OTTAWA -- The Canadian military says it is making plans to play a role in the eventual rollout of COVID-19 vaccines nationwide.
As positive news about potential vaccines continues to make headlines, there are already military teams “fully integrated” with the Public Health Agency of Canada on planning for what’s set to be a herculean effort: getting vaccines into the arms of millions of Canadians once Health Canada approves them.
During a House of Commons National Defence Committee meeting on Monday, Canadian Armed Forces Strategic Joint Staff Director of Staff Major Gen. Trevor Cadieu said the military will play a role in that effort.
“We are working with optimism and enthusiasm as part of the COVID-19 vaccine rollout task force. Specifically, the Canadian Armed Forces is assisting with the development of a logistics support plan for the rollout of the vaccine,” Cadieu told MPs.
“We’re helping to establish a national operation centre that will oversee distribution of the vaccine,” he said. “That will be the command and control hub that will coordinate the distribution of a COVID-19 vaccine across the country.”
Cadieu said that Chief of the Defence Staff Gen. Jonathan Vance has dispatched some of his best planners to work on a logistic support plan that: “for all intents and purposes will be the maneuver plan to support the delivery of the vaccine across the country.”
It remains to be seen the degree of involvement the military will have, and whether it’ll be as extensive as it is in the United States. There, a general is leading the “Operation Warp Speed” effort and according to a recent 60 Minutes report, plans are in place to secure the stockpiles with armed guards.
“The chief of defence staff will be prepared to provide advice on how best to use Canadian Armed Forces resources for the actual rollout of the vaccine,” said Cadieu.
On his way in to a cabinet meeting on Monday afternoon, Treasury Board President Jean-Yves Duclos told reporters that once a vaccine, or vaccines are in-hand, the federal government will “use all the resources that Canadians can muster… including the discussions and actions with our armed forces.”
In the last week or so, two vaccine candidates from Pfizer and Moderna have shown high rates of effectiveness in preventing COVID-19 disease in clinical trials, and Prime Minister Justin Trudeau has said the federal government is gearing up for a potential rollout in early 2021.
“It's not simply enough to have a vaccine discovered, not simply enough to have doses of the vaccines secured… We have to get them into people,” Trudeau said on Nov. 9.
In total, the federal government has allocated $1 billion to go towards vaccine procurement, and to-date has secured access to as many as 414 million doses of vaccine candidates from several producers: Medicago, AstraZeneca, Sanofi and GlaxoSmithKline, Johnson & Johnson, Novavax, Pfizer and Moderna.
HOW FAR FROM CANADIAN APPROVAL?
So far, no COVID-19 vaccine has been authorized safe for use in Canada. Health Canada will need to evaluate each candidate before it can be administered to Canadians.
“We need to see the data from the phase three trials,” said Dr. Caroline Quach-Thanh, chair of the National Advisory Committee on Immunization in an interview on CTV’s Power Play.
“We're working in parallel to make sure that things move swiftly… so that when it gets approved, our recommendations will be almost ready so that we can start deployment,” she said.
As for how long it could take for Health Canada to approve a vaccine once the data is submitted, Dr. Quach-Thanh said that it depends on how robust the manufacturers’ submissions are. If there are holes, or questions outstanding for regulators, it could take some back and forth she said.
Quach-Thanh also noted that unlike the U.S., Canada doen't have a form of emergency use authorization to speed things up.
“I think it's okay because then you know we're sure that the data has been looked at carefully in terms of efficacy and safety, we don't want anybody to be shortchanged,” she said.
FOUR-PRONGED PLAN, DETAILS SPARSE
To date, publicly available details around the plan to administer vaccines have been minimal. A number of the vaccine candidates being tested require two doses and must be stored at very cold temperatures, for example.
Last week, Public Services and Procurement Minister Anita Anand called Health Canada’s approval of an eventual vaccine or vaccines a “moving target” and said it was just one part of their four-pronged approach to vaccine deployment.
Anand said on Nov. 9 alongside Trudeau that preparations have been underway for months and that in terms of the involvement of the military, “all options are indeed on the table.”
“We are working always with the provinces and the territories to ensure a seamless distribution system is established,” Anand said at the time. “We are going to establish in a very complex environment an efficient and effective distribution system for these vaccines once they are approved.”
In addition to the needed regulatory approval, Canada needs to figure out how to biomanufacture elements of the vaccine, how to distribute those millions of vials, and how to oversee the on-the-ground administration of the vaccine.
In terms of biomanufacturing, Anand said that contracts have been signed to set up what are called “fill and finish” machines to mass-produce doses in Canada.
In terms of distribution, the contract tender for a national shipping plan has been issued and already 70 companies, including major cargo and airline brands have expressed interest in playing a role. Part of the government’s criteria is to have the ability for cold storage to preserve the millions of doses coming our way, and the ability to deliver to all regions in Canada.
As for the administration of the vaccine, the government is procuring millions of syringes, vials, needles, alcohol swabs, gauze, and containers for discarded needles that will all be essential.
If the vaccine is a two-dose process, Chief Public Health Officer Dr. Theresa Tam has recently spoken about the need for some form of computer system to keep track who has been vaccinated and whether they’ve received both doses.
PRIORITIZATION AND GAPS
It’s expected that once a vaccine or vaccines are ready to be administered to Canadians, the initial supplies will be rationed and given to the highest-risk populations, such as seniors as well as health-care and essential workers.
According to the preliminary guidance issued by the National Advisory Committee on Immunization, prioritization will be based on three factors: the state of the pandemic when the vaccine is available; the supply available and number of doses required; and the risk-benefit analysis of key populations such as those who are at higher risk for adverse outcomes if they contract the novel coronavirus.
During Monday’s committee meeting, Canadian Armed Forces Surgeon Gen. Marc Bilodeau told MPs that “discussion is ongoing” as to where members of the military would fall in the order of precedence for getting immunized for COVID-19, and whether it will be mandatory for the military to be vaccinated.
As well, Quach-Thanh noted on Monday that not all sectors of the population will be able to access initial vaccines due to the lack of research into the potential impacts on them, such as children and people who are pregnant.
“It's not that the vaccine is not made for children, it's just that children have not been recruited in any of the trials and so we have no data on children, which is a little bit normal. When we study new drugs or new medication we always start with adults and when it's safe and efficacious and adult then we go down to children just because that's how it's done. Same thing for pregnancy,” Quach-Thanh said.
She said it’s possible that Canada could be waiting between approved vaccines to have access to enough doses to give to everyone who wants to be vaccinated. That would be the case if the government is not able to secure additional doses of what would be a hotly in-demand effective vaccine.
“But, as we're speaking, you know we're expecting that it's going to be rolled out over the next year or so, before everybody in Canada is vaccinated,” she said.
