That depends on your company’s goals, according to medical experts. If many of your employees travel to exotic destinations on business, it may be wise to offer them coverage for certain travel vaccines. If you’re an organization promoting health and safety, you may want to offer coverage for a whole bag of vaccines—to send a consistent corporate message.
Working Well spoke with Drs. Stephen Shafran and Arif Bhimji to help you weigh the pros and cons of covering vaccinations for three common and preventable illnesses—influenza, hepatitis B and hepatitis A. Keep reading to find out whether your organization would benefit from adding these vaccines to its drug plan.
Influenza
What is it? Influenza is a common respiratory infection, caused by the influenza virus, affecting an estimated 10-25% of Canadians every year, according to Health Canada. Recovery can take a week to 10 days, but in some cases, the fl u can lead to serious complications, such as pneumonia. A person becomes sick by breathing in droplets of the virus coughed or sneezed into the air by an infected person, or by touching contaminated surfaces and transferring the virus to the eyes, nose or mouth. The fl u shot is 70-90% effective in preventing or reducing the severity of the illness.
Does government cover it? Ontario, the Yukon and Nunavut offer flu shots to everyone over the age of six months. Other provinces and territories cover the cost for children six to 23 months old, seniors, healthcare workers and others at high risk for complications, such as people with chronic diseases.
Should you cover it? According to a study by the University of Minnesota, flu immunization in working adults resulted in 43% fewer sick days and 44% fewer visits to the doctor during fl u season in 1994–’95. Estimated cost-savings were US$46.85 per vaccinated employee. “That’s a pretty good example of one vaccine [for which] employers probably should pick up the cost, because there’s a direct benefi t that clearly outweighs the investment,” says Dr. Bhimji, an occupational health physician and president of Medicentres Canada in Edmonton.
What does it cost? Around $10 per employee to deliver the fl u shot in the workplace, says Dr. Bhimji. While the cost of the vaccine itself ranges provincially, a person may pay $10 to $25 out of pocket at a doctor’s offi ce or walk-in clinic.
Hepatitis B
What is it? The hepatitis B virus (HBV) is the most prevalent strain of hepatitis attacking the liver. It can cause lifelong infection, scarring of the liver (cirrhosis), liver cancer, liver failure and even death. The virus is spread through contact with blood through unprotected sex, sharing needles with an infected person or needle-stick and sharps injuries in healthcare environments. Infected mothers can also pass on the virus to their unborn babies. In Canada, an estimated four in 100,000 people were infected in 1999, according to Health Canada. The HBV vaccine can prevent the infection.
Does government cover it? Only for children up to Grade 7. Two or three shots are needed over six months for full immunization.
Should you cover it? While all provinces and territories offer the vaccine, each rolled out its immunization program in a different year. So, whether your employees have received the vaccine depends on whether they were in the right province at the right time. Those who would benefi t from vaccination include employees with high-risk lifestyles characterized by sexual promiscuity, drug use or homosexuality, healthcare workers who come into contact with blood, travellers to areas with high rates of HBV and kidney dialysis patients, says Dr. Shafran, professor and director of infectious diseases, department of medicine, University of Alberta in Edmonton. Infected mothers may also benefi t from extended family coverage for the vaccine by allowing them to immunize their newborns. The (U.S.) Centers for Disease Control and Prevention estimates that for every one million adults vaccinated, US$100 million is saved in future, direct medical costs.
What does it cost? Around $100 for a series of shots.
Hepatitis A
What is it? Also a liver disease, the hepatitis A virus (HAV) is transmitted by ingesting food or liquid contaminated by human or animal waste and exposure to contaminated blood. Improper food handling, poor personal hygiene and poor sanitation practices are often sources of the virus. High-risk groups include gay men, people with liver disease, residents of communities with high rates or repeated outbreaks of HAV, members of the Canadian Armed Forces, animal handlers and international travellers, especially to Asia, Africa and the Middle East. Fortunately the number of HAV cases has dropped dramatically in Canada—from 3,562 in 1991 to 396 in 2003, according to the Public Health Agency of Canada. Vaccines are available to prevent both short-term and longterm infection.
Does government cover it? No.
Should you cover it? Employers should conduct a health risk assessment of their workforce to determine whether it’s appropriate to offer this vaccine. Coverage may be benefi cial for food service workers. “It’s something to consider if you are an employer and you don’t want to [be sued by] people getting hepatitis A in your restaurant,” says Dr. Shafran.
What does it cost? A hefty $40 to $50 per dose. Two doses are needed, six to 18 months apart.
As with any workplace health initiative, deciding which vaccines to cover is a matter of weighing the costs against the benefits. Conducting a health risk assessment of your employee population is an integral part of this process. Despite the costs, offering your employees coverage for vaccines is probably a good idea if you’re an organization promoting wellness—it shows you’re being consistent with your corporate message. Says Dr. Bhimji: “It comes down to money and how benevolent, for lack of a better term, a company wants to be.”
Adam Pletsch is a freelance writer in Toronto.
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