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A vial of AstraZeneca's COVID-19 vaccine, in Gragnague, France, on Feb. 26, 2021.FRED SCHEIBER/AFP/Getty Images

Canada hit a new daily record and passed a new milestone for vaccinations this week but will need to up its game to get a single dose to every eligible person by Canada Day.

It’s doable on paper but potential barriers loom. Export controls in Europe and India and the risk of production issues for brand-new vaccines are among them, along with ongoing fears that anxious Canadians will reject the troubled Oxford-AstraZeneca vaccine.

The number of people vaccinated with at least one dose topped five million as of Thursday morning, leaving about 27 million people over 16 still needing a first dose. About 1.4 million doses are needed to add kids between 12 and 15, who should soon be eligible to get the Pfizer-BioNTech vaccine after a successful trial concluded this week.

Current projections are that Canada will receive between 32 and 36 million doses of Pfizer, Moderna and the Oxford-AstraZeneca vaccine before June 30.

Provinces and territories injected nearly 220,000 doses of vaccine Wednesday, besting their previous record of 217,000 set five days earlier. They averaged more than 185,000 doses a day over the past seven days, the highest seven-day average to date.

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.

They will need to average somewhere between 310,000 and 330,000 doses a day to get one dose to all Canadians 12 years of age and older over the next three months.

Howard Njoo, deputy chief public-health officer, said almost three in four Canadians over the age of 80 have now received at least one dose, and so have nearly one-third of people between 70 and 79 years old.

“What we are seeing in terms of vaccine rollout is encouraging,” Dr. Njoo said.

But the risks of problems continue. The delivery of 590,000 doses of Moderna vaccine was delayed almost a week after a backlog in quality-assurance checks in Europe. Those doses were supposed to arrive March 27, but didn’t leave Europe by plane until Thursday.

Major-General Dany Fortin, the military commander co-ordinating the vaccine rollout for the Public Health Agency of Canada, said provinces should start getting them on Saturday.

Europe’s increased export controls haven’t yet prevented shipments to Canada but approvals are needed by the European Commission every week for the shipments to continue. That includes 17.8 million Pfizer doses and 12.3 million Moderna doses expected in the next three months.

Joelle Paquette, director-general in charge of vaccines at Public Services and Procurement Canada, said Thursday that India’s ban on exports from the Serum Institute of India will delay Canada’s April shipment of the AstraZeneca vaccine from there. Canada is expecting one million doses in April and 500,000 in May. Ms. Paquette said the doses will come eventually but she couldn’t put a date on it now.

She said she didn’t expect an impact from a problem with Johnson & Johnson’s manufacturing that forced the company to toss 15 million doses this week after a mix-up at a Maryland production facility.

Ms. Paquette said Canada doesn’t know yet where its J&J doses are being made yet but said the U.S. issue won’t affect Canada.

Maj.-Gen. Fortin said the first 300,000 doses from the international vaccine-sharing program known as COVAX are expected next week, and Canada is supposed to get another 1.6 million of those by the end of June.

The COVAX doses are AstraZeneca vaccine made in South Korea, and will be in addition to the 1.5 million AstraZeneca doses provinces started receiving Thursday from the United States.

Health Canada authorized the manufacturing facilities for those doses Wednesday, clearing the way for them to be distributed.

It remains to be seen how many Canadians will be eager to get them after the roller coaster of confusion surrounding that vaccine. That includes this week’s decision by every province to stop using it on people under the age of 55 while Health Canada waits for more data on the risk of blood clots.

Provinces have already doled out more than 85 per cent of the first 500,000 Serum Institute doses of AstraZeneca shipped in March, and Maj.-Gen. Fortin said he believed all the doses that expire Friday have been used.

Some provinces reported issues with cancellations for vaccine appointments following the AstraZeneca pause, but there are also signs that giving them out won’t be that hard.

Long lineups formed outside pharmacies in the Vancouver area Wednesday when AstraZeneca injections began there for people 55 to 65 years old.

Ontario is ramping up its AstraZeneca rollout this weekend, doubling the number of pharmacies that will get it, and expanding the age to 55 to 64 years old from 60 to 64.

One positive report Thursday is that provinces have had no trouble getting six doses out of every vial of Pfizer instead of five. Health Canada adjusted the number of doses per vial at Pfizer’s request in February, but getting the extra doses requires the use of a special syringe that lets less vaccine go to waste.

Maj.-Gen. Fortin said provinces have been sent 15 million of those syringes so far, and report being able to get the sixth dose out more than 98 per cent of the time.

Prime Minister Justin Trudeau says Pfizer is increasing its vaccine delivery schedule, adding five million doses to June shipments for a total of 9.6 million doses that month. This is in addition to expected shipments of two other vaccines.

The Canadian Press

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