Respiratory syncytial virus (RSV) is a common virus that affects the respiratory tract and is especially prevalent during the winter months. It impacts the lungs and breathing passages. Its symptoms can include cough, fever, wheezing, difficulty breathing, and a runny nose. It may be transmitted by respiratory droplets when a person coughs or sneezes, and by touching surfaces contaminated with the virus.

Arexy, an RSV vaccine, was recently authorized for use in Canada for the prevention of lower respiratory tract disease caused by RSV in adults 60 years of age and older. According to its manufacturer, it is 94% effective in preventing illness in seniors with underlying medical conditions.

The National Advisory Committee on Immunization (NACI) is currently reviewing the use of Arexvy to advise public and private plans on its coverage, though their input is not expected to be released until next year. Most Extended Health Care providers in Canada are currently reviewing whether they are going to cover Arexvy but are delaying their decision until NACI have completed their review and submitted their recommendation.

ARTA is not prepared to wait until next year to ensure our members remain healthy if an infection like RSV may be avoided. We are including coverage for Arexvy under each of the Extended Health Care plans, with coverage backdated to September 6, 2023 (this means if you paid for the vaccine out of pocket after September 6, you can still be reimbursed), for members age 60 and over. 

The vaccine costs between $250 and $300 dollars. ARTA will cover the cost of the vaccine under your prescription drug coverage level maximum, but will not cover any costs incurred for administering the vaccine.

Please note that claims incurred for the RSV vaccine made between September 6 and November 1 can now be submitted through the MyARTA Claims Portal. Claims made on November 2, 2023 or later can be direct billed by your pharmacist or submitted online through the MyARTA claims portal.