Employers can play a meaningful role in improving vaccine uptake, said Ajit Johal, a community pharmacist, clinical assistant professor at the University of British Columbia and founder of vaccine education non-profit organization immunize.io, during a session at Benefits Canada’s 2024 Vancouver Benefits Summit in May.
A recent partnership between the Richmond School District in British Columbia and immunize.io set out to tackle what the World Health Organization calls the three Cs of vaccine hesitancy: complacency, confidence and convenience.
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During the campaign, more than 300 out of 1,000 school district employees rolled up their sleeves to protect themselves from shingles (some staff didn’t participate because they had already been vaccinated). The campaign also boasted a two-dose vaccine completion rate of 97 per cent, far higher than the 60 to 70 per cent average in the general population.
The campaign included an intranet portal with information on the vaccines that would be offered, vaccine clinics in school gyms during professional development days and opportunities to book a vaccine with a partner pharmacy. The school district also introduced partial coverage for the $300, two-shot vaccine: plan members would pay for the first dose out of pocket, while the district would cover the second.
While Canada has done “very well” on childhood vaccinations, most adult Canadians aren’t up to date on their age- and risk-based vaccines, due to a lack of vaccine education and fewer Canadians having family doctors, said Johal. According to a survey by the Public Health Agency of Canada, 88 per cent said they think they’ve received all the vaccines they need but, when shown a list of the vaccines they should have received, 87 per cent of those respondents said they haven’t received them all.
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Canadians often aren’t up to date on their tetanus and diphtheria vaccinations, which many don’t know should be renewed every 10 years. Vaccines that aren’t funded by the public health-care system — including shingles, pneumococcal and respiratory syncytial virus vaccinations — have significant immunization gaps, he said, noting this is an area where plan sponsors can make a major difference.
There’s a particularly strong case for covering shingles vaccinations through employer-sponsored benefits plans. The illness, which shows up as a painful blistering rash and can cause complications such as long-term nerve pain, is a reactivation of a latent chicken pox infection in adulthood. Stress and age tend to cause the reactivation and incidence rates are much higher in Canadians aged 50 and older, many of whom are still in the workforce.
With an aging workforce that’s more susceptible to age-related, vaccine-preventable diseases, benefits coverage for unfunded vaccines can pay dividends by keeping plan members well and working, said Johal.
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Plan sponsors can also provide educational material on recommended vaccines for adults and host webinars on vaccine-preventable diseases. A 1965 study that attempted to increase tetanus vaccine uptake found that merely asking respondents whether they’d had their shot and making them aware of where to go to receive helped increase vaccination rates by 60 to 70 per cent — and was far more effective than warning them about how unpleasant the illness was.
“A clear pathway leads to behaviour change,” said Johal. “The traditional pathway to getting a vaccine is not easy, there are a lot of barriers. . . . And when it comes to our human nature in preventative medicine, there’s something called future discounting: any time I’m encountering a barrier to getting vaccinated, I’ll say, ‘That’s a lot of effort, I have more pressing things to do. This is a future me problem.’ The attrition really adds up.”
Read more coverage of the 2024 Vancouver Benefits Summit.