VACCINES – Should they be covered by Benefits Plans?

VACCINES – Should they be covered by Benefits Plans?

Because of COVID-19 and the development of new vaccines to fight the pandemic, vaccines have become a hotly debated topic in medical and political spheres. Here in Canada, the COVID-19 vaccines and boosters have been made available to the public free of charge, just as the annual flu shots are free too. For employers, there is no consensus on whether other vaccines should be covered in benefits plans or not.

Travel Vaccines

Travelers to a large number of international destinations must receive specific travel vaccines to be allowed into the country. The vaccines are necessary because of foreign diseases that can be contracted through water, in foods, and through insect bites.

An example is for Canadian visitors to Australia, the following vaccines are recommended or required: COVID-19, hepatitis A, hepatitis B, yellow fever, Japanese encephalitis, rabies, meningitis, polio, measles, mumps and rubella (MMR), Tdap (tetanus, diphtheria and pertussis), chickenpox, shingles, pneumonia and influenza. Travellers to Africa, Southeast Asia, Central and South America all have lists of vaccines, for these and other tropical diseases, which are required or recommended.

Travel vaccines can range in price depending on how many doses are required, from $45 – $230 each. There is usually a travel clinic consultation fee of approximately $50 on top of these vaccines to determine the ones you need. In Alberta, travel related services like the consultation, immunization and prescriptions for international travel are NOT covered by Alberta Health Care. So, a trip to Africa for example could cost over $500 for an employee. Should your benefit plan cover those travel vaccines?

The Pneumococcal Vaccine

Many people think that contracting pneumonia is like getting a really bad cold. Not so. Unlike a common cold, pneumonia can affect the patient’s long term health, and pose a serious or fatal threat to those with underlying conditions or in certain age groups. Pneumonia is especially dangerous for the very young, such as premature babies, and people over 65. People with chronic diseases of the kidneys, the liver, the lungs, including asthma and other respiratory problems, heart disease, diabetes, cancer, and HIV, should receive the pneumococcal vaccine. If these more vulnerable individuals contract seasonal flu, it can develop into pneumonia. The pneumonia vaccine costs $165.

The Shingles Vaccine

Many of us had chicken pox as children and remember how unpleasant it was. Unfortunately, the virus responsible for chicken pox still lurks in our bodies decades later and might make a reappearance as shingles, or herpes zoster, a far more unpleasant version of chicken pox with debilitating neurogenic pain.. Adults in Canada who had chicken pox as children or even later, are advised to get one of the two shingles vaccines available in Canada, Zostovax II (Live Zoster Vaccine LZV), and Shingrix (Recombinant Zoster Vaccine RZV). LZV is administered once as a subcutaneous injection, and RZV is administered intramuscularly in two doses, between 2 and 6 months apart. These vaccines cost between $350 – $400.

An Ounce of Prevention: The Pros of Covering Vaccines in Benefits

Prevention of tropical diseases goes beyond the safety of employees who make a one time trip to a tropical location and get the required travel vaccines. Some tropical diseases like malaria, and leishmaniasis, remain in the body long after recovery and the disease can recur if there has not been a post-infection protocol of proper treatment. Thus, travel vaccines not only protect a traveller for a particular trip, but also from having a recurrence of the disease later in life.

Nearly 1 in 3 Canadians develops Shingles in their lifetime. The incidence and severity of both Shingles and Pneumonia increases sharply after age 50. Effective treatments for these diseases are limited in their effectiveness which is why having access to safe and effective vaccines for Shingles and Pneumonia is a much better health option to reduce their occurrence.

The pros of including these three categories of vaccines in your benefits plans outweigh the costs. As Ben Franklin famously said, “An ounce of prevention is worth a pound of cure.” The costs to employers to pay for treatment of sick employees, and their lost work time, are potentially far greater than the costs of paying for vaccines. The costs of these vaccines can also be partially offset by encouraging employees to request generic versions of their prescriptions whenever possible.

A preferred way of managing the cost of adding vaccines to your Benefits Plan is to establish maximum amounts of reimbursement for the specific type of vaccine – for example, an Annual Maximum of $300 for Travel related Vaccines.

At Health Risk Services, we help managers of benefits plans make strategic decisions to craft cost-effective personalized plans that address very intrinsic elements of protection such as Vaccines. Let us assist you in attracting and retaining your employees.

To schedule your Complimentary Consultation with Health Risk Services, please call 403-236-9430 OR email: [email protected]