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Alberta Premier Jason Kenney listens as the 2021 budget is delivered in Edmonton on Feb. 25, 2021.JASON FRANSON/The Canadian Press

Alberta Premier Jason Kenney says his government will ensure that people can choose which COVID-19 vaccine they get, in part over concerns in some religious communities about the use of fetal cell lines in their development.

Public health experts have warned that allowing people to shop around for their preferred vaccine could slow a mass vaccination program that aims to reach as many people as possible with a limited supply of doses. Other provinces have balked at letting people pick and choose vaccines, including Quebec, where the fetal cell issue has also emerged as a concern among some Catholics in the province.

Mr. Kenney said he understands the moral questions about AstraZeneca and other vaccines that were developed using cell lines that were derived decades ago from aborted fetuses. Cell lines refer to a lineage of cells that are reproduced for medical purposes.

“I’ve been clear with our health officials here that people must have a choice partly to reflect their conscientious concerns that they may have on those ethical issues, but also they may be really well-read in the science of the competing vaccines and they may choose one over another for reasons of tested efficacy or other factors,” Mr. Kenney said during a live Facebook video on Wednesday evening.

Tracking Canada’s COVID-19 vaccine rollout plans: A continuing guide

Moderna, Pfizer, AstraZeneca or Johnson & Johnson: Which COVID-19 vaccine will I get in Canada?

Canada pre-purchased millions of doses of seven different vaccine types, and Health Canada has approved four so far for the various provincial and territorial rollouts. All the drugs are fully effective in preventing serious illness and death, though some may do more than others to stop any symptomatic illness at all (which is where the efficacy rates cited below come in).

PFIZER-BIONTECH

  • Also known as: Comirnaty
  • Approved on: Dec. 9, 2020
  • Efficacy rate: 95 per cent with both doses in patients 16 and older, and 100 per cent in 12- to 15-year-olds
  • Traits: Must be stored at -70 C, requiring specialized ultracold freezers. It is a new type of mRNA-based vaccine that gives the body a sample of the virus’s DNA to teach immune systems how to fight it. Health Canada has authorized it for use in people as young as 12.

MODERNA

  • Also known as: SpikeVax
  • Approved on: Dec. 23, 2020
  • Efficacy rate: 94 per cent with both doses in patients 18 and older, and 100 per cent in 12- to 17-year-olds
  • Traits: Like Pfizer’s vaccine, this one is mRNA-based, but it can be stored at -20 C. It’s approved for use in Canada for ages 12 and up.

OXFORD-ASTRAZENECA

  • Also known as: Vaxzevria
  • Approved on: Feb. 26, 2021
  • Efficacy rate: 62 per cent two weeks after the second dose
  • Traits: This comes in two versions approved for Canadian use, the kind made in Europe and the same drug made by a different process in India (where it is called Covishield). The National Advisory Committee on Immunization’s latest guidance is that its okay for people 30 and older to get it if they can’t or don’t want to wait for an mRNA vaccine, but to guard against the risk of a rare blood-clotting disorder, all provinces have stopped giving first doses of AstraZeneca.

JOHNSON & JOHNSON

  • Also known as: Janssen
  • Approved on: March 5, 2021
  • Efficacy rate: 66 per cent two weeks after the single dose
  • Traits: Unlike the other vaccines, this one comes in a single injection. NACI says it should be offered to Canadians 30 and older, but Health Canada paused distribution of the drug for now as it investigates inspection concerns at a Maryland facility where the active ingredient was made.

How many vaccine doses do I get?

All vaccines except Johnson & Johnson’s require two doses, though even for double-dose drugs, research suggests the first shots may give fairly strong protection. This has led health agencies to focus on getting first shots to as many people as possible, then delaying boosters by up to four months. To see how many doses your province or territory has administered so far, check our vaccine tracker for the latest numbers.

Coronavirus tracker: How many COVID-19 cases are there in Canada and worldwide? The latest maps and charts

While no direct head-to-head study has been conducted on the COVID-19 vaccines, current data suggest the AstraZeneca shot is just as effective as the Moderna and Pfizer-BioNTech mRNA vaccines at preventing serious illness and death. However, it may be less effective at preventing mild illness.

Alberta has already been allowing choice in a limited way. People aged 50-64 have the option of signing up for the AstraZeneca vaccine now or waiting their turn in the wider queue when they will be able to get vaccines produced by Pfizer-BioNTech and Moderna.

Mr. Kenney suggested that when additional vaccines are in use, including one from Johnson & Johnson that was recently approved, as well as others that are in trials or awaiting a decision from Health Canada, Albertans will be able to choose between any that are available.

The province’s Chief Medical Officer of Health, Deena Hinshaw, said on Thursday that the province is still sorting out the extent to which people will be able to choose their vaccines as more are approved, and how that might work, though she encouraged Albertans to take the first vaccine they are offered.

The debate about allowing people to have some say in which vaccine they get has grown louder as more manufacturers receive approval from Health Canada. Currently there are four vaccines approved for use in this country, with additional approvals possible soon.

B.C.’s Provincial Health Officer, Bonnie Henry, has dismissed the idea that people should have a choice: “Let me be very clear: The vaccine you are offered is the best vaccine,” she said last week. Ontario is not officially allowing vaccine choice, though the province has noted that people can influence what vaccine they get by booking in specific locations. The AstraZeneca vaccine, for example, is only being administered in pharmacies, while the ones from Pfizer and Moderna are available in hospital clinics.

Concerns about the use of fetal cells have added another layer.

The AstraZeneca and Johnson & Johnson vaccines were both developed using cell lines that were derived from legally aborted fetuses in the 1970s. There are also myths circulating online that claim some vaccines contain fetal tissue, which is not true.

The Canadian Conference of Catholic Bishops has issued several statements raising concerns about the use of fetal tissue in vaccine development. The conference recently told Catholics that they should opt for the Moderna or Pfizer vaccines if given the choice but issued a statement on Thursday that made it clear that it is morally permissible to use any vaccine if it is the only one available.

The Archbishop of Montreal issued a statement on Thursday that said Catholics “can, in good conscience, be inoculated with any of the authorized vaccines” and that doing so would be a charitable act.

The pharmaceutical industry’s use of cell lines originating from fetal tissue is a long-standing issue for some religious groups and abortion opponents.

While the mRNA vaccines from Pfizer-BioNTech and Moderna are not produced using human cell lines, some of the materials used in the testing of those vaccines may involve the use of those cell lines – as do a wide array of drugs and pharmaceutical products that are in common use.

Moira McQueen, who is executive director of the Canadian Catholic Bioethics Institute in Toronto, said for those who oppose the use of the cell lines, the ethical question is one that should be balanced with the risk to health and safety in instances when options are not available, a position taken by the Catholic Church. Dr. McQueen was among the signatories sent by a coalition of Christian groups last May to Prime Minister Justin Trudeau urging the development of vaccines that do not “create ethical dilemmas for Canadians.”

“If there were the possibility that by refusing a vaccine someone might endanger themselves, their families or other people, and where there is no assurance that [alternatives] will be available within a very short time … then I think people should be vaccinated anyway.”

Stephan Hwang, a physician and research scientist at St. Michael’s Hospital in Toronto, worries that encouraging people to choose between vaccines could cause some to delay their shots until they can get the one they want.

“It raises the potential that people will delay vaccination in an effort to get a preferred vaccine in a situation where every day and every week counts,” he said.

“This is not a situation where time is on our side.”

Dr. Hwang said differences in the effectiveness between vaccines are not significant and don’t justify anyone delaying getting a vaccine if there is one available to them.

With a report from Les Perreaux in Montreal

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