Canada faces narrowing window to distribute COVID-19 vaccines against the spread of infection

As Canadian health officials approach a decision on whether to approve a COVID-19 vaccine, experts say the timing of the vaccine’s arrival will be crucial in disrupting the pandemic’s anticipated impact in the new year.

On Wednesday, UK regulators gave their green light to the vaccine produced jointly by drug manufacturer Pfizer Inc. and its German partner BioNTech, paving the way for vaccinations to begin in Britain as early as next week.

That milestone is increasing pressure on Ottawa and the provinces to ensure vaccinations can begin promptly if equivalent authorization is granted by Health Canada.

The Pfizer vaccine is one of three that federal regulators began considering in October as part of an accelerated process. Together with the vaccines developed by Moderna and AstraZeneca, its approval would mark a turning point in the battle against the COVID-19 pandemic in Canada.

How many cases of coronavirus are there in Canada, by province and in the world? The latest maps and charts

The Canadian review of Pfizer’s COVID-19 vaccine candidate is expected to be completed soon, Hajdu says

In the short term, Ottawa said it expects six million doses, enough for three million people, from Pfizer and Moderna in the first quarter of 2021.

In Britain, Health Secretary Matt Hancock said his country will begin receiving the first shipment of 800,000 doses within days and expects to receive millions of doses by the end of this year. In the United States, some forecasts estimate that 20 million Americans will be vaccinated before January.

In this country, some provinces are starting to reveal what the launch could look like, including Alberta, where Premier Jason Kenney said Ottawa has assured the province that it will receive its first shipment of vaccines on January 4, 2021. Further shipments will arrive. in waves throughout the first part of next year, he said. Alberta wants 30% of residents to be vaccinated in the first half of the year. Other provinces, including Ontario, have yet to detail their implementation strategies.

The stakes for federal regulators and those involved in the logistics of delivering vaccines across the country could not be higher. With the number of cases and deaths expected to increase faster in Canada in the new year due to the pandemic, the difference of a few weeks in the arrival of the first vaccines could have a significant impact on the number of lives saved.

More than 12,300 have already died from the disease in Canada since the start of the pandemic. Recent modeling from the Seattle Institute for Metrics and Health Assessment shows that total deaths could exceed the 30,000 mark by March 1, even with strict adherence to public health guidelines such as wearing a mask.

Jane Heffernan, a mathematician at York University in Toronto who specializes in the spread of infectious diseases, said the impact of a vaccine arriving in Canada is highly time-sensitive due to the number of infections approaching another peak at the end. February or early March to its modeling.

Since the vaccines currently under consideration in Canada are given in two doses spaced weeks apart, they would not be expected to reach their maximum level of effectiveness until about a month after the first dose.

Although the first vaccines that arrive can only be given to the most vulnerable, “for any subpopulation to receive maximum benefit, we need to vaccinate before the peak,” said Dr. Heffernan.

However, hasty approval could also be disastrous if problems arise later, as public confidence in vaccines will be essential to fend off the long-term pandemic.

“What we don’t want – from any country – is that a vaccine that is not safe is approved. That will block everything, ”said Alan Bernstein, president and CEO of the Toronto-based research funding organization CIFAR.

The imminent availability of a vaccine in Britain has focused attention in Canada on the dual track of authorization and logistics, both of which will need to be in place to avoid delays in Canadians receiving approved vaccines as soon as they are manufactured.

Health Canada said it expects its independent review of the Pfizer vaccine to be completed soon, provided that a vaccine will only be authorized if it meets the requirements for safety, efficacy, and other requirements related to manufacturing and quality control.

The department also said the timing of its vaccine decision will be “roughly aligned” with the US and Europe, provided it has received all the necessary data to complete the review process.

In the United States, a U.S. Food and Drug Administration advisory committee is expected to consider an emergency use authorization for Pfizer vaccine at an open meeting on December 10. This step differs from Canada, where federal regulators have carefully reviewed data provided by the company.

A vaccine review normally takes the equivalent of 2,000 person hours involving 7 to 10 reviewers, according to Supriya Sharma, a chief medical consultant at Health Canada. For COVID-19 vaccines, the same effort is required, but the overall activity was compressed into a shorter number of days.

Dr Sharma said the vaccine applications are split into three information packs, which cover animal studies, clinical trials, and manufacturing process information. The analysis on all three fronts is then brought together to determine whether the benefits of the vaccine outweigh the risks.

“If all of this complies with the regulations, then [the vaccine] gets a permit, ”said Dr Sharma.

But a bigger and politically more volatile question is how quickly Canada can be ready to receive vaccine delivery if that authorization is granted quickly.

On Wednesday in Ottawa, the British approval fueled the opposition party’s demands that the federal government clearly explain when Canada will receive the vaccines and how they will be delivered to Canadians.

Conservative leader Erin O’Toole asked how Canadians will feel when other economies open up to Canada while the country waits for enough vaccines.

Ottawa’s planning is especially critical for Pfizer and Moderna vaccines, which have some of the most complex distribution requirements because they must be stored at ultracold and cold temperatures respectively.

On Wednesday, a spokesperson for Minister of Public Services and Procurement Anita Anand said Canada has so far secured nine ultra-cold freezers that can go as low as -80 ° C, which are needed for Pfizer vaccine, and 33 regular freezers for Moderna vaccine, which they can go to – 20 C.

Spokesman Cecely Roy said Canada has in total placed orders for 26 ultra-cold freezers and 100 standard freezers. On average, each freezer can hold 280,000 doses, but regular freezers can only hold between 96,000 and 160,000 doses. The minister’s office did not disclose whether the freezers that had already arrived in Canada were distributed across the country.

Pfizer told The Globe and Mail it is working directly with several provincial and territorial governments to support the distribution of its vaccine, which will be shipped in frozen vials from its manufacturing facilities to points of use in Canada in a “just-in time”. delivery “. The vaccine can be stored cold in special containers using dry ice until the destination is reached.

In Alberta, Kenney said he expects 435,000 people to receive vaccine injections in the first quarter of 2021, or about 10 percent of the province’s population. The first phase will focus on Alberta’s most at-risk groups, including residents of long-term care homes, designated life support facilities, and staff working in those operations. It will also include indigenous peoples living in reserves and the health workers most needed to keep facilities running and most likely to transmit the virus to others at risk.

“While we can’t control when these vaccines arrive in Alberta, we can make sure that when we get them, we’re ready to roll them out as quickly as possible.”

With reports from Kelly Grant, Carrie Tait and The Associated Press

Our Morning Update and Evening Update newsletters are written by Globe editors, providing a brief summary of the day’s biggest headlines. Sign up today.