Toronto's Mass Vaccination Clinic is shown on Jan. 17, 2021.Frank Gunn/The Canadian Press
This week Canada’s vaccine plan ran headlong into a serious supply shortage. The Trudeau government is vowing to keep its promise of getting the necessary shots to everyone in Canada who wants one by September, but the high-stakes effort has been met with confusion and a fog of information. That’s partly because of the fast-changing nature of the file: Regulatory timelines, purchase numbers and delivery dates shift almost daily. But some of the confusion comes from conflicting or inaccurate information from the most senior officials and politicians.
For example, when officials released the immunization plan during a Dec. 9 press conference, the Public Health Agency of Canada offered two competing timelines. The first set the goal of September, 2021, for immunizing everyone in Canada; the second said the goal would be December, 2021. The government later confirmed the goal was September.
More recently, on Jan. 12, Prime Minister Justin Trudeau said 20 million Canadians would be able to get their shots by June. But while the government says it’s possible that could happen with more vaccine approvals, so far the country has secured enough vaccines to inoculate 13 million people within that time frame.
The Globe and Mail is tracking Canada’s purchases and the progress of vaccines still in development to answer the most pressing questions for Canadians about the way out of the pandemic.
How many COVID-19 vaccine doses is Canada getting and when will you get your shot?
The federal government signed contracts to buy 234 million vaccine doses, with options to buy 164 million more. The number is shifting from earlier disclosures because Ottawa has already purchased 40 million more doses from Moderna and Pfizer, and let options for 16 million Moderna doses expire. Procurement Minister Anita Anand said the government let the options expire because they would only arrive after Canada’s September deadline to get shots to everyone.
CANADA’S VACCINE CONTRACTS
The federal government has signed contracts to buy seven COVID-19 vaccine candidates. If all of those vaccines get Health Canada authorization, then Ottawa would buy 234 million vaccine doses. The government also negotiated options that give it the right to buy 164 million more doses if it chooses to.
Doses
purchased
Options
available
VACCINE (type)
DOSAGE
STATUS
Pfizer/BioNTech (mRNA)
(millions of doses)
Authorized
in Canada
40
36
Moderna (mRNA)
Authorized
in Canada
40
Under Review
in Canada;
Partial phase 3
data available
AstraZeneca/Oxford U.
(Adenovirus vector)
20
Janssen/Johnson & Johnson
(Adenovirus vector)
Under Review
in Canada;
Phase 3 data
pending
10
28
NovaVax (Protein nanoparticles)
Phase 3
data pending
52
24
Medicago/GSK
(Virus-like particles with protein)
Phase 2/3
trial underway
20
56
Sanofi/GSK (Recombinant protein)
Phase 3 trial
delayed till at
least Q2 2021
52
20
CANADA’S IMMUNIZATION PLAN
By September, the federal government says they will have
enough vaccine to inoculate everyone in Canada who wants a
shot. If more vaccines are authorized, and delivered, that timeline
could be sped up.
FIRST QUARTER
SECOND QUARTER
THIRD QUARTER
38 million
vaccinated
3 million
vaccinated
Goal
23 million
vaccinated
J
F
M
A
M
J
J
A
S
Enough doses
secured for
3 million
Enough doses
secured for
13 million
Enough doses
secured for
36 million
Reality
THE GLOBE AND MAIL
CANADA’S VACCINE CONTRACTS
The federal government has signed contracts to buy seven
COVID-19 vaccine candidates. If all of those vaccines get Health
Canada authorization, then Ottawa would buy 234 million vaccine
doses. The government also negotiated options that give it the
right to buy 164 million more doses if it chooses to.
Doses
purchased
Options
available
VACCINE (type)
DOSAGE
STATUS
Pfizer/BioNTech (mRNA)
(millions of doses)
Authorized
in Canada
40
36
Moderna (mRNA)
Authorized
in Canada
40
Under Review
in Canada;
Partial phase 3
data available
AstraZeneca/Oxford U.
(Adenovirus vector)
20
Janssen/Johnson & Johnson
(Adenovirus vector)
Under Review
in Canada;
Phase 3 data
pending
10
28
NovaVax (Protein nanoparticles)
Phase 3
data pending
52
24
Medicago/GSK
(Virus-like particles with protein)
Phase 2/3
trial underway
20
56
Sanofi/GSK (Recombinant protein)
Phase 3 trial
delayed till at
least Q2 2021
52
20
CANADA’S IMMUNIZATION PLAN
By September, the federal government says they will have
enough vaccine to inoculate everyone in Canada who wants a
shot. If more vaccines are authorized, and delivered, that timeline
could be sped up.
FIRST QUARTER
SECOND QUARTER
THIRD QUARTER
38 million
vaccinated
3 million
vaccinated
Goal
23 million
vaccinated
J
F
M
A
M
J
J
A
S
Enough doses
secured for
3 million
Enough doses
secured for
13 million
Enough doses
secured for
36 million
Reality
THE GLOBE AND MAIL
CANADA’S VACCINE CONTRACTS
The federal government has signed contracts to buy seven COVID-19 vaccine candi-
dates. If all of those vaccines get Health Canada authorization, then Ottawa would buy
234 million vaccine doses. The government also negotiated options that give it the right
to buy 164 million more doses if it chooses to.
Doses
purchased
Options
available
VACCINE (type)
DOSAGE
STATUS
Pfizer/BioNTech (mRNA)
(millions of doses)
Authorized
in Canada
40
36
Moderna (mRNA)
Authorized
in Canada
40
Under Review
in Canada;
Partial phase 3
data available
AstraZeneca/Oxford U. (Adenovirus vector)
20
Janssen/Johnson & Johnson
(Adenovirus vector)
Under Review
in Canada;
Phase 3 data
pending
10
28
NovaVax (Protein nanoparticles)
Phase 3
data pending
52
24
Medicago/GSK (Virus-like particles with protein)
20
Phase 2/3
trial underway
56
Sanofi/GSK (Recombinant protein)
Phase 3 trial
delayed till at
least Q2 2021
52
20
CANADA’S IMMUNIZATION PLAN
By September, the federal government say sthey will have enough vaccine to inoculate
everyone in Canada who wants a shot. If more vaccines are authorized, and delivered,
that timeline could be sped up.
FIRST QUARTER
SECOND QUARTER
THIRD QUARTER
3 million
vaccinated
Goal
23 million
vaccinated
38 million
vaccinated
J
F
M
A
M
J
J
A
S
Enough doses
secured for
3 million
Enough doses
secured for
13 million
Enough doses
secured for
36 million
Reality
MARIEKE WALSH, IVAN SEMENIUK AND JOHN SOPINSKI / THE GLOBE AND MAIL
On Thursday the government updated its vaccination goals. It wants to inoculate three million people by March, 23 million people by June and everyone in Canada by the end of September. The government is on track to reach the September goal, but other vaccines will need to be approved to meet the June target.
Why did Canada buy hundreds of millions of doses more than we need?
If all seven vaccine candidates purchased by the federal government are approved, then Canada will have purchased enough vaccine doses to inoculate the population three times over. Because there was no way to know which vaccines would be approved first, Ms. Anand has said the government tried to diversify its options. On Dec. 20, Mr. Trudeau told CTV that if Canada ends up with excess doses “we will be sharing” them with the world.
How much did Canada pay for the COVID-19 vaccines?
In the fall, the federal government pinned the initial spend on vaccine contracts at more than $1-billion, but that number is expected to go much higher. Other countries have chosen to release more information, with Australia saying it has spent more than $3.2-billion to secure four vaccine contracts. The United States has released some of the most detailed information; for example, on Dec. 23 the U.S. government said it would buy 100 million additional Pfizer-BioNTech doses for $2.48-billion, which works out to $24.80 per dose. (Prices will vary between countries because each negotiated separately.)
The European Union has also kept its vaccine prices confidential but the curtain was accidentally lifted by a Belgian politician, who tweeted a price chart and then deleted it. According to that chart, published by Belgian newspaper Het Laatste Nieuws, the EU paid $22.91 per dose from Moderna and $18.47 per dose from Pfizer.
Why isn’t Canada releasing the vaccine contracts?
The federal government says it is keeping the contract details secret, partly because negotiations for vaccines and their delivery schedules are ongoing. Experts say withholding those contracts makes it difficult to hold the government to account and means the public can’t verify if the government is enforcing its contracts.
Other countries have approved AstraZeneca. Why hasn’t Canada?
In November, AstraZeneca was one of three companies on Canada’s order list to present interim results from a Phase 3 clinical trial – meaning a study that is large enough to offer a sense of how well a vaccine protects against COVID-19. But unlike the other two vaccines, which Canada authorized relatively quickly, the AstraZeneca vaccine (developed at Oxford University) produced divergent results where one shot unexpectedly showed higher efficacy than two. Since then, the U.K., India and several other countries have approved the vaccine for emergency use. Health Canada has said its regulators are waiting to see results from a separate trial of the vaccine underway in the U.S. Those data could be available by the end of this month. On Jan. 29, the European Medicines Agency is meeting to discuss authorizing the vaccine and Health Canada experts are set to participate in the meeting. Canada has not set a timeline for completing its review of the AstraZeneca vaccine but if the new data can address outstanding questions, an authorization could come as early as next month.
Vaccine doses by province
The Globe and Mail is tracking the number of available and administered vaccine doses by province and territory as well as the number of administered doses per 100 people. As of Jan. 20.
Doses administered
Prov.
Doses available
100 people
237.9 of 277.1
1.6
Ont.
2.0
174.3 of 237.1
Que.
1.9
B.C.
98.1 of 133.5
2.2
95.2 of 101.3
Alta.
2.3
27.2 of 29.3
Sask.
22.4 of 46.3
1.6
Man.
10.4 of 17.8
1.3
N.B.
9.2 of 23
0.9
N.S.
8.5 of 13.6
1.6
Nfld.
5.9 of 8.3
3.7
PEI
2.6 of 7.2
6.3
Yukon
2.5 of 6
6.5
Nunavut
N.W.T.
1.9 of 7.2
4.2
the globe and mail, source:
provincial governments
Vaccine doses by province
The Globe and Mail is tracking the number of available
and administered vaccine doses by province and territo
ry as well as the number of administered doses per 100
people. As of Jan. 20.
Doses administered
Prov.
Doses available
100 people
237.9 of 277.1
1.6
Ont.
2.0
174.3 of 237.1
Que.
1.9
B.C.
98.1 of 133.5
2.2
95.2 of 101.3
Alta.
2.3
27.2 of 29.3
Sask.
22.4 of 46.3
1.6
Man.
10.4 of 17.8
1.3
N.B.
9.2 of 23
0.9
N.S.
8.5 of 13.6
1.6
Nfld.
5.9 of 8.3
3.7
PEI
2.6 of 7.2
6.3
Yukon
2.5 of 6
6.5
Nunavut
N.W.T.
1.9 of 7.2
4.2
the globe and mail, source:
provincial governments
Vaccine doses by province
The Globe and Mail is tracking the number of available and administered vaccine doses by province and territory as well as the number of administered doses per 100 people.
As of Jan. 20.
Prov.
Doses administered
Doses available
100 people
Ont.
237.9 of 277.1
1.6
Que.
174.3 of 237.1
2.0
B.C.
98.1 of 133.5
1.9
Alta.
95.2 of 101.3
2.2
27.2 of 29.3
2.3
Sask.
Man.
22.4 of 46.3
1.6
N.B.
10.4 of 17.8
1.3
N.S.
9.2 of 23
0.9
8.5 of 13.6
Nfld.
1.6
PEI
5.9 of 8.3
3.7
Yukon
2.6 of 7.2
6.3
Nunavut
6.5
2.5 of 6
N.W.T.
1.9 of 7.2
4.2
the globe and mail, source: provincial governments
What is the status of the other vaccines Canada has purchased?
The next few weeks could prove pivotal for Canada’s vaccination plan. Along with data from AstraZeneca, first results are expected around the end of this month from a 60,000-person trial of the vaccine developed by Janssen Pharmaceuticals, owned by Johnson & Johnson. This vaccine has health officials hopeful because it is delivered in one shot rather than two — though a trial with two doses is now also underway.
Similarly, NovaVax Inc., the fifth company on Canada’s list has said it anticipates results in this quarter from a U.K.-based trial of its vaccine candidate involving 15,000 participants. NovaVax is now in the process of conducting an even larger vaccine trial in the United States but the company said that results from the earlier trial could potentially form the basis of a request for review — something the company has not yet initiated. When it announced its deal with Canada last summer, the company said it could begin supplying vaccine doses by the end of June and so far that time line has not changed.
Canada’s first homegrown vaccine to reach clinical trials, produced by Quebec’s Medicago Inc., is just beginning its Phase 3 study. In a best case scenario, the vaccine is not expected to be authorized and available until the fall. Meanwhile, a vaccine that Canada has purchased that was developed by international drug maker Sanofi did not perform well in elderly subjects in a Phase 2 trial and the company has delayed its Phase 3 trial. That vaccine is not expected to be administered in Canada this year.
How are those vaccines different from the two that Canada has already authorized?
All seven vaccines are based on the strategy of presenting the human immune system with copies of the coronavirus spike protein. The different vaccines do this in different ways. The two authorized vaccines implant genetic instructions in the form of messenger RNA (mRNA) inside a lipid coating, which penetrates into human cells and uses those cells to start making copies of the spike protein. The AstraZeneca and Johnson & Johnson vaccines carry DNA instead of RNA and that DNA is transported into cells using a modified virus, known as adenovirus. The adenovirus cannot replicate but the DNA it carries is taken up by cells and ultimately used to make spike protein. Importantly, since DNA is a more stable molecule than RNA, these vaccines can be shipped and stored more easily. The other three vaccines carry no genetic material at all but instead are made up of synthesized spike protein packaged to simulate a COVID-19 infection without introducing the actual coronavirus. While most of the vaccines involve some new technologies, the protein vaccines have a more established track record. The trade-off is that they have also taken longer to develop.
How much choice will I have in which vaccine I get?
The prospect of multiple vaccines with potentially different performance profiles presents health officials with an added layer of complexity. For example, interim results from the AstraZeneca vaccine showed an average efficacy of 70 per cent. That’s not as good as the 95 per cent achieved by the two mRNA vaccines.
Caroline Quach-Thanh, who chairs the National Advisory Committee on Immunization, said she and her colleagues are now considering how provinces can best decide which vaccines are used in which circumstances if more types of vaccines become available. While different vaccines may be recommended based on age and other health factors, experts consulted for this story said Canadians should not expect to shop from an array of vaccines.
With a report from Bill Curry
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Editor’s note: The graphic depicting vaccine contracts has been updated because the visual representation of doses purchased did not correspond with the numbers in a few cases. The numbers were correct.
Marieke Walsh
Ivan Semeniuk