The First Nations Health Authority (FNHA) is now providing direct payment for the Shingrix® shingles vaccine. This means that FNHA clients age 65 to 69 can receive the vaccine from a licensed pharmacist without having to pay up front and send in receipts for reimbursement.
Shingles – the common name for herpes zoster – is a painful blistering rash caused by a re-activation of the varicella-zoster virus. The pain of shingles can persist for weeks, months, or even longer after the rash has healed. Shingles can occur in anyone who has had chickenpox. However, it is more common – and more likely to cause complications and long term effects – in older people.
Last May, the FNHA introduced coverage for zoster vaccine Shingrix as a reimbursement process, and has since worked with benefits partner Pacific Blue Cross to enable direct payment. The FNHA is the first health authority in Canada to cover Shingrix, and has been working since last year to enable our clients to access it without having to pay up front.
Coverage of a shingles vaccine has been an important and recurring part of discussions with Chiefs, Health Directors and other First Nations health leaders in order to protect the health of Elders. “We are pleased we can respond to feedback and now offer direct payment to pharmacies for Shingrix, which has a 90 per cent effectiveness rate," said Dr. Evan Adams, the FNHA's Chief Medical Officer.
The 65 to 69-year-old age group was selected for the benefit coverage because the vaccine has a high impact on this age group. People in this age group are more likely to get shingles and have higher rates of hospitalization from it. The vaccine requires two doses to be fully effective. FNHA clients who received their first dose through the reimbursement process will be eligible for direct payment for their second dose.
Requests for coverage of the vaccine for those outside the 65 to 69-year-old age group will be considered if submitted with medical documentation from a primary care provider to support the request. The FNHA invites clients with questions about their health benefits coverage to visit www.fnha.ca/benefits or call First Nations Health Benefits at 1-855-550-5454.
Shingles Coverage Fact Sheet (PDF)