OTTAWA --
Canada's vaccine rollout is now well into its second phase, with the continuous arrival of larger shipments of vaccines. There is a focus on seeing every eligible Canadian receive their first dose by the summer, and so shots are being administered to a growing number of eligible Canadians each day.
How is this all working?
CTVNews.ca spoke with experts on vaccine efficacy, public health and public opinion, logistics and ethics, and dove into testimony offered to federal policymakers to provide answers about where the mass vaccination effort stands, what’s ahead, and when it may be your turn to get the jab.
The federal government’s latest commitment is that between 48 and 50 million doses of approved vaccines will arrive in this country by Canada Day, doubling to more than 100 million doses by the end of September, more than enough shots to immunize the entire population.
For specifics on the size of coming deliveries, bookmark this.
First here are the basics:
Canada currently has four COVID-19 vaccines approved for use: the Pfizer-BioNTech vaccine, the Moderna vaccine, the AstraZeneca vaccine and the Johnson & Johnson vaccine.
As of early May, Canada has received shipments from all four approved vaccine developers, but the latest arrival, the Johnson & Johnson vaccine, is being held back by Health Canada so it can conduct some additional quality assurance checks after it was discovered it used a drug ingredient manufactured at a U.S. plant flagged for safety issues.
The federal government has committed to having every eligible person—now anyone aged 12 and older—vaccinated who wants to be by the end of September 2021, with Prime Minister Justin Trudeau recently describing the path the country is on as one that will see a “one dose summer,” making way for a “two dose fall,” where life can start to return to normal.
In total, Canada has contracts with seven vaccine manufacturers for doses of their shots. If all seven vaccine candidates are approved, those contracts would see this country have access to more than 400 million doses, which is way more than will be needed to immunize a population of approximately 38 million. This means the excess will likely be shared globally.
If you aren’t already eligible, you should be very soon. Every week, more and more age groups are becoming eligible to get vaccinated, with some hot spot communities offering shots to any residents who are able to be vaccinated.
The move to delay second doses by up to four months, prompted by the National Advisory Committee on Immunization (NACI)’s recommendation, meant that more people have been able to receive a first shot earlier than they would have been able to by following the pharmaceutical companies' advised shorter intervals between doses. Though, there is also a focus now in some regions on ensuring those in high-risk health-care jobs get access to their second shots, and signals are there that the general public’s second doses could start to be bumped up.
As for how you will find out when it’s your turn to roll up your sleeve, the most specific and up-to-date local information, visit our national roundup for details on the plan in or around your community.
There is a team of Canadian Armed Forces logistical experts, currently being led by Brig.-Gen. Krista Brodie, working from inside the Public Health Agency of Canada (PHAC) that are responsible for receiving the shipments and then co-ordinating with each province and territory about the portion of each delivery that is being sent to each region, and ensuring they have the storage capacity and other requirements to receive them.
While this task seemed daunting enough with a small number of approved delivery and administration sites, new locations have been set up as vaccine clinics, from the Canada’s Wonderland amusement park near Toronto to Montreal’s Olympic Stadium. Pharmacies and small local clinics are also increasingly being stitched into the patchwork of administration sites as the mRNA vaccines are being found to be able to kept more stable longer outside of extreme cold storage.
The logistical factors that need to be considered when setting up mass vaccine sites or small local clinic locations include having enough immunizers to staff them and the ability to quickly add more if one week’s delivery is particularly sizeable.
There also needs to be adequate space for everyone passing through these facilities to be monitored for 15 minutes after their shots. “There is going to be disruption, there is going to be changes, there is going to be a big shipment at one time and then nothing for a while. That's the nature of supply. So you want to have your vaccination centers be able to absorb the variability in supply,” said Mahesh Nagarajan, operations and logistics professor at the University of British Columbia's Sauder School of Business, in an interview with CTV News.
In terms of how the doses are travelling, it depends on the vaccine. Pfizer contracted UPS to handle their deliveries and that’s been done through specialized containers designed to keep the shots cold enough while on the move.
As for how the other vaccine doses are being transported, the federal government has contracted FedEx Express Canada and Innomar Strategies for an “end-to-end, COVID-19 vaccine logistics solution.” This includes transporting the boxes of vaccines to administration points across Canada at the unique temperature requirements for the Moderna, AstraZeneca, and Johnson & Johnson vaccines.
At the time the contract was unveiled, president of Innomar Strategies Guy Payette told CTV News in an email that the storage facilities used along the cold chain “are equipped to store complex pharmaceutical products… are temperature-mapped and have a validated monitoring system to protect against temperature excursions.”
The biggest portion of the federal responsibility has been on the procurement end; from securing vaccine contracts to ensuring there are enough bandages, needles, syringes, alcohol swabs and any other immunization accoutrements in stock across Canada to support the vaccination effort. They are also collecting immunization data on a national level, and have offered to support provinces in their rollouts if needed.
Because Canada does not have sufficient domestic vaccine manufacturing capacity, there has been a reliance on other nations in this push to get to the other side of this pandemic. The federal government has come under fire for that, after Canadian vaccine-making capabilities deteriorated over decades.
Since then, the government has made a few announcements promising the creation of domestic manufacturing capacity, though it’s not expected any of these new sites will be fully functional in time to assist in the current COVID-19 vaccine effort. There’s been some suggestion that the facilities under development could also be used should COVID-19 booster shots be required in years ahead. More on that below.
Generally speaking, yes. As more vaccines are becoming available to more people, everyone has the option to opt to sign up when it’s their turn. Though, with the AstraZeneca vaccine being halted in several regions, some uncertainty remains about how this shot will be used going forward.
While NACI has suggested that based on your personal risk threshold if you are concerned enough about the rare risk of blood clots being reported in a small number of recipients of the AstraZeneca and Johnson & Johnson vaccines, that you could “wait” until you are able to receive an mRNA Pfizer or Moderna shot, Health Canada’s message remains: all vaccines are safe and effective and to take the first one you can.
“If a vaccine is offered to you, it is a good option, and we're always looking at the benefits of a vaccine, compared to the risks of that vaccine, but also you have to look at what would happen if you don't get vaccinated,” senior Health Canada adviser Dr. Supriya Sharma said on May 5, noting that of the vaccines given the green light so far have been shown to prevent serious illness, hospitalization, and death from COVID-19.
Increasingly, because of an uptick in the number of vaccines arriving, Canada's decision to largely delay administering second doses, and other major nations facing their own hurdles, Canada is moving up the global rankings.
No. Deputy Chief Public Health Officer Dr. Howard Njoo has said he’s optimistic the desire to get vaccinated will snowball as more people are able to be immunized. Generally speaking, he said, the number of people who are vaccine-hesitant is small, but PHAC is monitoring it and working on ways to solicit more buy-in.
“We don't want to ignore them, we want to make sure that their vaccine confidence is reinforced by giving them the right information,” Njoo said about so-called “anti-vaxxers.”
As Nik Nanos, founder of Nanos Research, said on an episode of Trend Line released March 11, based on a recent survey, around eight out of every 10 Canadians say that they are definitely or probably going to get vaccinated when it's their turn.
It’s possible down the line Canadians will have to receive a new needle to address a variant of concern that the existing vaccines show not to be effective at combating. It’s also possible people will need to top-up on immunity over time, since it remains unclear how long the antibodies last from the currently approved vaccines. This is because they have only been in existence and in use for such a short period of time.
Quach said that NACI anticipates they will be called on to advise about a follow-up dose at some point down the line.
“The longest we have is three months in the clinical trials. And in real life, I mean, people started to get really vaccinated in January… So we'll have to follow up on that as well,” she said. “We’re monitoring the data… We’ll see what the companies move forward with.”
On April 23, the federal government announced it had reached a deal with Pfizer to secure 35 million COVID-19 vaccine booster shots for next year and 30 million for the year after. The agreement includes options for an additional 30 million doses in both 2022 and 2023, and 60 million more in 2024.
It’s going to depend on more than the percentage of people who are vaccinated. The spread of variants and number of hospitalizations will also play a role in the gradual rollback of restrictions.
Federal public health officials have signalled that even when vaccines become widespread, there will need to be precautionary measures like frequent hand-washing, physical distancing and mask-wearing in place for some time.
The first indication of when things could start to shift came from Chief Public Health Officer Dr. Theresa Tam, as part of the April 23 modelling presentation. Tam projected that once 75 per cent of adults have their first dose, and 20 per cent have their second, restrictions could be lifted without maxing out hospital capacity.This could mean that summer could include camping, hiking, picnics, and patios, but crowds should still be avoided.
Then by the fall, if 75 per cent of those eligible for a vaccine have been fully vaccinated, expect to be able to gather indoors with people outside your household, participate in indoor sports, and attend family gatherings.
Though, some provinces have signalled they intend to begin reopening earlier than the national timetable has suggested, based on local case realities and vaccination rates.
It’s looking likely, at least when it comes to international travel. The federal government says that talks are ongoing with international counterparts about settling on some sort of consistent system to show some form of proof of vaccination in order to be able to travel abroad or come to Canada. Some provinces have already said that there are plans in the works, but there hasn’t been a widespread Canadian conversation about the idea.
As Health Minister Patty Hajdu said on an episode of CTV’s Question Period that aired on May 2, work continues on establishing what the international standard will be when it comes to these vaccine passports.
“We know there are a lot of different kinds of vaccines around the world, and we want obviously Canadians to be able to participate in international travel, so I can reassure Canadians that no matter what those requirements will be we'll have Canadians ready when the time is right to travel,” she said.
Hajdu has also poured cold water on the idea of developing a domestic vaccine passport system, though it remains up to each province and territory to establish what activities like attending schools, large sporting or cultural events would require showing proof of immunization to enter.
In an interview with CTV News, University of Toronto public health ethicist Alison Thompson said that there should be mass access to vaccines before vaccine passports come into play, or the country will start to see a two-tier system of people who can and can’t do certain things.
“Until we can ensure that everybody has an equal chance to get vaccinated, that that's really going to create inequities in our society,” she cautioned. “It's really tricky and I think it’s a conversation that I think needs to be happening in the public discourse, not just amongst policymakers and lawmakers, because it really will impact all of us.”
Edited by CTVNews.ca's Ryan Flanagan and Sonja Puzic
Personal support worker Michael Gellizeau receives the Pfizer-BioNTech COVID-19 mRNA vaccine during the COVID-19 pandemic in Toronto on Tuesday, December 15, 2020. Toronto and Peel region continue to be in lockdown. THE CANADIAN PRESS/Nathan Denette
