With that, Quebec and Alberta have withdrawn pretty much all COVID-19 vaccination coverage, a stark reversal from Ottawa’s announcement in January. Both provinces are facing massive deficits of their own. Quebec is dealing with a shocking anticipated deficit of $13.6 billion fiscal year 2025-2026, and Alberta a $6.5 billion hole by the end of this year.
In Canada, the National Advisory Committee on Immunization similarly continues to recommend COVID-19 vaccinations for all over six months of age. Instead of moving forward with universal coverage, both provinces have decided to focus on targeted high-risk groups. Notably, in Alberta the province will continue paying for vaccinations for immunocompromised people. This recent support flows to seniors living in care homes and getting home care, and seniors on income support. The province stated that it will end its universal vaccination program on June, but universal rules didn’t apply to these vulnerable populations.
Quebec’s updated rules will provide free vaccinations to individuals over 65, residents of nursing homes and seniors’ homes, pregnant women, health care workers, and residents of remote regions. Among other things, the flu vaccine will continue to be free for all Quebeckers over six months old.
These changes in both provinces have drawn the ire of health experts who worry they will create new health inequities. Jesse Papenburg, a pediatric infectious-disease specialist, explained how these changes will increase inequities in access to care.
“Even though you might argue about whether the data supports this approach of targeting high-risk only, it is still a move away from what has been done before and it does open a door for more variability in the future.” – Lynora Saxinger
In addition to the panning of this week’s announcement, experts have raised concerns about potential interprovincial variability in vaccine coverage. Saxinger remarked that unequal access could lead to a situation where some provinces provide high-quality vaccine services while others fall short.
“If we start seeing a lot of interprovincial variability in what’s being covered, you might end up with provinces that have A-team vaccine coverage and ones that have C-team vaccine coverage and I don’t think that’s appropriate.” – Lynora Saxinger
Policies strongly against these decisions seem to be based on fiscal limitations. A recent panel from the Institut national de santé publique du Québec (INSPQ) indicated a major reduction in COVID-19 hospitalization rate. They are no longer convinced that it’s cost-effective to vaccinate.
“The burden of hospitalization caused by COVID-19 is too low to make vaccination cost-effective.” – INSPQ panel (via Marie-Pierre Blier)
As these provinces continue to deal with budgetary constraints and the effects of their decisions on public health are realized over time. Health officials are walking a razor thin line between financial realities and the need to deliver fair and equitable healthcare. One that many leaders in the field are closely watching.
