'A medication‑only strategy is rather reactive, whereas a preventative standpoint is proactive,' says expert of benefit plans
Canadian employers are leaving major gaps in their vaccination strategies, with many group benefit plans lacking adult vaccine coverage altogether or failing to communicate it effectively to employees.
Those deficiencies are driving preventable illness, higher absence and disability costs, and increased operational risk, according to one expert.
“Vaccine coverage under private plans is optional,” says Jeannette Makad, associate vice president, enablement and insights at NFP Canada, adding that smaller groups may not offer the option.
Even where adult vaccine benefits are in place, they are often underused. “We can do better as an industry on communicating the worth of this coverage and promoting preventative strategies to the plan members themselves,” she says.
Makad estimates that 60 per cent of private plans in Canada include some form of vaccine coverage, but “the scope and the reimbursement levels really differ significantly by plan sponsor.”
Fragmented system, low adult uptake
These plan‑level gaps sit on top of a broader structural problem in Canada’s health system, according to Makad.
“We’ve got a really fractured system,” she says, as vaccination records are not centralised and coverage differs between public and private plans and across provinces, making it “hard to keep tabs on” adult vaccination uptake.
Makad says most adult vaccinations in Canada occur around the flu season, but “the uptake among the working‑age adults still remains pretty low,” with only a slight, anecdotal increase since the COVID‑19 pandemic.
Direct impact on absenteeism and operations
For employers, low adult vaccination rates translate into tangible workforce risk.
“When you’re sick, you don’t go to work or you’re not at work 100 per cent, at 100 per cent capacity,” Makad says, which affects not just the individual employee but also their family, as one spouse off sick can force the other to “pick up the slack”.
With more employees back in the office at least part‑time, she warns that “someone might show up not well and then impart their disease on other people”, potentially disrupting the continuity of operations if several staff members are off at once.
Makad notes that basic promotion of seasonal flu shots through the workplace can help employers “mitigate predictable seasonal spikes in absenteeism”.
‘Medication‑only’ benefits are reactive and costly
Makad is critical of benefit designs that focus almost entirely on drugs while treating vaccines as an afterthought.
“A medication‑only strategy is rather reactive, whereas a preventative standpoint is proactive,” she says. “A benefit strategy that focuses solely on medication coverage means employers are paying for treatment rather than preventing the illness in the first place.”
Many vaccine preventable illnesses—such as shingles or pneumococcal disease—can lead to long term complications and extended absences. They can also exacerbate comorbidities like cardiac disease, she says.
The National Advisory Committee on Immunization (NACI) recommends shingles vaccination for adults over 50, but in Ontario public coverage typically does not begin until age 65 to 70. The vaccine requires two doses at about $500 each, Makad notes.
“That can be quite costly for someone to get,” she says. “That’s why it’s key to have that conversation with employees, because employees might not even realise that they have this coverage under their plan. They think of medications as a treatment and not as a preventative measure.”
Long-held beliefs
Makad says long‑standing beliefs about the public system are also holding back adult immunisation.
“As Canadians, we are very entitled when it comes to our coverage,” she says. “We have this innate belief that if it needs to be covered, it will be covered under public plans. Unfortunately, that’s no longer necessarily the case.”
Relying on physicians alone to drive adult vaccination is risky, she adds. Referring to Canada’s recent loss of its measles‑free status and recommendations that those born after 1970 get a measles booster, she notes, “My doctor never once thought to tell me to get vaccinated against measles,” even though the shot is publicly funded in Ontario.
Photo from Mapol’s Private Drug Plan Leadership Vaccine Coverage Report Card 2025
What can HR do?
Makad urges HR professionals and plan sponsors to reassess both plan design and communication.
“If the vaccines aren’t already covered under the plan, definite consideration should be given to that,” she says. While there is a cost, she cites the World Health Organization’s view that immunisation is “one of the best health investments that money can buy”.
“Employers can definitely strengthen their workforce health and reduce preventable costs by taking a more strategic approach to their benefit plans, and adding vaccination coverage is definitely” one way to do that, she says.
Beyond plan changes, she recommends that employers clearly explain which vaccines are covered, make it easy to get vaccinated by setting up or promoting clinics, support higher‑risk groups, and consider allowing paid time off for vaccination.
“There’s little things that employers can definitely integrate into their overall wellness programme and benefit strategies to support their employees,” Makad says. “Again, communication is key.”
Recently, the Canadian Natural Resources Limited's rejection of a worker's religious exemption to its COVID-19 vaccination policy was overturned by Alberta's Human Rights Tribunal.
