Quebec residents can now book their COVID-19 vaccinations — but unless you’re a health-care worker or part of a high-risk group, you’ll have to pay for the shot. Unlike in previous years, Quebec is not offering a universal, free COVID-19 vaccination program for fall 2025. Dr. Jesse Papenburg, a pediatric infectious diseases specialist who sat on the expert committee advising the Quebec Health Ministry on its immunization strategy, says the new approach is based on both public health priorities and cost-effectiveness. “From a public health perspective, it makes more sense to prioritize people who are at higher risk of developing complications and being hospitalized from their COVID-19 infection,” he said. “Cost-effectiveness analysis done here in Quebec demonstrated that this is the most efficient use of our health-care dollars.” Those eligible for a free shot include people aged 65 and older, anyone who is immunocompromised or living with a chronic illness, health-care workers, and those who are pregnant. Everyone else will have to pay up to $180 for the vaccine. Patients’ rights advocate Paul Brunet says when it comes to communicable diseases, vaccination should be available to everyone. “I understand that this list is quite generous,” he said. “But people who are not on the list will probably not get vaccinated. And this could certainly be one of the risks our society will be incurring. At what cost? What are we saving? Are we talking about billions of dollars like the investment?” But Papenburg says in a stretched health-care system, resources must go where they’re most needed. “I understand why some people might be disappointed that it’s no longer free for all,” he said. “The vaccine works for everybody, but especially in high-risk people, because it prevents severe outcomes such as hospitalizations. People who aren’t in a high-risk category are, thankfully, at low risk of developing a serious COVID-19 infection that requires hospitalization.” Even if it comes at a cost, Papenburg says everyone should still consider getting vaccinated. “We see that COVID-19 circulation is already above 12 per cent in Quebec,” he said. “The influenza season hasn’t yet started, but it undoubtedly will within the coming weeks.” He recommends speaking with a doctor or pharmacist, or booking through ClicSante.ca.