COVID-19 vaccination in Canada
COVID-19 vaccination in Canada is an ongoing, intergovernmental effort coordinated between the bodies responsible in the Government of Canada to acquire and distribute vaccines to individual provincial and territorial governments who in turn administer authorized COVID-19 vaccines during the COVID-19 pandemic in Canada. Provinces have worked with local municipal governments, hospital systems, family doctors and independently owned pharmacies to aid in part, or in full with vaccination rollout.[2] The vaccination effort in full is the largest such immunization effort in the nation's history. The vaccination effort began December 14, 2020, and is currently ongoing.[3]
Date
December 14, 2020 – present
Vaccins contre la COVID-19 (French)
32,663,177 people with at least one dose administered of Pfizer, Moderna, AstraZeneca, Johnson & Johnson or Novavax
31,392,262 fully vaccinated people
(to which the first and second doses of vaccine were administered)
19,250,351 people with a booster dose [1]
85.41% of the Canadian population has received at least one dose of a vaccine [1]
82.08% of the Canadian population is fully vaccinated
49.80% of the Canadian population has received at least one booster dose
Health Canada is responsible for approval and regulation of vaccines (and other pharmaceuticals), while the Public Health Agency of Canada (PHAC) is responsible for public health, emergency preparedness and response, and infectious and chronic disease control and prevention. Vaccines are authorized by Health Canada, purchased by the Government of Canada and distributed by PHAC to individual provinces and territories in tranches based on various factors such as population size and prioritized peoples. The National Advisory Committee on Immunization (NACI) has also issued recommendations on how vaccines should be distributed, in what intervals and to which populations. NACI has also been involved in recommendations on the use or disuse of vaccines to certain ages or populations.
The National Research Council Canada (NRC) has made investments in the domestic development of vaccine candidates, including candidates by the University of Saskatchewan and Variation Biotechnologies. In May 2020, the NRC announced a planned agreement to conduct clinical trials of a vaccine candidate by Chinese company CanSino Biologics, and plans to manufacture it at its facilities in Montreal once authorized. However, the deal collapsed due to strained Canada–China relations, and the federal government later announced commitments to purchase vaccines being produced by AstraZeneca, Moderna, Pfizer and Janssen.
In early 2021, both Pfizer–BioNTech and Moderna did not ship the agreed upon quantities of secured vaccines to Canada and other countries, due to manufacturing challenges.[4] This caused a vaccine shortage and significant slowdown in vaccine rollout. By mid-February 2021, significant increases in manufacturing and delivery of vaccines in conjunction with a recommendation by NACI to extend second dose administration to a maximum of 16 weeks resulted in a larger ramp-up in vaccine delivery across the nation and by July 2021, Canada's vaccine supply had grown to allow a return to shortened dose intervals.[5]
Following Health Canada's emergency authorization of the Pfizer–BioNTech vaccine on December 9, 2020, mass vaccination efforts began across the country on December 14, 2020. The agency later authorized the Moderna vaccine on December 23, 2020. On February 26, 2021, Health Canada authorized the Oxford–AstraZeneca vaccine for use. Following concerns of blood clotting events the Oxford-AstraZeneca vaccine was largely discontinued for use, and those who had already received a first dose were encouraged to receive an mRNA vaccine as their second dose.[6] The Janssen vaccine was authorized on March 5, 2021; however, Canada did not receive a delivery of the Janssen vaccine until April 28, 2021;[7] which was then destroyed due to contamination issues at its factory of origin.[8][9] Use of Janssen was put on hold until November 2021, when the government acquired doses for use with vaccine-hesitant populations.[10]
Canada became the first country to authorize a COVID-19 vaccine for people younger than 16 after approving Pfizer's vaccine for children aged 12 to 15 on May 5, 2021.[11] In August 2021, the Moderna vaccine was authorized for use in children aged 12 and up.[12] On September 16, 2021, Health Canada granted full approval to the Moderna and Pfizer vaccines and in November 2021, Health Canada approved the Pfizer-BioNTech and Moderna vaccines for use as booster (or third doses).[13][14] On November 19, 2021, Health Canada approved the Pfizer-BioNTech vaccine (with a lower dosage) for children aged five to eleven.[15] On February 17, 2022, Health Canada approved the Novavax vaccine, which is the first approved COVID-19 protein subunit vaccine.[16]
Background and timeline[edit]
Preparations[edit]
In March 2020, the federal government announced a CA$275 million investment for "coronavirus research and medical countermeasures"[17] and on April 23, 2020, over CA$1 billion in additional financial support was announced. This funding for "national medical research strategy to fight COVID-19" included "vaccine development, the production of treatments, and tracking of the virus."[17]
Nancy Harrison and Cédric Bisson are co-chairs of the Therapeutics Task Force (TTF), which is tasked with prioritizing "financial support for promising COVID-19 treatment projects."[18] The secretariat of the Therapeutics Task Force is housed at the Department of Innovation, Science and Industry (ISED). Joanne Langley and J. Mark Lievonen are the co-chairs of the Vaccine Task Force (VTF) advising the federal government on "vaccine development, related bio-manufacturing and international partnerships".[18] The secretariat of the VTF is supported by the National Research Council of Canada (NRC).[18] The NRC was tasked with identifying potential vaccine candidates, and helping to expedite clinical trials and approval of them in Canada.[19]
Failed CanSino agreement[edit]
The NRC signed agreements with several companies that had been developing vaccine candidates, including Variation Biotechnologies (which has a facility in Ottawa), and the University of Saskatchewan Vaccine and Infectious Disease Organization–International Vaccine Centre (VIDO–InterVac). Canada did not have facilities capable of producing COVID-19 vaccines at the outbreak of the pandemic;[20][Notes 1][21][Notes 2][Notes 3][22] the NRC earmarked $45 million to upgrade its laboratories in Montreal in anticipation of vaccine production.[23]
On May 6, 2020, the NRC reached an agreement with Chinese pharmaceutical company CanSino Biologics to conduct clinical trials for its COVID-19 vaccine candidate Ad5-nCoV at Dalhousie University in Nova Scotia.[24] The NRC cited its "strong collaborative history" with CanSino, and past work on adenovirus vaccines, as part of its decision.[19] CanSino's candidate was the first to enter phase II trials, and was considered by the VTF to be one of the top candidates.[23]
The NRC would have received "a non-exclusive right to use, produce, and reproduce the vaccine for emergency pandemic use", free-of-charge. The agreement was announced by Prime Minister Justin Trudeau on May 12 during a press briefing, and trials were expected to begin within the next two weeks.[24] The trials were formally approved on May 15; the NRC stated that it hoped to produce between 70,000 and 100,000 doses of the CanSino vaccine per-month.[23]
The CanSino agreement was impacted by Canada's strained relations with China; the shipments of vaccine doses were blocked by Chinese customs, and the State Council of the People's Republic of China refused to authorize the shipment.[24][19] In July 2020, after reports emerged over the delays, the NRC stated that CanSino "[remained] very committed to the Canadian clinical trials."[23]
Agreements with Moderna, Pfizer, and AstraZeneca[edit]
With the CanSino deal falling through, and the VTF revising its recommendations based on clinical trial data from other countries, Minister of Public Services and Procurement Anita Anand announced on August 5, 2020, that the federal government had committed to purchasing doses of the Moderna and Pfizer–BioNTech vaccines.[23][25] In anticipation of a COVID-19 vaccine, the Canadian government purchased more than 75 million hypodermic needles and syringes.[26]
After the NRC found that its current lab would not meet good manufacturing practices Prime Minister Trudeau announced on August 31 a federal investment of $126 million to "design, construct, commission and qualify a new biomanufacturing facility"—the Biologics Manufacturing Centre, which was projected to be completed by the end of July 2021.[27] It would be built next to the NRC's current Royalmount site in Montreal and have a production capacity of approximately 2 million does per-month".[27]
In September 2020, the federal government committed to purchasing 20 million doses of the Oxford–AstraZeneca vaccine. It also announced that it would make a $440 million investment in the COVAX initiative, to help fund the equitable procurement of COVID-19 vaccines worldwide.[28][29]
In November 2020, Conservative Party leader Erin O'Toole criticized the federal government for focusing too heavily on the CanSino agreement, arguing that he "would not have put all our eggs in the basket of China."[30]
On November 20, 2020, Pfizer and BioNTech submitted their vaccine for emergency authorization to Health Canada.[31]
Vaccination by province and territory[edit]
Vaccine rollout[edit]
In December 2020, NACI issued initial recommendations for a multi-stage rollout of vaccines that would prioritize specific populations, beginning with people 70 and older, healthcare workers, employees and residents of long-term care facilities, and Indigenous people. The rollout then progressed towards other vulnerable groups, including first responders, essential workers, and people with comorbidities, before opening up to the wider general public.