NEW RELEASE:
Canada’s Adult Vaccine
Funding Gap
NACI recommends vaccines based on evidence—but public funding across Canada is inconsistent. Where you live continues to shape access to recommended adult vaccines.
About This Analysis:
Vaccines are one of the most effective and cost-saving tools in healthcare. Yet access to publicly funded adult vaccines in Canada depends heavily on geography—not just clinical need.
The Adult Vaccine Alliance (AVA) conducts an annual scan of vaccine funding across provinces and territories to identify gaps between:
National clinical guidance (NACI recommendations)
Public funding programs
This analysis highlights where programs are aligned—and where gaps persist—supporting evidence-informed advocacy for equitable access.
The Benchmark:
NACI Recommendations
Note: NACI recommendations provide clinical guidance. Public funding eligibility may vary by province/territory and may also differ by vaccine product, risk group, or delivery setting.
What Is Recommended?
The National Advisory Committee on Immunization (NACI) provides evidence-based recommendations for vaccine use across the life course. These recommendations reflect clinical need—not funding decisions.
AVA’s analysis focuses on six adult vaccines with significant impact on prevention, equity, and health-system resilience.
Click each vaccine to view NACI recommendations and why it matters.
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NACI recommends annual influenza vaccination for all individuals aged 6 months and older, with particular emphasis on adults at higher risk of severe outcomes, including:
Adults aged 65+
Pregnant individuals
People living with chronic health conditions
Immunocompromised populations
Residents of long-term care and congregate settings
Health care workers and others who may transmit influenza to high-risk individuals
Why it matters: Influenza contributes to significant seasonal hospitalizations and health-system strain. Annual vaccination is a foundational prevention measure.
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NACI recommends COVID-19 vaccination for previously vaccinated and unvaccinated individuals who are at increased risk of SARS-CoV-2 exposure or severe COVID-19 disease, including:
Adults 65 years of age and older
Residents of long-term care and other congregate living settings
Individuals who are moderately to severely immunocompromised
Adults with underlying medical conditions that place them at high risk of severe COVID-19
Pregnant individuals
Indigenous peoples
Members of racialized and other equity-deserving communities
Adults 18 years of age and older who provide essential community services
Health care workers and personal support workers (and other health care staff who have direct contact with patients)
Why it matters: COVID-19 continues to contribute to severe outcomes and health-system burden, particularly for priority populations most likely to experience severe outcomes such as older and medically vulnerable adults.
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NACI recommends pneumococcal vaccination for adults at increased risk of invasive pneumococcal disease, including:
Adults aged 65+
Adults with chronic conditions (e.g., cardiac, pulmonary disease, diabetes)
Individuals who are immunocompromised or have asplenia
Residents of long-term care and other congregate settings
Why it matters: Pneumococcal infection can lead to severe outcomes including pneumonia, bloodstream infection, and meningitis. Vaccination prevents avoidable illness and hospitalization in older adults and high-risk groups.
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NACI recommends shingles vaccination for:
Adults aged 50 years and older
Adults at increased risk of shingles and complications due to medical conditions or immunocompromising therapies (as applicable)
Why it matters: Shingles can cause debilitating pain and long-term complications like post-herpetic neuralgia.
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NACI recommends RSV prevention for adults at increased risk of severe outcomes, particularly:
Older adults (commonly framed as 60+ and/or 65+ depending on product guidance and risk stratification)
Adults with underlying conditions that increase risk of severe respiratory illness
Residents of long-term care / congregate living settings
Why it matters: RSV is a significant driver of hospitalization, outbreaks, and mortality among older adults, especially in long-term care. Prevention plays a role in reducing respiratory season strain and protecting vulnerable populations.
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NACI recommends HPV vaccination to prevent HPV-related cancers and disease.
Routine recommendation: HPV vaccination is recommended for people aged 9 to 26 years, particularly for those who have not previously been vaccinated (or have not completed the series).
Catch-up recommendation: Adults 27 years of age and older who are not adequately vaccinated may receive HPV vaccination, particularly where they remain at risk of HPV exposure.
Priority Groups: NACI guidance recognizes that HPV vaccination can be especially important for populations with higher HPV exposure risk and/or higher risk of complications, including:
individuals who are immunocompromised (including those living with HIV)
individuals with ongoing risk of HPV exposure
other populations identified as higher risk depending on clinical history and provider assessment
Why it matters: HPV vaccination is cancer prevention. Inconsistent public funding for adults—especially beyond age 26—creates inequitable access and missed prevention opportunities for people who did not receive vaccination through routine school-based programs or during the COVID-19 pandemic.
Why Funding Differs
Across Canada
Provinces and territories are responsible for their own immunization programs, including:
Which vaccines are funded
Who is eligible
How vaccines are delivered
When programs are implemented
As a result, a vaccine may be strongly recommended by NACI, yet still be:
Not funded
Partially funded
Limited to specific populations
Inconsistently accessible across care settings
This creates real-world access barriers—particularly for individuals without primary care or those relying on pharmacy-based services.
WHY THIS MATTERS?
A postal-code lottery in prevention
Access to recommended vaccines should be based on health risk—not geography.
Out-of-pocket costs limit uptake
Costs disproportionately impact low-income adults, seniors, and those without insurance.
Confusion across the system
Inconsistent funding creates complexity for patients, providers, and pharmacists.
Avoidable strain on the health system
Lower uptake leads to preventable illness, hospitalizations, and increased system burden.
THE GAP IN ACTION
This snapshot shows how public funding aligns with NACI recommendations across provinces and territories.
Toggle vaccines to see the status of funding across our provinces.
System Barriers
to Access
788 days
Zero Provinces
Even after regulatory approval and national guidance, vaccines often face significant delays before being publicly funded. These delays limit access, increase out-of-pocket costs, and reduce the impact of prevention.
Structural barriers contribute to uneven adoption across provinces and territories—reinforcing inequities in access.
Median time from approval to public funding in Canada
Fully aligned with national recommendations
Moving Toward More Consistent Access
Canada’s adult immunization system should not depend on one’s postal code.
Improving alignment between national recommendations and provincial implementation can:
Reduce inequities in access
Improve uptake
Prevent avoidable illness
Strengthen health system sustainability
AVA is working with partners across the country to support:
More consistent public funding
Timely adoption of NACI recommendations
Accessible delivery models, including pharmacy-based care
Stronger coordination and accountability across jurisdictions