How to access the new RSV vaccine, and how much will it cost? Your questions answered

This story idea came from audience members, like you, who asked about the RSV vaccine. Email us your questions. We are listening: ask@cbc.ca.

It’s that time of year, respiratory illnesses are going around — including respiratory syncytial virus (RSV). 

Typically, mild RSV symptoms can include runny nose, coughing, sneezing, wheezing, fever and a decrease in appetite and energy. For most people, it appears like a common cold. 

However, older people and infants may be at greater risk of developing more severe outcomes from RSV, like a severe infection of the lower respiratory tract, which could lead to hospitalization.

This year, for the first time, a vaccine is available to help protect older adults against the virus. Health Canada approved Arexvy in August for adults aged 60 and over. There is no approved vaccine for children or younger adults. 

In a clinical trial published earlier this year, Arexvy showed nearly 83 per cent efficacy in preventing lower respiratory tract disease caused by RSV. It also showed a 94 per cent efficacy in preventing severe RSV-associated illness, according to the FDA’s analysis of data. 

Many of you wrote to us or left comments asking questions about where you can get the shot and how much it costs. Here’s what we know.

Will my province or territory cover the cost?

It depends where you live.

Ontario is currently the only province that is publicly funding the RSV vaccine to some people over 60. That includes people living in long-term care homes, elder care lodges, and some retirement homes licensed to provide dementia care services in the province.

Many provincial and territorial health authorities say they are waiting for guidance from the National Advisory Committee on Immunization (NACI) before deciding whether or not to include Arexvy in any publicly funded programs. NACI analyzes available evidence and provides guidance on who vaccines should be offered to, and how.

Alberta, B.C., Manitoba, New Brunswick, N.L., Nova Scotia, P.E.I., Saskatchewan and Yukon noted the vaccine would be available for purchase out-of-pocket in pharmacies or may be covered by private health insurance. 

Other details may vary by province. For example, in Nova Scotia you will need a prescription to access the vaccine. New Brunswick said individuals will have to pay for both the vaccine and having it administered. B.C. told CBC News about their searchable database for pharmacies that will offer the shot. 

There is no publicly available guidance for N.W.T. and Nunavut and they have not responded to our request by the time of publication.

What’s it going to cost me?

If you do have to pay out-of-pocket, provinces and territories told CBC News the vaccine will cost you in the range of $200 to $350, depending on where you live.

Why are some vaccines covered, but others aren’t?

It boils down to what the provincial and territorial health authorities decide to put on their drug plans for their province or territory.

Without guidance from NACI, those health authorities have been reluctant to include Arexvy for this season. It may be covered in the future, but that will depend on each province or territory and how they implement NACI’s guidance.

In an earlier email to CBC News, Health Canada said guidance from NACI on the use of the vaccine is expected next year.

Dr. Samir Sinha, director of geriatrics at Sinai Health System and the University Health Network in Toronto, says the biggest challenge when a vaccine isn’t publicly covered is that people feel it’s probably not important, and that’s not correct.

Some people may have coverage through a private drug plan, said Sinha.

“Because the effectiveness of this vaccine is quite significant, many insurers have already decided when they look at the data, despite not having a NACI recommendation … there’s such compelling evidence already in their view that they’re going ahead and covering it.”

Should I get it?

If you are eligible, that decision is up to you.

Health-care professionals are urging seniors to get the shot if they can access it.

“The reason I’m recommending that all of my patients above 60 get it is because RSV is a very, very common virus that’s been circulating for years, but one that we’ve been relatively helpless against,” said Sinha.

“The challenges with RSV is that, unlike influenza and COVID-19, we don’t actually have anything to give you other than oxygen and fluids,” he said.

“It’s been a tricky virus to create a vaccine for and we still don’t actually have any effective treatments for people who might catch RSV.”

In the U.S., research has shown adults over 65 have the highest mortality risk from RSV, and there was a six to eight per cent fatality rate among older adults hospitalized with RSV, according to a report from The National Institute on Ageing, a Canadian think tank focused on Canada’s aging population. 

It’s unclear exactly how many people 60 and older in Canada are hospitalized or die from the illness each year, as experts say it’s not properly tracked.

When is the best time to get it?

If you can, Sinha says “get it now.”

“RSV starts to really circulate in November and all the way through to May. So if you get your vaccine now, it’ll last you two seasons and it may even last you a third,” he said.

Dr. Samir Gupta, a respirologist, clinician-scientist and associate professor in the Department of Medicine at the University of Toronto, agreed.

“I would recommend a two week gap before or after COVID or flu vaccination,” Gupta told CBC News in an email.

What are the side effects?

You might experience some side effects like a sore arm, tiredness and fatigue.

“You’re probably going to have some sort of reaction,” said Sinha. “A reaction is a good sign because it tells me that you have an immune system that’s working and responding to the vaccine.”

“But I advise my patients to not get the vaccine a day before a significant event like your granddaughter’s wedding, you know, because you might be down and out for a day or two,” he said.

He also added that if you’ve gotten the shingles vaccine and you can recall what your symptoms might have been around that, you might have a similar symptom profile because the RSV vaccine uses that same adjuvant therapy.