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Why Canada's vaccine rollout is slower than other countries — and what can be done to fix it – CBC.ca

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Canada is falling behind in its initial rollout of COVID-19 vaccines at a critical time in the pandemic, and experts say our most vulnerable populations are being left at risk.

Despite having months to prepare for the deployment of the initial shipment of vaccines to those most threatened by COVID-19 in long-term care facilities, a consistent rollout plan has yet to fully materialize on the ground.

“It just seems to be chaos right now,” said Alyson Kelvin, an assistant professor at Dalhousie University and a virologist at the Canadian Centre for Vaccinology evaluating Canadian vaccines with the VIDO-InterVac lab in Saskatoon. 

“We know who is a vulnerable population, so we need a strategy of actually vaccinating them.”

Long-term care residents were largely left out of Canada’s initial rollout of the Pfizer-BioNTech vaccine, which requires storage temperatures of –80 to –60 C, in favour of waiting for the more easily transportable Moderna vaccine and vaccinating health-care workers first.

But once thawed, the Pfizer-BioNTech vaccine can be used for up to five days at basic refrigeration temperatures — meaning it could be taken out of distribution hubs across the country and brought into long-term care facilities directly during that window of time. 

A registered pharmacy technician prepares COVID-19 vaccines in Toronto on Dec. 15. (Evan Mitsui/CBC)

“We treated the Pfizer vaccine with as much care and respect as possible and that really created all these hub sites,” said Dr. Zain Chagla, an infectious diseases physician at St. Joseph’s Healthcare Hamilton and an associate professor at McMaster University. “And I think that did hinder some of the innovation and the ability to do things elsewhere.”

Fragmented rollout across Canada a ‘failure’

The federal government has deployed almost 500,000 doses of both the Pfizer-BioNTech and Moderna vaccines to distribution sites across the country since mid-December, but the actual rollout of vaccinations is up to the individual provinces and territories. 

Quebec took the bold step of actually putting its vaccine distribution centres inside long-term care facilities, making it easier to inoculate residents as quickly as possible.  

While British Columbia made the decision to move the Pfizer-BioNTech vaccine from its distribution sites almost immediately into long-term care homes to inoculate residents and staff upon receiving its first doses.

Andy Yoon, 77, of Abbotsford, B.C., became the first long-term care resident in the Fraser Health region to receive the COVID-19 vaccine on Dec. 24. (Submitted by Fraser Health)

Yet Ontario decided against bringing the Pfizer-BioNTech vaccine directly into long-term care homes initially, despite other provinces doing so, and is only now doing so more than three weeks after receiving its first shipment. 

Dr. Vera Etches, Ottawa’s medical officer of health, announced Tuesday the city would be transporting the Pfizer-BioNTech vaccine out of its distribution hub at the Ottawa Hospital and directly into long-term care residences, after vaccine-handling criteria from Pfizer were changed.

Despite receiving 53,000 doses of the Moderna vaccine last week, which is much easier to bring into long-term care residences, only 3,000 doses have actually been administered in Ontario as of Tuesday.

Ontario has pledged to vaccinate all residents, health-care workers and essential caregivers at long-term care homes in the hardest hit regions of Toronto, Peel, York and Windsor-Essex by Jan. 21, but has not set a deadline for the rest of the province. 

To date, fewer than 1,000 long-term care residents have been vaccinated in Ontario.

“The provincial health-care systems aren’t experts in newly emerging viruses, brand new speedy vaccine platforms and pandemics,” said Kelvin. For that reason, ongoing communication from the federal government to the provinces and territories and local level is essential, she said.

“To leave each province and territory to have to come up with their own plan, when they’re not experts in this, I think is a failure.” 

Kelvin said putting experts with relevant backgrounds in long-term care at the helm of vaccine rollouts across the country could have mitigated some of the missteps made so far.

“We need somebody who’s knowledgeable about long-term care facilities in Canada and their current functioning states,” she said.

WATCH | Vaccination lessons from around the world: 

Canada’s COVID-19 vaccine rollout has gotten off to a sluggish start, but there could be lessons to learn from countries such as Israel, which has vaccination clinics operating around the clock. 3:11

Chagla said Ontario could have either proactively opened up more vaccine distribution centres, or used the five-day model of thawing the Pfizer-BioNTech vaccine and getting it directly into long-term care facilities in order to vaccinate those most at risk sooner.

‘Rules are made to be broken’

Dr. Allison McGeer, a medical microbiologist and infectious disease specialist at Toronto’s Mount Sinai Hospital who worked on the front lines of the SARS epidemic in 2003, says provinces need to be much more flexible in how they roll out the vaccines. 

“You want to do what got done in studies, because you know what the outcome of studies were,” she said, referring to the clinical trial data for both COVID-19 vaccines. 

“However, this is a pandemic and rules are made to be broken.” 

Quebec and Manitoba decided not to reserve second doses for those who had received their first shot in an effort to speed up their vaccination campaigns, while Ontario has asked Health Canada to “look into” the possibility of providing Moderna’s vaccine as a single dose.

Both the U.S. Food and Drug Administration and the Public Health Agency of Canada advise against administering only a single dose of the vaccine.

McGeer said Canada should be focused on the most effective way to use the vaccines it has in hand, as opposed to letting them sit in freezers, even if that doesn’t always line up entirely with the usage guidelines.

WATCH | Weighing the pros and cons of going ‘off label’:

In order to distribute more COVID-19 vaccines faster, some jurisdictions are looking at using different vaccine doses, vaccination schedules and possibly mixing and matching vaccines. Experts say these choices are about weighing the risks of going ‘off label’ and the potential rewards. 2:01

She said that includes being open to the possibility of administering more initial doses to people as quickly as possible and spacing the second doses differently over a longer period of time.

“While we have to be careful with messing with what we’re doing with vaccines, we also really want to be focused on the most protection for the largest amount of people in the shortest period of time,” she said.

“And that definitely means being open to half doses, spreading doses further apart, mixing vaccines.”

Chagla agrees there are ways to pick up the pace that could be considered, including prioritizing giving people their first dose without reserving their second. 

“But I don’t think we’re even at that point yet,” he said. “We just need to start getting the logistics up, and again, using the supply we have before we start reconsidering.”

The U.K. has come under fire for its decision to stretch the interval between doses to up to three months, as opposed to the recommended three to four weeks, and for opening the door to giving a person doses of two different vaccines.

Israel has made the decision to use up its initial supply of COVID-19 vaccines as quickly as possible in order to vaccinate as many people with the initial doses it has, with more than two million people set to get a shot by the end of the month. 

“We need to be open to the concept that the way [the vaccines] were studied is not necessarily the best way to use them in the middle of a pandemic,” said McGeer.

“In Ontario, it actually doesn’t matter, because we’re so far behind in delivering vaccine that we could give second doses to everybody that’s had a first dose and we wouldn’t make a dent in our vaccine supply.

“So it’s actually become irrelevant.” 

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Canada records over 6,800 new COVID-19 cases as officials announce vaccine delay – Global News

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Canada added over 6,800 new cases of the novel coronavirus Friday as federal officials revealed that vaccine shipments to the country would be delayed for four weeks over production issues.

In a press conference Friday, Procurement Minister Anita Anand said that only half of Pfizer-BioNTech’s promised COVID-19 vaccine doses would arrive in the next month.

Read more:
‘Temporary delay’ chops Canada’s deliveries of Pfizer vaccine in half for four weeks

The delay, which would impact production for a “short period” according to her, would be made up by the end of March and was due to the company scaling up its manufacturing capacity for European countries.

“This expansion work means that Pfizer is temporarily reducing deliveries to all countries receiving vaccine manufactured at its European facility — and that includes Canada,” said Anand, who reassured that the setback would not impact Canada’s long-term vaccination plan.

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10:45
How will I know it’s my turn to get the vaccine? Your COVID-19 questions answered


How will I know it’s my turn to get the vaccine? Your COVID-19 questions answered

Several provincial leaders including Saskatchewan Premier Scott Moe, B.C.’s Health Minister Adrian Dix and Ontario Premier Doug Ford have since raised concern over the delay, as a second shot of the Pfizer vaccine is expected to be administered within 21 days of the first for it to achieve maximum efficacy.

News of the delay also comes amid new federal COVID-19 modelling that showed the country was on track to surpass 10,000 new cases of the virus a day by February if Canadians kept maintaining the “current number of people we contact each day.”

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Chief public health officer Dr. Theresa Tam, who presented the modelling at a media conference, said that the rise in new infections was largely due to Canadians gathering during the holidays.

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According to her, current measures would have to be “further intensified” in order to curb the virus’ spread.

According to the modelling, virus cases could potentially surge past 30,000 a day if Canadians increased their current contacts each day by February.

“If we ease measures too soon the epidemic will resurge even more strongly,” said Tam.


Click to play video 'Coronavirus: Canada’s deliveries of Pfizer vaccine hit by ‘temporary delay,’ Anand says'



1:44
Coronavirus: Canada’s deliveries of Pfizer vaccine hit by ‘temporary delay,’ Anand says


Coronavirus: Canada’s deliveries of Pfizer vaccine hit by ‘temporary delay,’ Anand says

As of Friday evening, cases of COVID-19 in Canada floated at just under the 700,000 mark, though a total of 601,000 people have since recovered. Deaths linked to COVID-19 now stand at 17,729 after another 192 fatalities were reported.

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To date, more than 20,238,921 tests have been administered and at least 765,100 doses of the vaccine have been distributed across Canada.

Ontario reported the highest number of infections Friday with another 2,998 cases as well as 100 deaths, though 46 of those deaths were reported to have occurred earlier in the pandemic.

Read more:
Canada on track for 10K COVID-19 cases a day, measures must be ‘further intensified’: feds

Quebec added another 1,918 cases Friday as well as another 62 deaths. More than 8,900 deaths have now been recorded in the province, which is the hardest hit in Canada.

Health officials in B.C. announced another 500 lab-confirmed cases Friday as well, pushing the province’s official caseload to 59,583. Another 534 cases are considered “epi-linked,” which are cases that displayed symptoms and were in close contacts of confirmed cases but were never tested.

Nine of those epi-linked cases were included Friday’s count.

Another nine people were reported to have died from the virus there, with the province’s current death toll standing at 1,047.


Click to play video 'Coronavirus: Hajdu says Health Canada would need to approve change in Pfizer manufacturing site'



0:59
Coronavirus: Hajdu says Health Canada would need to approve change in Pfizer manufacturing site


Coronavirus: Hajdu says Health Canada would need to approve change in Pfizer manufacturing site

Alberta added another 785 cases Friday, pushing its total caseload to 115,370. The province’s death toll from the virus also stands at 1,402 after 21 more deaths were announced.

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Saskatchewan reported another 386 cases and four more deaths, while Manitoba recorded 191 infections and five more fatalities.

Several provinces in Atlantic Canada also reported new cases of the virus Friday.

New Brunswick added another 25 cases, Nova Scotia two more and Newfoundland and Labrador another infection. P.E.I. did not report any new cases Friday.

In Canada’s North, only the Northwest Territories reported one case of the virus.


Click to play video 'Coronavirus: Trudeau comments on strengthening COVID-19 travel measures'



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Coronavirus: Trudeau comments on strengthening COVID-19 travel measures


Coronavirus: Trudeau comments on strengthening COVID-19 travel measures

The country’s increase in cases also comes amid another grim milestone as over two million people worldwide were reported to have succumbed to the virus since the start of the pandemic, according to Johns Hopkins University.

To date, more than 93,751,000 people have been diagnosed with COVID-19, with the U.S., India and Brazil continuing to lead in both infections and deaths.

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With files from The Canadian Press and Global News’ Rachel Gilmore and Katie Dangerfield.

© 2021 Global News, a division of Corus Entertainment Inc.

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Canada's coming month of Pfizer COVID-19 vaccine shipments will be reduced by half – CTV News

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OTTAWA —
Over the next month Canada will be experiencing a “temporary” delay in Pfizer-BioNTech vaccine shipments due to the pharmaceutical giant’s expansion plans at its European manufacturing facility, with the shortage resulting in an average of 50 per cent of coming doses delayed each week.

While shipments will continue in the coming weeks, the amount of doses in them will be lessened, sometimes by hundreds of thousands of doses.

“Pfizer has confirmed that Canada’s deliveries will be impacted for the next four weeks. We will see an average reduction over this timeframe of 50 per cent of expected deliveries. There will minimal impact next week… The most profound impact will be in the week of January 25,” said Maj.-Gen. Dany Fortin, who is leading Canada’s logistical rollout. 

This setback to Canada’s short-term COVID-19 vaccine delivery schedule means the number of doses going to each province and territory will have to be readjusted. Fortin said that the allocations will begin to scale back up in the first two weeks of February, before returning to the size of doses originally anticipated. 

Canada was planning on receiving between 124,800 and 366,600 Pfizer doses every week between now and the end of February, as part of the plan to have six million doses total from Pfizer and Moderna by the end of March when Phase 1 ends.

The delivery for the week of Jan. 25, which Fortin said is likely to see the largest reduction, was set to be 208,650 doses. If that’s reduced by half, Canada will receive 104,325 Pfizer doses that week, which is fewer than the forecasted allocation received this week.

“In my conversation this morning with Pfizer, it was very clear that we’re are still correct in our planning assumption to receive approximately four million doses of Pfizer by March 31,” Fortin said,

Fortin said that knew the company would at some point need to scale-up their manufacturing to ramp-up its mass production, but the news of the looming construction project was brought to the federal government’s attention in the last 24 hours, according to Treasury Board President Jean-Yves Duclos.  

Procurement Minister Anita Anand announced the delay on Friday, saying all nations who are receiving vaccines from this Pfizer facility will be receiving fewer doses.

“It is a temporary reduction, it’s not a stoppage… We will make up those doses,” Anand said.

Addressing the setback during his Rideau Cottage address on Friday, Prime Minister Justin Trudeau said that shipments have largely been ahead of schedule so far, but that “with an undertaking this historic, it’s only to be expected that there will be a few bumps along the way.”

Norway, which is also receiving Pfizer doses from its Europe facilities has announced that “for some time ahead” their deliveries will be reduced. In the coming week their shipment will be reduced by approximately 18 per cent.

“The reduction is due to a reorganisation at Pfizer in connection with an upgrade of production capacity… It is not yet clear how long it will take before Pfizer is up to maximum production capacity again,” said the statement published by the Norwegian Institute of Public Health. 

The government sought to ensure that all countries who will be impacted, will be “equitably treated” in terms of delivery reductions, according to Anand. Fortin confirmed later Friday that this will be the case, with all seeing deliveries reduced by 50 per cent on average.

Anand said that while Canada is expecting to be able to catch up, the delay is “unfortunate.”

“However such delays and issues are to be expected when global supply chains are stretched well beyond their limits,” Anand said.

By end of the day Friday, the federal government will have distributed a total of 929,000 doses of the two approved COVID-19 vaccines, around 84 per cent of which have been administered.

WON’T IMPACT PHASE 2  

The plan is to receive “more than” one million doses of approved vaccines every week, on average, starting in April with Phase 2. 

Trudeau said that while this issue is out of Canada’s hands, the country “must still get ready for the ramp-up,” in Phase 2. 

Fortin said the delays “will not change our second quarter goals,” though he could not guarantee future delays. He said he understands and feels the “disappointment,” but “we need to move forward.”

He committed to keep all key stakeholders, and Canadians appraised of any future delivery schedule changes. 

The ongoing initial vaccination stage has seen Canada pushing to properly allocate and prioritize key groups like residents and staff in long-term care homes as well as front-line health-care workers. 

In this first stage of the vaccine campaign, Canada has seen both doses sitting in freezers as well as provinces saying they are running short, while those on the front line have sought to sort out who should and shouldn’t be receiving shots at this time.

“It was with precisely these types of issues in mind that Canada pursued the aggressive procurement strategy that we did,” Anand said. “This approach of ensuring diversity and volume months ago is what now gives us flexibility and margins to remain on track in difficult times.” 

Asked whether Canada will be looking to revisit their decision to not procure additional Moderna doses to make up the shortage over the next few weeks, Fortin said the amount scheduled to arrive from that company will stay the same.

As previously reported, the additional 16 million Moderna doses that the federal government left on the table in talks with that company would not be arriving until late 2021. 

As for whether Canada looked into being able to receive Pfizer shipments from the  United States facility, Fortin said that the federal government looked into it, but for now Canada’s line of doses will continue to come exclusively from the European facility.

Health Minister Patty Hajdu added that because as part of the regulatory approval granted to Pfizer, Health Canada approves the manufacturing sites as well as the vaccine itself.

“So, should we procure from even the same company a different site, then there would need to be review of the manufacturing data,” she said. 

Several federal officials sought to reassure Canadians Friday that the country remains on track to vaccinate everyone who wants to be, by the end of September.   

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Canada's coming month of Pfizer COVID-19 vaccine shipments will be reduced by half – CTV News

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 on


OTTAWA —
Over the next month Canada will be experiencing a “temporary” delay in Pfizer-BioNTech vaccine shipments due to the pharmaceutical giant’s expansion plans at its European manufacturing facility, with the shortage resulting in an average of 50 per cent of coming doses delayed each week.

While shipments will continue in the coming weeks, the amount of doses in them will be lessened, sometimes by hundreds of thousands of doses.

“Pfizer has confirmed that Canada’s deliveries will be impacted for the next four weeks. We will see an average reduction over this timeframe of 50 per cent of expected deliveries. There will minimal impact next week… The most profound impact will be in the week of January 25,” said Maj.-Gen. Dany Fortin, who is leading Canada’s logistical rollout. 

This setback to Canada’s short-term COVID-19 vaccine delivery schedule means the number of doses going to each province and territory will have to be readjusted. Fortin said that the allocations will begin to scale back up in the first two weeks of February, before returning to the size of doses originally anticipated. 

Canada was planning on receiving between 124,800 and 366,600 Pfizer doses every week between now and the end of February, as part of the plan to have six million doses total from Pfizer and Moderna by the end of March when Phase 1 ends.

The delivery for the week of Jan. 25, which Fortin said is likely to see the largest reduction, was set to be 208,650 doses. If that’s reduced by half, Canada will receive 104,325 Pfizer doses that week, which is fewer than the forecasted allocation received this week.

“In my conversation this morning with Pfizer, it was very clear that we’re are still correct in our planning assumption to receive approximately four million doses of Pfizer by March 31,” Fortin said,

Fortin said that knew the company would at some point need to scale-up their manufacturing to ramp-up its mass production, but the news of the looming construction project was brought to the federal government’s attention in the last 24 hours, according to Treasury Board President Jean-Yves Duclos.  

Procurement Minister Anita Anand announced the delay on Friday, saying all nations who are receiving vaccines from this Pfizer facility will be receiving fewer doses.

“It is a temporary reduction, it’s not a stoppage… We will make up those doses,” Anand said.

Addressing the setback during his Rideau Cottage address on Friday, Prime Minister Justin Trudeau said that shipments have largely been ahead of schedule so far, but that “with an undertaking this historic, it’s only to be expected that there will be a few bumps along the way.”

Norway, which is also receiving Pfizer doses from its Europe facilities has announced that “for some time ahead” their deliveries will be reduced. In the coming week their shipment will be reduced by approximately 18 per cent.

“The reduction is due to a reorganisation at Pfizer in connection with an upgrade of production capacity… It is not yet clear how long it will take before Pfizer is up to maximum production capacity again,” said the statement published by the Norwegian Institute of Public Health. 

The government sought to ensure that all countries who will be impacted, will be “equitably treated” in terms of delivery reductions, according to Anand. Fortin confirmed later Friday that this will be the case, with all seeing deliveries reduced by 50 per cent on average.

Anand said that while Canada is expecting to be able to catch up, the delay is “unfortunate.”

“However such delays and issues are to be expected when global supply chains are stretched well beyond their limits,” Anand said.

By end of the day Friday, the federal government will have distributed a total of 929,000 doses of the two approved COVID-19 vaccines, around 84 per cent of which have been administered.

WON’T IMPACT PHASE 2  

The plan is to receive “more than” one million doses of approved vaccines every week, on average, starting in April with Phase 2. 

Trudeau said that while this issue is out of Canada’s hands, the country “must still get ready for the ramp-up,” in Phase 2. 

Fortin said the delays “will not change our second quarter goals,” though he could not guarantee future delays. He said he understands and feels the “disappointment,” but “we need to move forward.”

He committed to keep all key stakeholders, and Canadians appraised of any future delivery schedule changes. 

The ongoing initial vaccination stage has seen Canada pushing to properly allocate and prioritize key groups like residents and staff in long-term care homes as well as front-line health-care workers. 

In this first stage of the vaccine campaign, Canada has seen both doses sitting in freezers as well as provinces saying they are running short, while those on the front line have sought to sort out who should and shouldn’t be receiving shots at this time.

“It was with precisely these types of issues in mind that Canada pursued the aggressive procurement strategy that we did,” Anand said. “This approach of ensuring diversity and volume months ago is what now gives us flexibility and margins to remain on track in difficult times.” 

Asked whether Canada will be looking to revisit their decision to not procure additional Moderna doses to make up the shortage over the next few weeks, Fortin said the amount scheduled to arrive from that company will stay the same.

As previously reported, the additional 16 million Moderna doses that the federal government left on the table in talks with that company would not be arriving until late 2021. 

As for whether Canada looked into being able to receive Pfizer shipments from the  United States facility, Fortin said that the federal government looked into it, but for now Canada’s line of doses will continue to come exclusively from the European facility.

Health Minister Patty Hajdu added that because as part of the regulatory approval granted to Pfizer, Health Canada approves the manufacturing sites as well as the vaccine itself.

“So, should we procure from even the same company a different site, then there would need to be review of the manufacturing data,” she said. 

Several federal officials sought to reassure Canadians Friday that the country remains on track to vaccinate everyone who wants to be, by the end of September.   

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