Canada: What the report says about flu vaccine access in your community

Planning to have your kid vaccinated for cold and flu symptoms — or for protecting yourself — in 2019? You may want to give that a little more thought.

A Toronto study released Wednesday shows the city is preparing to vaccinate low-income children in new ways, and the province isn’t involved.

Now, lower-income kids are about five times less likely to get vaccinated than similar kids in the general population. The study found that the vaccine gap shrinks when a clinic’s doors are open to those earning less than $20,000 a year, but that nearly 20% of households in the low-income bracket still can’t afford to pay for vaccinations, the study said.

This isn’t news to the Ontario government.

“Any family can come to the clinic and pay for vaccines, even if their household income isn’t high enough to qualify for free vaccines,” the province said in a statement, adding that cost-sharing rates in the province range from 50% to 100% of the cost.

But some health care providers and researchers disagree with this approach.

“A one-size-fits-all model is not the best way to address gaps in supply,” said Dr. Stefan Streeter, medical director of the Outcome Research and Prevention Services at Children’s Hospital of Eastern Ontario, which is a member of the Greater Toronto Area Immunization Network.

“Offering the one and only option to vaccine-resistant children is not in the best interest of the health system or children,” Streeter said.

His organization does not provide emergency vaccines for children and recommends low-income patients cover their vaccines out of pocket before seeing a pediatrician.

“At the end of the day, the public health office made a decision that the only way to contain vaccine-preventable diseases was through antiviral drugs, and it’s very effective in curbing the risks in children, but there are very few cases,” he said.

Ontario’s Ministry of Health said in a statement to CNN that it has expanded access to vaccination through programs such as annual winter vaccinations for kids.

“The study simply illustrates the system limitations of public health and this particular problem does not justify refusing to enable some patients to receive those vaccines,” said Dr. Mark MacDonald, president of the Medical Association of Ontario.

Public health officials in Ontario will begin rolling out plans to try to narrow the vaccine gap starting December 1, a spokeswoman for the ministry said. A statement from the organization said officials will prioritize three to four per cent of patients, and said there is an existing waiting list for some vaccines.

A plan is also in the works to eliminate the waiting list, the spokeswoman said.

Meanwhile, Dr. Wendy Chung, medical director for influenza and respiratory infections at the Ontario Health Network, is pushing for a new vaccine.

“At some point, we should change our current system to make a vaccine mandatory,” she said.

The group is lobbying the government to mandate vaccines for children under age 8 and adults in high-risk situations.

The new vaccine, called COVID-19, is currently under development. Chung thinks that while it won’t be available in time for the flu season this year, she thinks it will be available in time for the flu season in 2020.

“I think it’s a great first step to have someone at risk wanting to have this vaccine, and being able to pay out of pocket and then have the government saying ‘We will offer it to you, regardless of your income,’” she said.

But Streeter said he’s not convinced that a mandatory vaccine will be effective.

“The co-pay for a vaccination at a private clinic should be uniform with a standard vaccine … where it’s both predictable and affordable for everyone,” he said.

“When you require it, you start a system of subsidizing and that puts a financial burden on some families.”

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