Root of Canada COVID-19 vaccine shortage goes back decades



A Health-Care Worker Prepares A Dose Of The Pfizer-Biontech Covid-19 Vaccine at a UHN COVID-19 Vaccine Clinic In Toronto on Thursday, January 7, 2021.
The Canadian Press/Nathan Denette


By Joel Lexchin, University of Toronto


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.

Unheeded warnings

Close-up of a man at a microphone
Dr. David Naylor, then Dean of Medicine at the University of Toronto, is seen in Halifax in September 2003 at the Annual Conference of Federal, Provincial and Territorial Ministers of Health discussing his report on a Canadian centralized centre for disease control.
(CP PHOTO/Scott Dunlop)

 

 

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.

COVID-19 response

Here are the reported and estimated Canada data.

CanadaCasesDeathsCuredActive
Reported:4,259,37045,180 1.06% CFR4,166,86947,321
Estimate:23,554,31658,734 *0.25% IFR23,042,786261,685

Source: Civil Society Partners in Solidarity against COVID-19

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.

Trudeau and two scientists, all in white lab coats and face masks, in a lab
Prime Minister Justin Trudeau, left, with scientists Anja Rodenbrock, centre, and Stephane Lanthier during a visit to the National Research Council’s Human Health Therapeutics Research Centre facility in Montréal on Aug. 31, 2020.
THE CANADIAN PRESS/Graham Hughes

 

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.

Delayed deliveries

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.)

A large empty room with tables set up with vaccination supplies and biohazard bins.
Toronto’s Mass Vaccination Clinic is shown on Jan. 17, 2021.
THE CANADIAN PRESS/Frank Gunn

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.The Conversation

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

This article is republished from The Conversation under a Creative Commons license. Read the original article.

 

Canadian COVID-19 Data for 09/27/2022.

Source: Civil Society Partners in Solidarity against COVID-19

Population: 38,749,252 adjusted for estimated real COVID-19 deaths

CanadaCasesDeathsCuredActive
Reported:4,259,37045,180 1.06% CFR4,166,86947,321
Estimate:23,554,31658,734 *0.25% IFR23,042,786261,685

*Inferred IFR is an estimate only. The actual COVID-19 IFR may not be accurately calculated for the entire human race until long after the pandemic has ended.

Canada ProvincesDeathsCFR%CasesCuredActive
COVID-19 Totals:45,1801.064,259,3704,166,86947,321
* Quebec16,7171.401,193,9641,163,98213,265
Ontario14,3420.981,459,3531,428,79816,213
Alberta4,8720.80605,757594,1556,730
BC4,2531.11384,266375,7444,269
Manitoba2,1431.43149,622145,8171,662
Sask1,5071.05143,747140,6431,597
NB4760.6276,31674,992848
Nova Scotia5180.42123,549121,6581,373
NL2350.4651,44650,639572
* PEI570.1151,41050,782571
Yukon310.634,8854,80054
NWT220.1911,51111,361128
Nunavut70.203,5313,48539
Repatriates013130
Sub Totals45,1801.064,259,3704,166,86947,321

Recoveries are estimated using a Canadian-specific algorithm. Canadian COVID-19 Data is weekly by the country. Some data CSPAC obtains from Public Health Units is updated daily.

* Quebec and * Prince Edward Island data is current daily.

Below: Extensive Estimates using data from multiple sources.

Beta experimental estimates for Canada. Reported + unreported mild + asymptomatic COVID-19 infections.

The total actual number of infections in Canada including all the untested, unreported, asymptomatic infections is likely greater than 23,554,316 (60.79% of the population) including mild and asymptomatic cases. That would mean the estimated inferred average Infection Fatality Rate:
(IFR) is likely around 0.25%

Canadian COVID-19 deaths to 2022-09-26 are estimated to be 58,886 Using estimated IFR of 0.25% which is far below global average IFR.

58,886 (0.25% IFR) is the CSPaC estimated number of Canadian COVID-19 deaths (based on the inferred IFR) including those deaths unreported as COVID-19). The IHME estimates excess deaths in Canada to reach much higher than CSPaC estimates.

See The Lancet estimate of excess mortality from COVID-19 (Download PDF) in 191 countries/territories and 252 subnational units of select countries, from 1 January 2 0 2 0, to 31 December 2 0 2 1.

58734 Is the CSPaC estimated number of Canadian COVID-19 deaths based on a modified universal algorithm which factors more sophisticated public health infrastructure and also fewer available urgent care beds and facilities which is a problem in much of Canada in an emergency measures context.

The closeness of the two numbers derived from unique data and methods suggests their high probability. The blended data of three projections from three different biostatistician labs also confirms the estimates +/- .01%.

It is safe to say that Canadians have endured the grief of losing 58734 family members. Every number has a face. May their memory be forever a blessing to their families and friends.

Canada's advanced public health standards.

Canada and the USA both have a significantly lower than global average Infection Fatality Rate. (influenza has an IFR of .1% or 6 per 100k (2019)).

Ontario, Canada Reports


Ontario Regional Public Health Units (PHU) - Reported by Ontario Province.

These reports from the Ontario Provincial government differ significantly (much lower) from the data reported by individual Public Health Units (PHU). CSPaC includes links to each PHU to allow readers of this report to check the latest data from their public health unit.


Health UnitCasesDeathsCFRRecoveriesActive
Algoma District9,647650.7%9,417165
Brant County13,058980.8%12,819141
Chatham-Kent9,7521001.0%9,532120
Hamilton65,3946080.9%64,108678
Ottawa81,9858861.1%80,397702
Durham Region67,6015100.8%66,648443
Eastern Ontario17,9522431.4%17,473236
Grey Bruce9,925790.8%9,705141
Haldimand-Norfolk9,618921.0%9,43690
Haliburton Kawartha Pine Ridge10,8191261.2%10,550143
Halton Region53,4273510.7%52,710366
Hastings & Prince Edward Counties12,340840.7%11,849407
Huron Perth8,3261251.5%8,078123
Kingston Frontenac Lennox & Addington20,403790.4%19,968356
Lambton County12,9421511.2%12,636155
Leeds Grenville And Lanark District11,2831141.0%10,878291
Middlesex-London42,8044451.0%41,850509
Niagara Region45,7935731.3%44,829391
North Bay Parry Sound District7,509620.8%7,306141
Northwestern12,273360.3%12,067170
Oxford Elgin-St.Thomas15,7641831.2%15,245336
Peel Region196,4991,4270.7%193,9381,134
Peterborough County-City8,8061001.1%8,517189
Porcupine8,247770.9%8,09674
Renfrew County And District5,920631.1%5,733124
Simcoe Muskoka District51,0014861.0%50,016499
Sudbury And District18,1421680.9%17,651323
Thunder Bay District15,5151170.8%15,099299
Timiskaming2,345251.1%2,27446
Toronto350,7914,3961.3%344,3242,071
Waterloo Region50,9374730.9%50,118346
Wellington-Dufferin-Guelph24,5281750.7%24,127226
Windsor-Essex County48,1526691.4%46,901582
York Region121,9451,0930.9%120,078774
Last Updated: 2022-09-26 Time 05:20:18 GMT. Source: CSPaC

Global COVID-19 Data for 09/27/2022.

Source: Civil Society Partners in Solidarity against COVID-19