Millions of dollars and hundreds of hours of researchers’ time have been invested in the hunt for a vaccine for the novel coronavirus.
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It’s paying off – experts say we could see the first vaccines approved by the end of 2020, but there’s still a lot of questions that need to be answered before you roll up your sleeve. These include how well it works, which shot we use, and who gets first crack at the new vaccine.
Where research stands
In late July, some manufacturers announced promising early results. A vaccine candidate developed by researchers at Oxford University in the U.K. appeared to cause an immune response with minimal side effects. A joint Canadian and Chinese project also announced that they were moving forward with further testing, after seeing some success.
According to the World Health Organization, there are currently 165 vaccine candidates being studied worldwide. Five of those are in Stage 3 clinical trials – typically the last stage, after which the vaccine could be approved if it shows positive results.
One of those, by the company Moderna, is now being tested in thousands of people across the U.S., in a trial that started Monday.
“I think it’s pretty exciting that a number of vaccines have moved on to this phase,” said Dr. Manish Sadarangani, an assistant professor at the University of British Columbia and director of the Vaccine Evaluation Centre at B.C. Children’s Hospital.
“I think it’s actually incredible to think that, given that normally vaccine development takes 10 to 15 years at least, that we’ve done several years’ worth of development in the space of a few months.”
Manufacturers were able to move so quickly in part because they’re building upon other vaccines, he said. “It’s not quite plug-and-play,” he said, but manufacturers were able to take existing vaccines and swap out a few pieces to try to match them to the SARS-CoV-2 virus rather than starting from scratch.
Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, told Congress Friday that he’s hoping for one or two successful vaccines by late fall or early winter.
While some experts have said it will take longer, others like Craig Jenne, an associate professor in microbiology, immunology and infectious diseases at the University of Calgary, believe it’s possible.
“I do believe that we will see one and maybe even two vaccines approved both by the FDA and by the European Regulatory Agency before the end of the calendar year,” he said.
“That doesn’t mean that January 1st we can get vaccinated.”
Safe and effective
Health Canada will want to review safety data itself and approve a vaccine on its own judgment, rather than just applying “a rubber stamp” to whatever the U.S. approves, Jenne said. This will take some time.
Sadarangani doesn’t believe there is any reason to be concerned about the speed of the research. “I think, to be honest, the follow up of participants in the trials has been very rigorous. These are people who are followed up very closely to look for side effects,” he said.
COVID-19 vaccines will still have to provide safety and efficacy data the same way as any other vaccine in order to be approved, he said. This includes monitoring for side effects even after it hits the market, as there might be very specific groups of people who experience side effects from the shot, which weren’t identified in trials.
The vaccine won’t necessarily be 100 per cent effective in preventing COVID-19 either.
“The WHO has set the bar at 50 per cent,” said Dr. Brian Ward, an infectious diseases professor at Montreal’s McGill University and medical director of Medicago, a Canadian vaccine manufacturer that is working on its own vaccine candidate.
“A vaccine that is 50 per cent effective will be considered a good enough vaccine to move forward.”
Even a partially effective vaccine would allow us to get back to something closer to pre-pandemic life, Ward said. There’s another advantage too: it’s likely that even if the shot doesn’t fully protect someone, it will still drastically cut down the chance of severe illness if they do catch the virus.
This happens with the flu shot, he said, where your symptoms are likely reduced, even if it doesn’t always keep you from catching the flu. “If we can reduce SARS coronavirus to being like the other human coronaviruses where it’s like a cold, that would also be certainly good enough.”
Getting the shot
Even after a shot is approved, it could still take a while before it’s generally available, experts say.
First of all, there are likely to be several vaccine formulations that get approved, said Jenne, who also holds a Canada Research Chair.
“As an immunologist, I very much hope that we get more than one answer,” he said.
Having several different vaccines would be a good thing, he said, as some might be more suited to give to vulnerable populations like people with pre-existing conditions or the elderly. It’s also possible that an individual might be able to get even better immunity by taking several shots.
The other reason we need many different vaccines approved worldwide, or at least made worldwide, comes down to manufacturing capacity, Ward said.
“Almost all of the vaccines that are in clinical trials are testing two doses, and most of them are likely to need two doses based on animal data to date. So that means that if we’re going to vaccinate the world at 7.8 billion people, we’re going to need 15.6 billion doses of vaccine.”
Even the pharmaceutical giants are only talking about producing 500 million doses per year, meaning it would take years to vaccinate everyone unless there are many different vaccines being made, he said.
Some countries, such as the U.S., have already made deals with pharmaceutical companies to secure supplies of an eventual vaccine, leaving smaller countries like Canada further down the list.
“If you’re talking about trying to vaccinate huge numbers of people across the globe, then I think the timeline is going to be a bit longer,” Sadarangani said.
“I don’t think it’s going to be a one-off: suddenly there’s a vaccine and everyone’s going go and get it the next week.
“I think it’s going to be a sequential thing where there’s decisions that need to be made about how to prioritize the use of the vaccines, and who should get the vaccine first, who’s at the highest risk of getting severe disease. And then who gets it in subsequent production batches.”
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The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
