A new report card on territorial and provincial efforts to vaccinate seniors gives the Northwest Territories a failing grade, but a top public health official says it doesn’t take the northern context nor the challenges of the Covid-19 pandemic into account.
The latest report card is the second to be released by Canada’s National Seniors’ Advocacy Organization, or CanAge, which focuses on vaccines for older adults against the seasonal flu, shingles and pneumonia. In both 2021 and 2022, the organization gave the NWT a D grade for issues with vaccine funding, availability and public confidence, as reported by NNSL.
“The Northwest Territories government didn’t make any notable improvements,” Laura Tamblyn, chief executive of CanAge, told Cabin Radio.
She highlighted that the shingles vaccine is not publicly funded for all seniors in the NWT, vaccines are not available at pharmacies among other locations, and there has been a lack of improvement in awareness about vaccines.
Comparatively, she said, the Yukon was the most improved jurisdiction in Canada between 2020 and 2021, due to new funding for the shingles vaccine, provision of a high-dose flu shot for seniors, and upgrades to how immunization information is communicated to the public.
Tamblyn said the NWT government could learn not only from the Yukon when it comes to supporting vaccines for adults, but from its own successes with the delivery of Covid-19 vaccines.
“The use of more sites is very easy and we’ve already seen that accomplished for Covid-19,” she said. “It doesn’t make any sense that we can’t also do that for things like influenza and pneumonia.”
The NWT government’s ambitious Covid-19 vaccine rollout involved teams of healthcare workers travelling to every community, along with pop-up clinics and initiatives to encourage vaccine uptake. To address questions and concerns about Covid-19 vaccines, health promotions workers set up in-person information booths, top health officials appeared on CBC Radio to answer listener questions, and the health department regularly posted information in a number of languages on social media.
Covid-19 vaccination rates are high across the territory, particularly among seniors. As of February 13, 97 percent of NWT residents 80 years and older are fully vaccinated, 100 percent of residents aged 75 to 79, 92 percent for those aged 70 to 74, and 91 percent of 65 to 69-year-olds.
Pandemic’s impact on resources
Dr André Corriveau, the NWT’s deputy chief public health officer, said one reason there hasn’t been as much focus on other vaccines over the past two years is because of the strain the pandemic has had on healthcare resources.
“The priority has been put on the Covid response. Not everything has moved as quickly as we would like to,” he said.
Corriveau added he doesn’t feel CanAge’s report captures the unique context of the North, where logistics, infrastructure and vast distances between communities make it challenging to deliver services. While the NWT government was given the opportunity to provide input on the report, Corriveau said the people qualified to respond were busy managing the pandemic response.
Corriveau pointed out many NWT communities do not have pharmacies and territorial legislation does not currently permit pharmacies to deliver vaccines. He added the National Advisory Committee on Immunization’s recommendation that seniors aged 65 and older receive a high-dose influenza vaccine is discretionary.
Despite challenges, Corriveau said vaccine uptake has been successful among seniors in the NWT, particularly when it comes to the influenza vaccine.
“Generally speaking, I would say that seniors are quite attuned to the importance of being immunized,” he said.
“We try to have a program that delivers it in a convenient way and it’s about communicating the importance of those vaccines to the right population.”
From 2020 to 2021, 13,942 influenza vaccines were administered to NWT residents with the highest coverage rates – around 60 percent – among those aged 65 and older.
The shingles vaccine
The shingles vaccine Shingrix is covered for some seniors in the NWT.
Since January 2021, the territorial government has funded the vaccine for residents aged 65 to 70. The vaccine is also covered for First Nations, Inuit and Métis people in the same age range through the non-insured health benefits program.
According to the Canadian immunization guide, however, the shingles vaccine is recommended for adults aged 50 and older, residents in long-term care facilities, and adults with compromised immune systems.
Mary Tapsell, vice president of the Yellowknife Senior Society said seniors have to pay for the cost of the vaccine up front and then seek reimbursement from Blue Cross or non-insured health benefits.
She questioned why funding is not available for seniors older than 70 years of age. She added that since the NWT government began funding the vaccine, it has done little to increase public awareness about shingles and the importance of getting vaccinated.
“Shingrix got dropped between the cracks for quite awhile,” she said. “The shingles disease doesn’t impact populations because it’s not transmissable that way. So it never got addressed for years until we kind-of pointed it out.”
“We’re all very concerned with Covid and we’re happy that our government has been on top of things, but it should never be used as an excuse to not provide services for important vaccinations.”
Tapsell said Shingrix is costly at around $160 per dose. Two doses are required with a recommended interval of two to six months between doses.
Shingles is a re-activation of the virus that causes chickenpox, which can cause a painful rash and, for some people, can lead to long-term complications like nerve pain, hearing problems, brain inflammation or even death. Nearly one in three Canadians gets shingles in their lifetime, with incidence and severity increasing sharply after the age of 50. Treatments for shingles have been shown to have limited effectiveness.
Tapsell said the NWT government does not provide public data on how many people in the territory get shingles every year – information she has requested – nor the impacts to the healthcare system.
“It needs a lot of research,” she said.
The number of people aged 60 years and older in the NWT rose nearly 70 percent in the past decade, the second-highest increase in Canada and well above the national average.
CanAge recommends the NWT government expand its coverage and remove financial barriers for the shingles vaccine to improve uptake. It also recommends creating a government and community working group to raise awareness about the need for adult vaccinations, particularly in remote communities, and working with community-based health supports to get the broadest vaccine uptake possible.
The organization has called on the federal government to help the territories when it comes to funding and support for vaccination programs in rural and remote areas.
Canada not taking adult vaccinations seriously, CanAge says
Across Canada, Tamblyn said improvements need to be made when it comes to vaccinating seniors against preventable conditions.
Only Ontario and PEI received a B grade and Yukon a C grade in this year’s report card. CanAge gave BC, Manitoba, New Brunswick, Newfoundland and Labrador, Nova Scotia, Quebec and Saskatchewan varying D grades, while Nunavut received an F.
“Canada hasn’t taken its adult vaccinations particularly seriously,” Tamblyn said. “We’ve done a good job on childhood vaccinations … but once we become age of majority, people often forget that we need vaccines.”
One of the issues, she said, is that public health has been routinely underfunded as the focus is often on acute care, which is more costly.
“It’s our hope that the increased awareness around public health and the importance of vaccines for Covid-19 can spill over to raising awareness of getting these [other] vaccine shots.”