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COVID-19 vaccination in Canada

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COVID-19 vaccination in Canada
DateDecember 14, 2020 (2020-12-14)
LocationCanada
Also known asVaccins contre la COVID-19 (French)
CauseCOVID-19 pandemic in Canada
Organised byHealth Canada
Public Health Agency of Canada
Provincial and Territorial governments
Participants1,210,461 people with at least one dose administered of Pfizer-BioNTech and Moderna
496,887 Total vaccinated people
(to which the first and second dose of vaccine were administered)[1]
Outcome3.19% of the Canadian population has received at least one dose[2]
WebsiteGovernment of Canada
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The COVID-19 vaccination programme in Canada is an ongoing, intergovernmental effort coordinated between the bodies responsible in the Government of Canada and the individual Provincial and Territorial governments to acquire, distribute and administer approved COVID-19 vaccines during the COVID-19 pandemic in Canada. Mass vaccination efforts began across the country on December 14, 2020. Health Canada has so far approved the Pfizer–BioNTech COVID-19 vaccine and the mRNA-1273 vaccine developed by Moderna.

In Canada, Health Canada is responsible for approval and regulation of vaccines (and other pharmaceuticals), while the Public Health Agency of Canada (PHAC) is responsible for public health, emergency preparedness and response, and infectious and chronic disease control and prevention. Vaccines are approved by Health Canada, purchased by the Government of Canada and distributed by PHAC to individual provinces and territories in tranches based on various factors such as population size and prioritized peoples.

From about mid-January until mid-February, both the Pfizer–BioNTech and Moderna did not ship the agreed upon quantities of secured vaccines to Canada and other countries, due to manufacturing challenges.[3] By February 18, Major General Dany Fortin, who is "leading vaccine logistics" at the Public Health Agency of Canada (PHAC), announced that the vaccine delivery was back on track and that there will now be an "abundance of supplies" which will result in a "significant scaling-up of immunization plans in provinces."[4] According to the PHAC's vaccine distribution tracker, Pfizer's new "locked in" delivery schedule includes 403,650 doses and 475,000 doses in the last weeks of February and 444,600 doses per week in March.[5][4]

Background and timeline

Preparations

In anticipation of a COVID-19 vaccine, the Canadian government purchased more than 75 million hypodermic needles and syringes in summer 2020.[6] The government made deals with the leading research companies developing a vaccine.[7]

In September 2020, AstraZeneca agreed to provide 20 million doses of the Oxford–AstraZeneca COVID-19 vaccine to Canada.[7][8]

Initial approvals and rollout

On December 9, 2020, Health Canada approved the Pfizer–BioNTech COVID-19 vaccine. The Public Health Agency of Canada supervises the rollout and administration of the vaccine.[9] By mid-December 2020, Pfizer had agreements to supply 20 million doses to Canada.[10]

Healthcare institutions began administering the first 30,000 doses of the Pfizer–BioNTech COVID-19 vaccine in Canada on December 14. A total of 249,000 doses are expected to be delivered by the end of 2020.[11] Because of the cold storage logistics, the initial doses were delivered to 14 distribution sites in the provinces, with none being sent to the Canadian territories since they could not properly store the vaccine. The 14 original distribution sites are located in St. John's, Halifax, Charlottetown, Miramichi, Quebec City, Montreal, Ottawa, Toronto, Winnipeg, Regina, Edmonton, Calgary, and two in the Greater Vancouver area.[12] The Canadian government expects the vaccine to be administered to high-priority groups, designated by each province, until the end of March.[11] Most provinces are first prioritizing some subset of healthcare workers, except for Quebec, which is prioritizing residents of long-term care homes, as well as British Columbia, New Brunswick, and Prince Edward Island, which are prioritizing both. Most provinces also have plans to expand priority status to additional groups—such as the elderly, or adults in Indigenous communities—before expanding to the general public.[13]

The same week as initial vaccinations for the Pfizer–BioNTech COVID-19 vaccine, it was announced Canada would receive 168,000 doses of the Moderna COVID-19 vaccine, an mRNA-1273 vaccine, before the end of 2020, approved by Health Canada on December 23.[14][15] Unlike the Pfizer–BioNTech COVID-19 vaccine, the Moderna vaccine does not require extreme cold temperature storage[15] which meant that as of December 28, Northwest Territories and Yukon had received their first shipments of 7,200 each of the Moderna vaccine.[16] Vaccinations in each territory are not scheduled to occur until mid-January.[17]

Manufacturing delays

In mid to late January, details emerged about manufacturing delays by both approved vaccines made by Pfizer and Moderna affecting the country's vaccine rollout in late January through the month of February.[18][19] On February 3, the European Commission approved delivery of COVID-19 vaccine to Canada, in spite of production constraints in Europe. Canada was one of many countries that applied for delivery and does not have its own manufacturing capacity.[20] By February 4, Major General Fortin said while that Pfizer explained its dramatically lower vaccine shipments—with a decrease of 80% in all Pfizer shipments—as caused by "plant upgrades at a facility in Belgium", Moderna has offered no explanation for similar delays.[3] By early 2021, the speed of Canada's deployment of COVID-19 vaccines had become the topic of widespread public discussion, along with the related question of why the vaccines were not being produced in Canada.[21][22]

Fortin said that 180,000 Moderna doses had arrived in Canada on the morning of February 4 and Canada is "still expecting 2 million Moderna doses by the end of March.[3] On February 4, Fortin said that about 70,000 Pfizer-BioNTech doses will arrive in the next week.[23]

Canada does not have facilities capable of producing COVID-19 vaccines.[24][Notes 1][25][Notes 2][Notes 3][26] On August 31, 2020, Prime Minister Trudeau had announced a federal investment of $126 million to "design, construct, commission and qualify a new biomanufacturing facility"—the Biologics Manufacturing Centre to be completed by the end of July 2021.[27] It will be built beside the National Research Council Canada's Royalmount site in Montréal and will have a "production capacity of approximately 4,000 litres per month, which translates to approximately 2 million doses of a vaccine per month".[27] The federal government will provide an annual operating costs fund of $20 million. On February 2, 2021, Trudeau announced a deal with Novavax to produce COVID-19 vaccines at the Biologics Manufacturing Centre, making it the first to be produced domestically.[28] The Novavax COVID-19 vaccine is currently awaiting approval by Health Canada.[29] This is the first deal signed by Canada that allows a domestic manufacturing of a foreign vaccine. The contract with Novavax is for 52 million doses of the vaccine.[28] Following the recommendations of the COVID-19 Vaccine and Therapeutics Task Forces and COVID-19 Joint Biomanufacturing Subcommittee, the federal government announced investment in two biomanufacturing companies—Vancouver-based Precision NanoSystems Incorporated (PNI) and Markham, Ontario-based Edesa Biotech Inc. (Edesa).[30] PNI, biotechnology company, will receive up to $25.1 million to build a "$50.2 million biomanufacturing centre to produce vaccines and therapeutics for the prevention and treatment of diseases such as infectious diseases, rare diseases, cancer and other areas of unmet need". Edesa will receive up to $14 million to Edesa Biotech to "advance work on a monoclonal antibody therapy for acute respiratory distress syndrome, which is the leading cause of COVID-19 deaths.[30]

On February 3, COVAX published the country-by-country vaccine distribution forecast to COVAX participants—Canada will receive 1,903,200 doses of the Oxford–AstraZeneca vaccine by the end of the first half of 2021.[31][32]

On February 12, the minister of Public Services and Procurement Canada (PSPC) announced that Canada had "negotiated an accelerated delivery schedule for Pfizer-BioNTech’s COVID-19 vaccine."[33] By the end of September, Canada will receive the 40 million Pfizer-BioNTech doses.[33]

Return to regular shipments

Major General Fortin announced on February 18, that the period in which Canada experienced limited supplies, is now over and there will be an "abundance of supplies" in the spring and summer months. This will result in a "significant scaling-up of immunization plans in provinces."[4] Pfizer's new "locked in" delivery schedule includes 475,000 doses in February and 444,600 per week in March, according to the PHAC's vaccine distribution tracker, .[5][4] A February 18, 2021 article in New York Times said that Canadians were concerned about the rollout of the vaccination program.[34] According to the same Times columnist, who had interviewed those involved in "vaccine development, epidemiology, infection control and medical supply chains", they all said it was not surprising that Canada's rollout was not happening as planned. While they could understand why Canadians were frustrated, they said, this is the "nature of new vaccines".[35]

Vaccination rollout by province and territory

COVID-19 vaccinations in Canada by province and territory, September 30, 2022 (
)
Province Population People who have at least one dose People fully vaccinated Total population with at least one dose (%) Total population fully vaccinated (%) Ref
alt = British Columbia British Columbia 5,174,724 4,559,145 4,399,082 87.43% 84.36% [36]
alt = Alberta Alberta 4,444,277 3,630,480 3,425,775 81.72% 77.11% [36]
alt = Saskatchewan Saskatchewan 1,179,906 976,094 916,695 82.73% 77.70% [36]
alt = Manitoba Manitoba 1,382,904 1,145,269 1,101,542 82.77% 79.61% [36]
alt = Ontario Ontario 14,789,778 12,790,406 12,302,531 86.27% 82.98% [36]
alt = Quebec Quebec 8,585,523 7,907,623 7,206,045 91.90% 83.75% [36]
alt = New Brunswick New Brunswick 783,721 700,212 661,271 88.72% 83.79% [36]
Prince Edward Island Prince Edward Island 160,536 156,154 144,466 95.03% 87.92% [36]
Nova Scotia Nova Scotia 982,326 889,828 842,600 89.70% 84.94% [36]
Newfoundland and Labrador Newfoundland and Labrador 520,286 498,432 476,756 95.75% 91.59% [37]
alt = Yukon Yukon 42,596 36,691 35,380 85.36% 82.31% [36]
alt = Northwest Territories Northwest Territories 44,991 41,094 39,663 90.31% 87.16% [36]
alt = Nunavut Nunavut 39,536 33,543 29,021 85.13% 73.65% [36]
alt = Canada Canada 38,131,139 33,364,971 31,580,827 87.24% 82.57% [36]


Additionally, 3,600 Moderna vaccines have been kept for "Federal Application" for use with the Canadian Armed Forces and the Correctional Service of Canada.[38]

Vaccines on order

There are several COVID-19 vaccines at various stages of development around the world. As of 2 December 2020 the Canadian government had invested over $1 billion,[36] including pre-placed orders for seven different vaccines, two of which are now approved by Health Canada. These pre-orders total more than 400 million doses.[39][40][36][41] Eight of the nine vaccines require two doses each to be effective, with the exception of the Janssen Pharmaceutica (Johnson & Johnson) vaccine candidate which only requires one dose.[36]

Vaccine Progress Doses ordered Approval Deployment
Pfizer–BioNTech COVID-19 vaccine phase III clinical trials 40 million[42] 9 December 2020[43] 14 December 2020
Moderna phase III clinical trials 44 million [44] 23 December 2020[45] 31 December 2020
Oxford-AstraZeneca phase III clinical trials 23.9 million [46] 26 February 2021[47] Pending
Novavax phase III clinical trials up to 76 million Pending Pending
Medicago phase II clinical trials[48] up to 76 million Pending Pending
GSK/Sanofi Pasteur phase I clinical trials up to 72 million Pending Pending
Janssen phase III clinical trials up to 38 million Pending Pending

National framework for priority vaccine administration

According to the Government of Canada, the following peoples should be prioritized in three stages:[49]

Stage People included
1 People who are at higher risk of severe outcomes of COVID-19 and/or most likely to transmit to those at higher risk for severe illness or death.

Such as:

  • Residents and staff of shared living settings who provide care for seniors
  • Adults 70 years of age and older, with order of priority, beginning with adults 80 years of age and older and decreasing the age limit by 5-year increments to age 70 as supply becomes available
  • Frontline health care workers who have direct contact with patients, including personal support workers and those who work in health care settings
  • Adults in Indigenous communities
2 When enough COVID-19 vaccines and supplies become available to stage 1 groups, stage 2 should offer vaccinations to:
  • Adults in or from Indigenous communities not included in stage 1, including those who live in urban settings
  • Residents and staff of all other shared living settings, such as shelters, group homes, correctional facilities and housing for migrant workers
  • Adults 60 to 69 years of age
  • Adults in racialized and marginalized communities
  • First responders, including police, military, firefighters and coast guard
  • Frontline essential workers who can’t work virtually such as postal services, border services, rotational workers, grocery store staff, transportation workers, those involved in the pandemic response, food production or manufacturing workers, teachers and school or childcare staff not working virtually
  • Essential primary caregivers for people who can’t care for themselves and are at high risk of severe illness from COVID-19 due to advanced age
3 As supply increases and people in previous stages have been offered vaccines, stage 3 should offer vaccines to:
  • People 16 to 59 years of age with an underlying medical condition who are at high risk of severe illness due to COVID-19, including their essential primary caregiver
  • Adults 50 to 59 years of age without an underlying medical condition
  • Non-frontline health care workers are needed to maintain health care capacity but don’t have direct close physical contact with the public
  • Non-frontline essential workers who don’t have direct close physical contact with the public

Key people

Notes

  1. ^ In a January 14, 2021, Opinion piece in the Financial Post, responding to the delay in rolling out of Canada's vaccination program, GlaxoSmithKline Canada's Paul Lucas—who served as CEO from 1995 to 2012—said that, fifty years ago, during the Liberal premiership of Pierre Trudeau, there was little interest in chemical patents. Lucas said that this policy discouraged private investment in pharmaceutical innovations in Canada and caused the Canadian pharmaceutical industry to become focused on generic drugs.
  2. ^ Health policy professor emeritus Joel Lexchin said that the publicly-owned vaccine manufacturer Connaught Laboratories was privatized under the Conservative government of prime minister Brian Mulroney (1984-1993). Connaught was then part of Sanofi Pasteur. GSK acquired the Quebec-based vaccine manufacturer IAF BioChem. Sanofi and GSK—corporations outside Canada controlled decision-making about production. The three biggest vaccine makers—GlaxoSmithKline, Merck and Sanofi—lacked the new technologies essential for the production of newer forms of vaccine, that upstarts—such as Moderna and BioNTech—had mastered and by December it was evident that they were incapable of producing an effective COVID-19 vaccine.
  3. ^ According to Lexchin, newly-elected U.S. President Joe Biden reportedly continued the controversial America First policy of predecessor Donald Trump with respect to vaccine distribution. Canada was unable to obtain vaccine doses from the United States, even though the relevant American vaccine manufacturing facilities are relatively close to the Canada–United States border: Pfizer's facility in Kalamazoo, Michigan and Moderna's facility in Portsmouth, New Hampshire (actually a Lonza Group facility producing under contract).

References

  1. ^ https://covid19tracker.ca/vaccinationtracker.html
  2. ^ https://covid19tracker.ca/vaccinationtracker.html
  3. ^ a b c Tasker, John Paul (February 4, 2021). "Canada doesn't know how many more Moderna doses will be delivered, or why there are delays". CBC. Retrieved February 4, 2021.
  4. ^ a b c d Jones, Ryan Patrick (February 18, 2021). "COVID-19 vaccine deliveries back on track following weeks of delay, says Public Health Agency". CBC News. Retrieved February 18, 2021.
  5. ^ a b COVID-19 Tracker Canada, Vaccination Tracker, retrieved February 18, 2021
  6. ^ "Planning ahead: U.S., Canada order 177M more COVID-19 vaccine syringes from BD". FierceBiotech.
  7. ^ a b "With no successful vaccine candidates yet, Canada signs deal to secure 20M more COVID-19 vaccine doses". CBC News. September 25, 2020. Retrieved December 15, 2020.
  8. ^ Health Canada (October 2, 2020). "Health Canada begins first authorization review of a COVID-19 vaccine submission". gcnws. Retrieved December 30, 2020.
  9. ^ Tasker, John Paul (December 9, 2020). "Health Canada approves Pfizer COVID-19 vaccine". CBC News. Retrieved December 9, 2020.
  10. ^ Tasker JP (November 9, 2020). "Trudeau says promising new Pfizer vaccine could be 'light at the end of the tunnel'". CBC News. Archived from the original on November 9, 2020. Retrieved November 9, 2020.
  11. ^ a b Bilefsky, Dan; Austen, Ian (December 14, 2020). "Canada and the Coronavirus Vaccine: Here's What It Means". The New York Times. Retrieved December 15, 2020.
  12. ^ "Here's the COVID-19 vaccine rollout plan, province by province | CBC News". CBC. December 10, 2020. Retrieved December 15, 2020.
  13. ^ "When will Canadians get COVID-19 vaccines? The federal and provincial rollout plans so far". Retrieved December 15, 2020.
  14. ^ "Canada approves moderna vaccine".
  15. ^ a b Aiello, Rachel (December 15, 2020). "Canada locks in thousands more early COVID-19 vaccine doses". CTVNews. Retrieved December 16, 2020.
  16. ^ Hinchey, Garrett (December 28, 2020). "First doses of Moderna COVID-19 vaccine arrive in Yukon, N.W.T." CBC News. Retrieved February 18, 2021.
  17. ^ "First shipments of Moderna coronavirus vaccine arrive in Yukon, N.W.T." Global News.
  18. ^ "Canada Expects Further Pfizer Vaccine Delay Prompting Protests". The Toronto Sun.
  19. ^ "Moderna Cut Deliveries to Canada". CBC. Retrieved February 3, 2021.
  20. ^ Cousins, Ben (February 3, 2021). "Europe approves vaccine delivery to Canada". Coronavirus. Retrieved February 3, 2021.
  21. ^ Austen, Ian (February 18, 2021). "Delays Turn Canada's Vaccination Optimism Into Anxiety". The New York Times. p. A6. Retrieved February 22, 2021.
  22. ^ Austen, Ian (February 20, 2021). "Why Canada's Vaccine Rollout Slowed Down". The New York Times. ISSN 0362-4331. Retrieved February 22, 2021.
  23. ^ Aiello, Rachel (February 4, 2021). "Canada to keep feeling impacts of COVID-19 vaccine delivery issues: Fortin". CTV. Retrieved February 4, 2021.
  24. ^ Lexchin, Joel (February 8, 2021). "The roots of Canada's COVID-19 vaccine shortage go back decades". The Conversation. Retrieved February 22, 2021.
  25. ^ Lucas, Paul (January 22, 2021). "Why we're not doing better on COVID vaccines". Financial Post via the National Post. Opinion. Archived from the original on February 22, 2021. {{cite web}}: |archive-date= / |archive-url= timestamp mismatch; February 9, 2021 suggested (help)
  26. ^ Kuchler, Hannah; Abboud, Leila (February 15, 2021). "Why the three biggest vaccine makers failed on Covid-19". Financial Post. Retrieved February 22, 2021.
  27. ^ a b Canada, National Research Council (September 18, 2020). "COVID-19 response: Building the infrastructure". Retrieved February 3, 2021.
  28. ^ a b Rabson, Mia (February 2, 2021). "Canada signs deal to produce Novavax COVID-19 vaccine at Montreal plant". CP24. Retrieved February 3, 2021.
  29. ^ Staff, Reuters (February 2, 2021). "Canada signs first deal for manufacture of foreign COVID-19 vaccine". Reuters. Retrieved February 3, 2021. {{cite news}}: |first= has generic name (help)
  30. ^ a b Office, Prime Minister's (February 2, 2021). "New support to produce COVID-19 vaccines and treatments in Canada". Retrieved February 3, 2021.
  31. ^ Jerving, Sara (February 3, 2021). "COVAX releases country-by-country of vaccine distribution figures". Devex. Retrieved February 3, 2021.
  32. ^ "The Covax Facility: Interim Distribution Forecast – latest as of February 3, 2021" (PDF). COVAX. February 3, 2021.
  33. ^ a b "Canada negotiates accelerated delivery schedule for Pfizer-BioNTech's COVID-19 vaccine". Public Services and Procurement Canada (Press release). Gatineau, Quebec. February 12, 2021. Retrieved February 18, 2021.
  34. ^ Austen, Ian (February 18, 2021). "Delays Turn Canada's Vaccination Optimism Into Anxiety". The New York Times. p. A6. Retrieved February 22, 2021.
  35. ^ Austen, Ian (February 22, 2021). "Why Canada's Vaccine Rollout Slowed Down". The New York Times. ISSN 0362-4331. Retrieved February 22, 2021.
  36. ^ a b c d e f g h i j k l m n o p "COVID-19 Tracker Canada - Vaccination Tracker". covid19tracker.ca. Cite error: The named reference "auto" was defined multiple times with different content (see the help page).
  37. ^ https://covid-19-newfoundland-and-labrador-gnl.hub.arcgis.com/
  38. ^ Canada, Public Health Agency of (December 3, 2020). "Vaccines and treatments for COVID-19: Vaccine rollout". aem.
  39. ^ Gordon, Julie (December 4, 2020). "Canada doubles Moderna vaccine order, daily COVID-19 cases could top 10,000 by January" – via www.reuters.com.
  40. ^ George-Cosh, David (November 10, 2020). "Canada has option for 56M more Pfizer vaccine doses: Anand - BNN Bloomberg". BNN.
  41. ^ "Coronavirus vaccine tracker: How many people in Canada have received shots?". Coronavirus. December 29, 2020.
  42. ^ https://www.cbc.ca/news/politics/trudeau-vaccines-covid19-1.5869906
  43. ^ "Health Canada approves Pfizer's COVID-19 vaccine". thestar.com. December 9, 2020.
  44. ^ https://www.businesswire.com/news/home/20210212005486/en/Canada-Purchases-Additional-4-Million-Doses-of-Moderna%E2%80%99s-COVID-19-Vaccine
  45. ^ "Shipment of Moderna COVID-19 vaccine arrives in Canada one day after approval". CBC News. December 24, 2020. Retrieved February 18, 2021.
  46. ^ https://www.ctvnews.ca/health/coronavirus/health-canada-approves-two-astrazeneca-covid-19-vaccines-1.5325451
  47. ^ https://www.cbc.ca/news/politics/astrazeneca-approved-1.5929050
  48. ^ "COVID-19 Programs". www.medicago.com.
  49. ^ Canada, Public Health Agency of (December 3, 2020). "Vaccines and treatments for COVID-19: Vaccine rollout". aem.
  50. ^ Canada, Public Health Agency of (November 27, 2020). "Major-General Dany Fortin assisting Government of Canada's vaccine distribution planning". gcnws.
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