Back in 1976, as fear over a swine flu epidemic seized the United States, Canada suddenly found itself waiting on vaccines that wouldn’t arrive.
The United States, in an effort to inoculate itself, decided to vaccinate its entire population. Congress had, as recalled by a Globe and Mail writer in the winter of 1977, “appropriated all the available U.S vaccine for the American market.” And Canada’s leading manufacturers reportedly couldn’t produce enough vaccine for the country to follow suit.
Now, as the global race towards a COVID-19 vaccine charges on, some working in the vaccine field predict that history could repeat itself.
“This is going to happen all over the world,” Brian Ward, the medical officer for Quebec City-based vaccine manufacturer Medicago, said while discussing the late 1970s American clampdown on flu shots.
“Vaccines manufactured in Country X are going to stay in Country X until the population needs in that country are satisfied, and then sent elsewhere.”
READ MORE: Contracts prepared feds to distribute H1N1 vaccine; $450 million in similar deals don’t apply to COVID-19
Medicago itself is an illustration of the complexities at play. The company has two vaccine manufacturing facilities: one in Quebec that can make one to two million doses per month, and one in North Carolina that can make 10 to 12 million doses per month. While both facilities could feasibly produce enough vaccine to immunize all Canadians in a matter of months, Ward said, it wasn’t “immediately obvious” the U.S. would let the vaccines produced in N.C. cross the border into Canada — if their product was licensed in both countries.
The head of the VIDO-InterVac laboratory at the University of Saskatchewan, Volker Gerdts, recently pointed to insufficiencies in Canada’s domestic vaccine-making capacity.
“There are new research projects, where there are university-type discoveries trying to get forward. For those studies to get material that can go into clinical trials, one has to go to other countries, to get it manufactured in other countries,” Gerdts told iPolitics.
“Because Canada lost its manufacturing capacity.”
And similar worries were noted by physician Natasha Crowcroft — who serves as director of the University of Toronto’s Centre for Vaccine Preventable Diseases, and formerly worked as Public Health Ontario’s chief of infectious diseases.
“With the way vaccines are manufactured, we don’t make all our own vaccines in Canada. No country does. It’s going to be tricky. We saw that with the face masks,” Crowcroft said. In early April, tensions flared as a delivery of personal protective masks were reportedly held up by U.S. officials en route to Canada, during the global scramble for PPE. “We had agreed that Canada was buying them and they were supposed to be on their way here. The U.S. government was still saying no.”
Crowcroft believes federal officials are “very aware” of the risk of not getting enough COVID-19 vaccine. Canada’s pandemic influenza preparedness plan, in fact, specifically lays out that federal, provincial and territorial governments should develop strategies to mitigate the effects of “insufficient or delayed” vaccine supply — should that situation arise. But, Crowcroft said, it was tricky to know how federal officials should now prepare for the global demand. “We don’t know who’s going to be successful in making a vaccine that works, so who do you negotiate with right now?”
A great deal is still unclear about the future for COVID-19 vaccines — including which efforts will prove successful, which countries will be able to make vaccines, how many will be on the market, the number of doses needed to achieve immunity, and how long development will take. Earlier this week, Prime Minister Justin Trudeau urged world leaders to work together in the vaccine race during an EU-hosted pledging event — which the United States did not take part in, per CBC News.
Trudeau was quizzed by reporters on Monday about why the country wasn’t yet committing more funding towards the global effort, prompting the prime minister to pledge “more to come.” In March, the feds promised $192 million to ventures like Medicago and VIDO-InterVac and, last month, announced more funding still — including $23 million to accelerate vaccine development, $600 million for private sector-led clinical trials over two years, and $29 million for what was described as second-phase upgrades to the National Research Council of Canada’s Human Health Therapeutics facility in Montreal.
READ MORE: Trudeau pledges national medical research strategy and country-wide blood testing
VIDO-InterVac has been given $12 million by the feds for the second phase of a vaccine manufacturing facility build. Medicago has a new facility in the works too, which they aim to have operational by 2023. Even with that extra capacity, they don’t have the same muscle as pharmaceutical giants like U.S.-based Johnson & Johnson, which has committee to “rapidly produce and supply” more than a billion doses of an eventual immunization worldwide. Two other major players in the field, Sanofi and GlaxoSmithKline, announced in April that they had joined forces to develop their own COVID-19 vaccine.
Canada inked a contract with GlaxoSmithKline in 2011 to supply influenza vaccines, including in a pandemic scenario, along with a three-year contract signed in 2019 with Sequirus Canada Inc. as a backup supplier. Public Service and Procurement Canada says the GSK contract includes an option to extend the agreement for a year into 2022. They intend to do so, and say contract terms for a new deal are in the works.
But the feds confirmed that their existing contracts won’t apply to COVID-19 vaccines. As reported by iPolitics, the companies are only required to provide vaccines during influenza pandemics — a category that excludes the current coronavirus. Public Service and Procurement Canada declined to reveal the text of their current agreements with GSK and Sequirus, citing “commercial confidential information.”
A 2010 report by Ontario’s top medical officer revealed that their supply of vaccine for the H1N1 pandemic — which was smaller, in Canada and worldwide, than COVID-19 — was out of their hands in many ways.
“More than enough was ordered, but we were hardly the only jurisdiction doing the ordering,” the report says.
“There was simply a mismatch between supply and demand.”
For Canada to obtain enough COVID-19 vaccine for its population — once one or, more likely, several are available worldwide — Crowcroft urged federal officials to closely monitor the evolving science worldwide, and be “quick to react when you know there’s a good candidate.”
“Another strategy would be to say, ‘Okay, well let’s hope one of the Canadian vaccines work and we’ll put our money on that.’ It’s a bit of a gambling thing,” she floated.
Overall, Crowcroft believes the immunization challenge presented by COVID-19 is unprecedented.
“We’ve never had to vaccinate the whole world quite so quickly,” she said, while noting that other countries were likely facing far more uphill battles to get ahold of COVID-19 vaccines than Canada.
“I think one thing we’re finding with this pandemic is it’s just revealing layers of inequity in the world,” she observed. “We knew they were there, but it’s peeling them for everyone to see who is at risk: who gets access to care and who, eventually, is going to get access to vaccines.”
— With files from Kevin Dougherty and Charlie Pinkerton
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