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Vaccine Industry Committee (VIC): Pre-Budget Submission

Submission for the Pre-Budget Consultations in Advance of the 2025-26 Federal Budget

By the Vaccine Industry Committee

Recommendation: In support of the renewal of the National Immunization Strategy, the government should take a focused, coordinated and comprehensive approach to immunization, supported by increased annual funding, to bolster public vaccination programs across Canada, which are the cornerstone of our health and economic security.

August 2024

SENT VIA: Submission Portal

TO: Standing Committee on Finance (FINA)

Thank you for the opportunity to provide input on FINA’s consultations in advance of the 2025-26 federal budget.

The Vaccine Industry Committee (VIC) is an industry led group focused on improving vaccine awareness and understanding and supporting the development of vaccine related policy in Canada. It is a unique mix of large multinationals and pre-commercial Canadian vaccine innovators. The committee works to ensure secured supply of vaccines for Canada, advocates for equitable access to vaccines for all Canadians, promotes the value of immunization as one of the most cost-effective health interventions available, and expands Canadian vaccine innovation and manufacturing capacity.

In this submission, the VIC is pleased to provide the following recommendation for how the federal government can play a key role in preventative health:

In support of the renewal of the National Immunization Strategy, the government should take a focused, coordinated and comprehensive approach to immunization, supported by increased annual funding, to bolster public vaccination programs across Canada, which are the cornerstone of our health and economic security.

Vaccines are one of the greatest successes in medical history and should be considered an important investment in the health and economic security of our country given the immense benefits they deliver:

  • Health benefits: Vaccines are among the most effective tools in preventing infectious diseases and reducing morbidity and mortality rates. For instance, from 1980 to 2019, the global mortality rate due to infectious diseases per 100,000 population declined by 64%1 and global immunization efforts have saved an estimated 154 million people over the past 50 years.2 As well, a UK study published in The Lancet found that “the HPV immunization programme has successfully almost eliminated cervical cancer in women born since Sept 1, 1995.”3 Vaccines also contribute to herd immunity, protecting those who cannot be vaccinated due to medical conditions. Vaccines play a key role in helping achieve social equity by creating a level playing field across different socio-economic groups, although additional work needs to be done to reach more disadvantaged and underserved populations.
  • Strengthening health systems: By preventing the spread of infectious diseases and certain illnesses, vaccines reduce the burden on health systems.4 This is especially important in the context of our strained health systems in the aftermath of COVID and the increased demands driven by our aging population (nearly 20% of the Canadian population is aged 65 years and over).5 Vaccines reduce hospitalizations and decrease the need for other medical interventions, allowing scarce resources to be allocated more effectively and efficiently to other key areas, such as primary, emergency, tertiary and long-term care.
  • Cost-effective tool: Vaccines are a cost-effective investment in public health.
    • A recent study by the Office of Health Economics in the UK shows that investing in adult vaccines can return up to 19 times their initial cost when their significant benefits beyond the healthcare system are taken into account (up to US$4,637 for one individual’s full vaccination course).6
    • An Ontario economic analysis shows that an estimated 2.5% increase in influenza vaccination rates of elderly Canadians results in a $16 million reduction in healthcare costs.7
  • Impact to Global health threats: Immunization is one of the potential ways of reducing anti-microbial resistance (AMR). As was detailed in the Pan-Canadian action plan on AMR, improving immunization rates can reduce the overall burden of infectious diseases, resulting in reduced hospitalizations and anti-microbial use.8
    • In 2018, it is estimated that AMR infections in Canada alone cost the healthcare system $1.4 billion and caused 5,400 deaths.9
    • One study estimated that increasing uptake of the pneumococcal conjugate vaccine could reduce antibiotic use for pneumococcal pneumonia in children 5 years and under by 47%24
  • Promotes economic stability: By preventing illnesses, vaccines help reduce absenteeism in the workplace and increase overall economic output of citizens. This is critical given the shrinking workforce in Canada due to our aging population. As we witnessed during the COVID-19 pandemic, the economic stability of a country is closely linked to the health of its population. Pandemics and disease outbreaks disrupt economic activities, cause significant financial losses and strain public health resources. In fact, a study by the C.D. Howe Institute shows that the prompt and universal access to COVID-19 vaccines in late 2020 and in 2021 saved billions of dollars in health and economic costs. The think tank also found that a six-month delay in these vaccines would have resulted in an economic loss across Canada of about $156 billion in economic activity in 2021.10 By investing in vaccines, and keeping vaccination processes and tracking up-to-date, the government can therefore help mitigate these risks by being prepared to address future pandemics and outbreaks, ensuring a more stable and resilient economy.

Given the broad health, societal, and economic benefits, it is encouraging to see a robust and growing pipeline of innovative and promising vaccines, including those developed and manufactured in Canada.

Unfortunately, Canadian governments’ investments in routine vaccination is estimated to be less than 0.2% of total public healthcare spending.11 As a result, there are challenges and inequities in accessing vaccines across the country, with several provinces failing to include in their public immunization programs new vaccines that have been approved by Health Canada and recommended by National Advisory Committee on Immunization (NACI), which makes recommendations to governments on the use of vaccines in Canada.11

As well, current coverage for influenza, adult, and childhood vaccines are currently below the goals set by the federal government in the National Immunization Strategy.12 For instance, only 55% of seniors received a pneumococcal vaccine in 2020, significantly lower than the national coverage goal of 80%.13 In 2021, only 79 per cent of children had two doses of the measles (MMR) vaccine by their seventh birthday – meaning two in 10 kids weren’t fully up-to-date on their shots. That’s down from 87 per cent just four years earlier,

and some areas and communities have even lower rates. 14Even considering updated COVID vaccines, Canada is falling far short of our immunization targets, including among our vulnerable senior populations.15 The pandemic has also severely impacted school-based immunization programs in most provinces/territories, resulting in vaccination backlogs.16

Under its Biomanufacturing and Life Sciences Strategy, the federal government has taken several measures, including the creation of the Canada Biomedical Research Fund and the Biosciences Research Infrastructure Fund. These efforts help promote Canada’s health security and ensure that Canada is prepared for future pandemics by increasing domestic capacity through investments and partnerships across the academic, public, private and non-profit sectors to produce life-saving vaccines and therapeutics.17

Building on these efforts, we urge the federal government to implement a comprehensive, whole-of-government strategy to ensure that investments in research and biomanufacturing are effectively translated into the adoption and uptake of new, innovative vaccines across the country.

In particular, there is a critical need for further, continued federal public health investments, on an annual recurring basis, to help support the provinces and territories in:

  • Catching up on missed routine vaccinations due to the COVID-19 pandemic disruptions.
  • Closing gaps in provincial/territorial public immunization programs, which currently exclude several innovative vaccines approved by Health Canada and recommended by NACI, to ensure more equitable access to new and effective vaccines across the country.
  • Appropriately resourcing NACI and PHAC to keep reviews timely and programs current. Despite an on-going Triple-Demic of influenza, COVID, and RSV respiratory vaccines, it took NACI over 11 months after licensure to provide advice on the first new RSV vaccine, and there are other vaccines on the NACI workplan that have been licensed for over a year, and have not yet been reviewed.

A wide range of stakeholders agree that action should be taken to ensure that NACI-recommend vaccines are available to all Canadians, including the Adult Vaccine Alliance

(which includes several health care workers, academics, industry partners, pharmacy leaders, public health experts and patient groups),18 the Canadian Association of Retired Persons (CARP)19 and CanAge.20 Other organizations, such as 19 to Zero21 and The Federation of Medical Women of Canada22 have been calling for routine vaccines backlogs to be eliminated.

In addition to funding for vaccines, and in the context of its upcoming renewal of its National Immunization Strategy, the federal government can also help achieve greater uptake of vaccines by Canadians to meet its national coverage goals by including specific measures, supported by adequate funding, to:23

  • Increase education efforts on vaccination to reach more Canadians, especially underserved and high-risk groups
  • Improve access to vaccination services by making better use of pharmacies
  • Help establish an automated, harmonized, and interconnected system nationwide to quickly and comprehensively gather vaccination data, enabling better monitoring of coverage rates.

In sum, in support of the renewal of the National Immunization Strategy, the government should take a focused, coordinated and comprehensive approach to immunization, supported by increased annual funding, to bolster public vaccination programs across Canada, which are the cornerstone of our health and economic security.

Sincerely,

Kevin Sauve, Chair, Vaccine Industry Committee

1 The European House – Ambrosetti on GBD data, 2024.

2 The European House – Ambrosetti on Shattock AJ et al. (2024), «Contribution of vaccination to improved survival and health: modelling 50 years of the Expanded Programme on immunisation”, Greenwood B (2015), «The contribution of vaccination to global health: past, present and future”, WHO and GBD data, 2024. Of note, this study is to be published in the Lancet.

3 Falcaro M et al., The effects of the national HPV vaccination programme in England, UK, on cervical cancer and grade 3 cervical intraepithelial neoplasia incidence: a register-based observational study, The Lancet,398:10316, 2084-2092, (2021): https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02178-4/fulltext.

4 The European House – Ambrosetti on Masters R et al. (2017), «Return on investment of public health interventions: a systematic review”, Office of Health Economics data, 2024.

5 Statistics Canada, Older Adults and Population Aging, 2023: https://www.statcan.gc.ca/en/subjects-start/older_adults_and_population_aging.

6 El Banhawi H. et al. The Socioeconomic Value of Adult Immunisation Programmes, Office of Health Economics, 2024.

7 O’Reilly D. et al., Economic analysis of pharmacist-administered influenza vaccines in Ontario, Canada (2018): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6207261/#:~:text=Increasing%20influenza%20vaccinations%20can%20lead,reduction%20in%20health%20care%20costs.

8 Pan-Canadian Action Plan on Antimicrobial Resistance. Accessed July 29th 2024: pan-canadian-action-plan-antimicrobial-resistance.pdf (canada.ca)

9 PHAC 2023 News Release: Federal, Provincial and Territorial Governments Jointly Release the Pan-Canadian Action Plan on AMR – Canada.ca

10 C.D. Howe Institute, COVID vaccine campaigns saved $billions in damages, press release, Dec. 15, 2022: https://www.cdhowe.org/media-release/covid-vaccine-campaigns-saved-billions-damages.

11 IQVIA report, Understanding Current Immunization Funding, Decision-making, and Gaps in Vaccine Access and Coverage in Canada, 2023: BIOTECanada_Vaccine-Funding-and-Access-Gap_Final-Report_May-2023.pdf.

12 Health Canada, Vaccination Coverage Goals and Vaccine Preventable Disease Reduction Targets by 2025.

13 Health Canada, Vaccination Coverage Goals and Vaccine Preventable Disease Reduction Targets by 2025.

14 CBC News, Canada heading toward major measles outbreak without vaccine boost, new modelling suggests | CBC News

15 Government of Canada, COVID-19 Vaccination coverage last updated July 12, 2024: https://health-infobase.canada.ca/covid-19/vaccination-coverage/.

16 IQVIA report, Understanding Current Immunization Funding, Decision-making, and Gaps in Vaccine Access and Coverage in Canada, 2023: BIOTECanada_Vaccine-Funding-and-Access-Gap_Final-Report_May-2023.pdf.

17 Government of Canda, Canada Biomedical Research Fund and Biosciences Research Infrastructure Fund: https://www.sshrc-crsh.gc.ca/funding-financement/cbrf-frbc/index-eng.aspx.

18 Adult Vaccination Alliance, press release, 2023: https://www.newswire.ca/news-releases/canada-s-adult-vaccine-alliance-officially-launches-to-champion-improved-access-to-vaccines-837238375.html.

19 Survey Says: CARP members share perspective on vaccinations: https://www.carp.ca/2023/12/14/survey-says-carp-members-share-perspective-on-vaccinations/; and CARP and Pneumonia: https://www.carp.ca/pneumonia/.

20 CanAge Vaccine Report, 2022: https://www.canage.ca/wp-content/uploads/2022/02/CanAge_VaccineReport22.pdf.

21 CBC article, 2022: https://www.cbc.ca/news/canada/vaccine-lag-canada-1.6490032; Blog, An Effective Prescription for an Increasing Problem, 2022: https://occ.ca/an-effective-prescription-for-an-increasing-problem/.

22 The Federation of Medical Women of Canada, press release 2023: https://www.newswire.ca/news-releases/fmwc-hpv-task-force-issues-new-white-paper-to-address-ongoing-hpv-vaccination-crisis-in-ontario-877700564.html.

23 IQVIA report, Understanding Current Immunization Funding, Decision-making, and Gaps in Vaccine Access and Coverage in Canada, 2023: BIOTECanada_Vaccine-Funding-and-Access-Gap_Final-Report_May-2023.pdf.

24 Laxminarayan R et al. Access to effective antimicrobials: A worldwide challenge. Lancet. 2016