The pain started suddenly for Marion Watkinson—a burning sensation across her ribs that the 72-year-old Burnaby resident initially dismissed as muscle strain. Three days later, the telltale rash appeared.
“I thought I’d pulled something gardening,” Marion tells me as we sit in her sunlit kitchen. Her fingers tap nervously on her teacup. “By the time I got to the doctor, the blisters were spreading and the pain was… well, I’ve given birth twice, and this was worse.”
Marion had shingles, a viral infection caused by the same virus responsible for chickenpox. Once you’ve had chickenpox, the virus remains dormant in your body, potentially reactivating decades later as shingles—particularly as immune systems naturally weaken with age.
For years, British Columbians over 50 have had to pay out-of-pocket for the shingles vaccine, with costs ranging from $150 to $200 per dose. This financial barrier has left many seniors vulnerable to a condition that affects approximately one in three people during their lifetime, according to the BC Centre for Disease Control.
But change may finally be coming. Health Minister Adrian Dix announced last week that the province is actively considering adding the shingles vaccine to the list of publicly funded immunizations for adults over 50.
“Prevention is always more cost-effective than treatment,” Dix stated during a press conference in Victoria. “The evidence shows that shingles places a significant burden on both patients and our healthcare system.”
That burden is something Dr. Manisha Bhardwaj sees regularly at her Vancouver family practice. “Many people don’t realize how debilitating shingles can be,” she explains when I visit her clinic. “Beyond the acute phase, about 10 to 18 percent of patients develop postherpetic neuralgia—nerve pain that can persist for months or even years.”
The doctor’s examination room walls display anatomical charts and family photos. Her voice carries the weariness of someone who has delivered difficult news too often. “I’ve had patients who couldn’t work, couldn’t sleep, couldn’t function because of post-shingles pain. And most of these cases could have been prevented with vaccination.”
The vaccine in question—Shingrix—is particularly effective, reducing the risk of shingles by more than 90 percent and postherpetic neuralgia by 89 percent, according to clinical trials published in the New England Journal of Medicine. Unlike earlier vaccines, it’s recommended even for people who have already experienced shingles, as recurrence is possible.
Ontario and the Yukon already cover the vaccine for certain age groups. Other provinces, including Alberta and Manitoba, have been considering similar programs but have cited budget constraints.
For James Kwong, a health economist at the University of British Columbia, the financial argument for coverage is clear. “When we calculate the cost of shingles, we need to include emergency room visits, prescription pain medications, lost work hours for both patients and caregivers, and long-term management of complications,” he explains during our meeting at UBC’s School of Population and Public Health.
Kwong gestures to a spreadsheet on his monitor showing a cost-benefit analysis. “Even at conservative estimates, publicly funding the vaccine saves money in the healthcare system within three to five years.”
The push for coverage has gained significant momentum from patient advocacy groups like Seniors’ Voice BC. At their monthly meeting in a community center in Richmond, I meet Doris Chen, who leads the organization’s healthcare committee.
“Many of our members live on fixed incomes,” Chen explains as volunteers arrange chairs and set out coffee. “When you’re choosing between groceries, housing, and preventive healthcare, something like a shingles vaccine often gets postponed—until it’s too late.”
The group has collected over 15,000 signatures on a petition advocating for vaccine coverage. Their efforts reflect growing recognition that preventive health measures for seniors aren’t luxury items but essential components of public health policy.
For Indigenous elders, access issues are compounded by historical healthcare disparities. Agnes Williams, a health coordinator with the First Nations Health Authority, describes how these barriers affect communities.
“Our elders are particularly vulnerable,” Williams tells me as we walk through the FNHA’s Vancouver office. “Many live in remote communities where healthcare access is already challenging. When you add financial barriers to preventive care, you’re essentially accepting higher rates of preventable suffering.”
Williams notes that Indigenous approaches to elder care emphasize prevention and holistic wellness—principles that align perfectly with vaccination programs but are undermined by cost barriers.
Back in Burnaby, Marion Watkinson is still dealing with lingering nerve pain six months after her shingles outbreak. “I wish I’d known how bad it could be,” she says, wincing slightly as she reaches for a photo album. “I would have found a way to afford the vaccine.”
She shows me pictures of her grandchildren’s recent visit—images of a family gathering she nearly missed due to her illness. “That’s what people don’t understand about shingles. It doesn’t just hurt physically. It takes away time with the people you love.”
The Ministry of Health has indicated that a decision on vaccine coverage will be announced as part of the next provincial budget. For now, healthcare providers continue to recommend the vaccine despite its cost, particularly for those at higher risk.
As I prepare to leave Marion’s home, she touches my arm. “Make sure you tell them—this isn’t just about saving money. It’s about saving people from suffering they don’t deserve.”
For thousands of British Columbians over 50, the province’s decision could mean the difference between protection and vulnerability to a disease that does far more than just leave a rash. It’s a reminder that as our population ages, prevention becomes not just good medicine, but good policy.
