The roots of Canada’s COVID-19 vaccine shortage go back decades
by Joel Lexchin, Professor Emeritus of Health Policy and Management, York University, Emergency Physician at University Health Network, Associate Professor of Family and Community Medicine, University of Toronto
Canada is facing delays in vaccine delivery from both Pfizer and Moderna
As of Feb. 5, Canada had administered 2.7 COVID-19 vaccination doses per 100 people compared to 61.7 for Israel and 16.2 for the United Kingdom. By contrast, Canada has signed contracts with seven different companies for a total of 234 million doses with options for tens of millions more.
What’s going on?
To understand the problem, we need to go back to the 1980s. At that time, the government-owned Connaught Labs was producing vaccines here in Canada and decision-making was in the public realm. But Connaught was partially privatized and then finally allowed to be sold to the French company Merieux (now part of Sanofi) by the Conservative government of Brian Mulroney.
Fast forward to the 2000s, when Québec-based vaccine manufacturer IAF BioChem went through a couple of sales and ended up being owned by GlaxoSmithKline (GSK).
Sanofi and GSK still make vaccines in Toronto and Ste-Foy, but decisions about what vaccines to produce are not in Canadian hands.
It didn’t have to be that way. After the SARS outbreak in 2003, the report Learning from SARS led by Dr. David Naylor recommended that Canada develop a “national vaccine strategy” and prioritize the security of our vaccine supply. We got another warning about the need for a secure and steady supply of vaccines with the H1N1 pandemic of 2009 when there were production delays at the GSK plant in Ste-Foy.
Nobody seems to have been paying attention. As a result, when the COVID-19 pandemic started, Canada was left with few options.
Canada’s first attempt to ensure domestic production was a deal with the Chinese manufacturer CanSino Biologics in May 2020. Had that deal gone ahead, it would have involved trials at the Canadian Centre for Vaccinology at Dalhousie University and, if successful, subsequent domestic manufacturing. But within days of the agreement being announced, there were already troubles as the Chinese delayed sending the seed material for the vaccine and, ultimately, it never arrived.
Efforts to secure a domestically made supply then turned to upgrading the National Research Council (NRC) facility in Montréal and subsequently building an entirely new plant at a total cost of $170 million. In doing so, the government bypassed providing PnuVax, a biopharmaceutical company also located in Montréal, with any of the $600 million from Industry Canada’s Strategic Innovation Fund earmarked for the research or development of COVID-19 vaccines and therapies.
PnuVax had been renovated in 2012 to meet Health Canada standards and according to sources cited by the Globe and Mail, the company could have been ready to produce millions of doses of a COVID-19 vaccine by the end of 2020.
Prime Minister Justin Trudeau initially said the NRC facility would be up and running by November 2020 and producing 250,000 doses a month. However, in early February, Trudeau admitted that the NRC plant wouldn’t be ready until the summer of 2021, and with the need to outfit the facility for the Novavax vaccine and subsequent Health Canada inspections, there won’t be any vaccine coming from there until the end of 2021.
The failure of the CanSino deal and the delay in building the new NRC facility left Canada reliant on foreign sources of vaccine. The contracts for the vaccine were negotiated based on advice provided by the 18 member COVID-19 Vaccine Task Force set up by the NRC in June 2020.
Both the co-chairs of the task force have conflicts of interest with companies producing the vaccines and the terms of the contracts are being kept secret. Among other things, we don’t know what price Canada is paying for each vaccine, what the timeline for delivery is, whether there are penalties for delays and how the contracts are being enforced, if at all.
Complicating things even further, the contracts focused on large-scale delivery starting in April 2021 because of uncertainty back in the summer about when vaccines would be available.
Now Canada is facing delays in vaccine delivery from both Pfizer and Moderna, the companies making the only two vaccines approved in Canada so far. The Pfizer plant in Belgium, where our vaccine comes from, is being retooled to increase production while the exact reasons for the Moderna delay are unclear. Moderna is shipping its vaccine to Canada through Belgium. (Both companies and the federal government have promised that the amounts scheduled for delivery by the end of March will be honoured.)
On top of having no domestic production and the delays, Canada is facing vaccine nationalism from other countries. U.S. President Joe Biden is sticking to an America-first position and not allowing the Pfizer plant in Michigan or the Moderna plant in New Hampshire to export any of their vaccines to Canada until all Americans have been vaccinated.
The European Union is also threatening to block the export of vaccines possibly affecting exports from Belgium, as it too is confronting delays in being able to vaccinate its citizens.
One response from Canada to all of this is to claim 1.9 million doses of the yet-to-be-approved AstraZeneca vaccine from COVAX, a facility primarily set up to ensure that low- and middle-income countries will have access to vaccines. Canada is the second-largest country donor to COVAX and is entitled to claim vaccines from COVAX, but is doing so when, as of Feb. 3, only four African countries have started vaccinating their citizens.
In an interview on CBC’s As It Happens, Karina Gould, Canada’s minister of international development, defended Canada’s move, a made-in-Canada form of vaccine nationalism.
Ensuring that Canadians would receive an effective vaccine quickly was never going to be a sure thing; there was always plenty of opportunity for something to go wrong. But the uncertainty involved has been compounded by a lack of government planning in the past, secrecy, a lack of international co-operation and poor government decision-making. Let’s hope we do better when the next pandemic comes around.