines, what the timeline is for rolling out the new distribution system and whether or not the vaccine can be added to group health benefit plans.
Will group benefits offer coverage?
The United Nurses of Alberta (UNA) is already in talks with employers, seeking to get COVID immunization coverage added to group health benefits.
"But even if they do, what that means is that it will fall onto the insurance companies, which will mean increased premiums both for employees and employers," said Heather Smith, UNA's president.
UNA is also looking into benefits covering the cost for its staff. If it can't get sorted out in time for the fall rollout of vaccines, Smith said they plan to offer reimbursement for employees who pay to get immunized.
Jason Schilling, president of the Alberta Teachers' Association, said they are exploring options through insurance, but he has also written to ministers asking them to reverse the decision.
"We have policy around this that teachers should get vaccinations provided to them because they're working in congregated settings with students," Schilling said. "We know we have overcrowded classrooms."
Alberta Union of Public Employees vice-president Bonnie Gostola calls the plan to charge for the shots a "slap in the face" to members working in roles like hospital porters, housekeeping, and other service roles.
"Workers that barely make above minimum wage — $110 is one day pay for those members – it's excessive, especially when they are also responsible for looking after other people," she said.
Gostola said AUPE has been telling workers this is an occupational health and safety issue, and that it believes the employer needs to take on the responsibility of covering the cost of vaccines.
Some employers are suggesting other avenues for staff. The Canadian Air Transport Security Authority said in a statement that its workers will be able to use their employee health care spending account to pay for the shot.
A complex change
For people who do have health benefits, getting COVID vaccines added to group benefit coverage won't be simple. Alberta Blue Cross – a non-profit insurance provider that runs government coverage programs as well as private plans – has been getting inquiries from both employers and plan members about covering the vaccines.
"We are waiting for more information on the COVID vaccines — including the cost and specific details on the way Albertans will access and be charged for the COVID vaccine — before we can make a decision regarding private plan coverage," said Blue Cross spokesperson Sharmin Nault Hislop in a statement.
"The change is complex and there are a lot of factors at play."
Hislop explained that it's not a simple internal decision as private plans have many different designs, some including vaccine coverage and some that don't.
The organization also has an internal drug review process that needs to be done to determine if and how it can add COVID-19 vaccines to its roster of covered medications.
U.S. comparison
There is variability in the types of health care and medications publicly covered province-to-province. For example, shingles vaccines are free for older adults in some jurisdictions but not others.
But changing access to COVID-19 shots, which were freely available across the country for so long, creates a compelling case study, said Jamie Daw, an assistant professor at Columbia University's Mailman School of Public Health.
"I think it's not something that anyone expected access would be taken away," Daw said.
"I think that's sort of part of this broader conversation about sort of privatization in the Canadian health-care system more generally, and how we should grapple with it and what policies and regulations might be needed in cases like this."
Daw said that in the United States, about 90 per cent of Americans can still get COVID vaccines for free — covered by private insurance, and Medicare and Medicaid programs.
Unlike Canada where following the isn't required, the U.S. has federal regulations requiring that certain vaccines be fully covered by public and private coverage.
Diverging from NACI's recommendations
The province said in the 2023-2024 respiratory virus season, 135 million worth of doses went to waste. For the upcoming season, Alberta has ordered 500,000 doses – some of which will be given for free to the identified high-risk groups, and the rest available for purchase to help Alberta recoup the coast.
Most Albertans will soon pay about $110 for a COVID shot
1 day ago
Duration 2:43
With Alberta soon to end free COVID-19 vaccines for most residents, there's growing concern about cost, coverage and access — especially for vulnerable seniors. When provincial funding ends, most Albertans will have to pay an estimated $110 per dose.
A statement from Minister of Primary and Preventive Health Services Adriana LaGrange's office this week said the decision still offers protection to vulnerable Albertans, and takes low uptake of the vaccine by the general population into account.
And while Lagrange's office said the province was informed by NACI's recommendations on vaccines, it decided not to offer free vaccines to a number of high risk, priority groups that NACI identifies because of "Alberta's specific needs," such as uptake trends.
Those high-risk groups not being offered free vaccines include all people over 65, pregnant people, Indigenous people, members of racialized and other equity-denied communities, and health-care workers and other care providers in community settings.
The exclusion of people over 65 is particularly concerning to Dr. Lynora Saxinger, an infectious diseases specialist at the University of Alberta. She said it's a major deviation from NACI's recommendations, which do take cost to provinces into consideration.
"It doesn't really endorse using the vaccine very strongly from a public health perspective if they're not covering it," Saxinger said.
