COVID-19 vaccination in Canada is an ongoing, intergovernmental effort coordinated between the bodies responsible in the
Government of Canada
The government of Canada (french: gouvernement du Canada) is the body responsible for the federal administration of Canada. A constitutional monarchy, the Crown is the corporation sole, assuming distinct roles: the executive, as the ''Crown ...
to acquire and distribute vaccines to individual
provincial and territorial governments who in turn administer authorized
COVID-19 vaccines
A COVID19 vaccine is a vaccine intended to provide acquired immunity against severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2), the virus that causes coronavirus disease 2019 (COVID19).
Prior to the COVID19 pandemic, an est ...
during the
COVID-19 pandemic in Canada
The COVID-19 pandemic in Canada is part of the ongoing worldwide pandemic of coronavirus disease 2019 (). It is caused by severe acute respiratory syndrome coronavirus 2 (). Most cases over the course of the pandemic have been in Ontario, Que ...
. Provinces have worked with
local municipal governments, hospital systems,
family doctors and independently owned
pharmacies
Pharmacy is the science and practice of discovering, producing, preparing, dispensing, reviewing and monitoring medications, aiming to ensure the safe, effective, and affordable use of medicines. It is a miscellaneous science as it links heal ...
to aid in part, or in full with vaccination rollout.
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.
Health Canada
Health Canada (HC; french: Santé Canada, SC)Health Canada is the applied title under the Federal Identity Program; the legal title is Department of Health (). is the Structure of the Canadian federal government#Departments, with subsidiary unit ...
is responsible for approval and regulation of vaccines (and other pharmaceuticals), while the
Public Health Agency of Canada
The Public Health Agency of Canada (PHAC; french: Agence de la santé publique du Canada, ASPC) is an agency of the Government of Canada that is responsible for public health, emergency preparedness and response, and infectious and chronic diseas ...
(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
The National Advisory Committee on Immunization (NACI; french: Comité consultatif national de l'immunisation; french: CCNI, label=none) is an advisory body that provides the Government of Canada with medical and scientific advice relating to h ...
(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
The National Research Council Canada (NRC; french: Conseil national de recherches Canada) is the primary national agency of the Government of Canada dedicated to science and technology research & development. It is the largest federal research ...
(NRC) has made investments in the domestic development of vaccine candidates, including candidates by the
University of Saskatchewan
A university () is an institution of higher (or tertiary) education and research which awards academic degrees in several academic disciplines. Universities typically offer both undergraduate and postgraduate programs. In the United States, t ...
and
Variation Biotechnologies
Variation Biotechnologies Inc. (VBI), also known as VBI Vaccines Inc., is a biopharmaceutical company, headquartered in Cambridge, Massachusetts, with research facilities in Ottawa, Ontario, Canada, and a research and manufacturing site in Rehovot ...
. In May 2020, the NRC announced a planned agreement to conduct clinical trials of a vaccine candidate by Chinese company
CanSino Biologics
CanSino Biologics (), often abbreviated as CanSinoBIO, is a Chinese vaccine company.
History
CanSino Biologics was founded in 2009 in Tianjin by Yu Xuefeng, Zhu Tao, Qiu Dongxu and Helen Mao Huihua.
In July 2018, it filed an application to l ...
, and plans to manufacture it at its facilities in Montreal once authorized. However, the deal collapsed due to strained
Canada–China relations
Canada–China relations, or Sino-Canadian relations, officially date back to 1942, when Canada sent an ambassador to China. Before then, Canada had been represented by the British ambassador. The Communist victory (1949) in the Chinese Civil W ...
, and the federal government later announced commitments to purchase vaccines being produced by
AstraZeneca
AstraZeneca plc () is a British-Swedish multinational pharmaceutical and biotechnology company with its headquarters at the Cambridge Biomedical Campus in Cambridge, England. It has a portfolio of products for major diseases in areas includin ...
,
Moderna
Moderna, Inc. ( ) is an American pharmaceutical and biotechnology company based in Cambridge, Massachusetts that focuses on RNA therapeutics, primarily mRNA vaccines. These vaccines use a copy of a molecule called messenger RNA (mRNA) to produ ...
,
Pfizer
Pfizer Inc. ( ) is an American multinational pharmaceutical and biotechnology corporation headquartered on 42nd Street in Manhattan, New York City. The company was established in 1849 in New York by two German entrepreneurs, Charles 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.
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.
Following
Health Canada
Health Canada (HC; french: Santé Canada, SC)Health Canada is the applied title under the Federal Identity Program; the legal title is Department of Health (). is the Structure of the Canadian federal government#Departments, with subsidiary unit ...
'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
The Moderna COVID19 vaccine (INN: elasomeran), sold under the brand name Spikevax, is a COVID-19 vaccine developed by American company Moderna, the United States National Institute of Allergy and Infectious Diseases (NIAID), and the Biomedi ...
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. The
Janssen vaccine was authorized on March 5, 2021; however, Canada did not receive a delivery of the Janssen vaccine until April 28, 2021; which was then destroyed due to contamination issues at its factory of origin. Use of Janssen was put on hold until November 2021, when the government acquired doses for use with
vaccine-hesitant populations.
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.
In August 2021, the Moderna vaccine was authorized for use in children aged 12 and up. 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). On November 19, 2021, Health Canada approved the Pfizer-BioNTech vaccine (with a lower dosage) for children aged five to eleven.
On February 17, 2022, Health Canada approved the
Novavax vaccine, which is the first approved COVID-19 protein subunit vaccine.
Background and timeline
Preparations
In March 2020, the federal government announced a CA$275 million investment for "coronavirus research and medical countermeasures"
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."
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."
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".
The secretariat of the VTF is supported by the
National Research Council of Canada
The National Research Council Canada (NRC; french: Conseil national de recherches Canada) is the primary national agency of the Government of Canada dedicated to science and technology research & development. It is the largest federal research ...
(NRC).
The NRC was tasked with identifying potential vaccine candidates, and helping to expedite clinical trials and approval of them in Canada.
Failed CanSino agreement
The NRC signed agreements with several companies that had been developing vaccine candidates, including
Variation Biotechnologies
Variation Biotechnologies Inc. (VBI), also known as VBI Vaccines Inc., is a biopharmaceutical company, headquartered in Cambridge, Massachusetts, with research facilities in Ottawa, Ontario, Canada, and a research and manufacturing site in Rehovot ...
(which has a facility in Ottawa), and the
University of Saskatchewan
A university () is an institution of higher (or tertiary) education and research which awards academic degrees in several academic disciplines. Universities typically offer both undergraduate and postgraduate programs. In the United States, t ...
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;
[In an article in the ''Financial Post'' on January 14, 2021, responding to the delay in rolling out of Canada's vaccination program, ]GlaxoSmithKline
GSK plc, formerly GlaxoSmithKline plc, is a British multinational pharmaceutical and biotechnology company with global headquarters in London, England. Established in 2000 by a merger of Glaxo Wellcome and SmithKline Beecham. GSK is the ten ...
Canada's Paul Lucas—who served as CEO from 1995 to 2012—said that, fifty years ago, during the Liberal premiership of Pierre Trudeau
Joseph Philippe Pierre Yves Elliott Trudeau ( , ; October 18, 1919 – September 28, 2000), also referred to by his initials PET, was a Canadian lawyer and politician who served as the 15th prime minister of Canada
The prime mini ...
, there was little interest in chemical patent
A chemical patent, pharmaceutical patent or drug patent is a patent for an invention in the chemical or pharmaceuticals industry. Strictly speaking, in most jurisdictions, there are essentially no differences between the legal requirements to ob ...
s. Lucas said that this policy discouraged private investment in pharmaceutical innovations Pharmaceutical innovations are currently guided by a patent system, the patent system protects the innovator of medicines for a period of time. The patent system does not currently stimulate innovation or pricing that provides access to medicine for ...
in Canada and caused the Canadian pharmaceutical industry to become focused on generic drug
A generic drug is a pharmaceutical drug that contains the same chemical substance as a drug that was originally protected by chemical patents. Generic drugs are allowed for sale after the patents on the original drugs expire. Because the active ch ...
s.[Health policy professor emeritus Joel Lexchin said that the publicly-owned vaccine manufacturer ]Connaught Laboratories
The Connaught Medical Research Laboratories was a non-commercial public health entity established by Dr. John G. FitzGerald in 1914 in Toronto to produce the diphtheria antitoxin. Contemporaneously, the institution was likened to the Pasteur Inst ...
was privatized under the Conservative government of prime minister Brian Mulroney
Martin Brian Mulroney ( ; born March 20, 1939) is a Canadian lawyer, businessman, and politician who served as the 18th prime minister of Canada from 1984 to 1993.
Born in the eastern Quebec city of Baie-Comeau, Mulroney studied political sci ...
(1984-1993). Connaught was then part of Sanofi Pasteur
Sanofi Pasteur is the vaccines division of the French multinational pharmaceutical company Sanofi. Sanofi Pasteur is the largest company in the world devoted entirely to vaccines. It is one of four global producers of the yellow fever vaccine.
...
. GSK acquired the Quebec-based vaccine manufacturer IAF BioChem. Sanofi and GSK—corporations outside Canada controlled decision-making about production. Th
three biggest vaccine makers
—GlaxoSmithKline, Merck and Sanofi—lacked the new technologies essential for the production of newer forms of vaccine, that upstarts—such as Moderna and BioNTech—had mastered and by December it was evident that they were incapable of producing an effective COVID-19 vaccine.[According to Lexchin, newly-elected U.S. President Joe Biden reportedly continued the controversial America First policy of predecessor ]Donald Trump
Donald John Trump (born June 14, 1946) is an American politician, media personality, and businessman who served as the 45th president of the United States from 2017 to 2021.
Trump graduated from the Wharton School of the University of Pe ...
with respect to vaccine distribution. Canada was unable to obtain vaccine doses from the United States, even though the relevant American vaccine manufacturing facilities are relatively close to the Canada–United States border
The border between Canada and the United States is the longest international border in the world. The terrestrial boundary (including boundaries in the Great Lakes, Atlantic, and Pacific coasts) is long. The land border has two sections: Can ...
: Pfizer's facility in Kalamazoo, Michigan
Kalamazoo ( ) is a city in the southwest region of the U.S. state of Michigan. It is the county seat of Kalamazoo County. At the 2010 census, Kalamazoo had a population of 74,262. Kalamazoo is the major city of the Kalamazoo-Portage Metropolit ...
and Moderna's facility in Portsmouth, New Hampshire
Portsmouth is a city in Rockingham County, New Hampshire, United States. At the 2020 census it had a population of 21,956. A historic seaport and popular summer tourist destination on the Piscataqua River bordering the state of Maine, Portsmou ...
(actually a Lonza Group
Lonza Group is a Swiss multinational manufacturing company for the pharmaceutical, biotechnology and nutrition sectors, headquartered in Basel, with major facilities in Europe, North America and South Asia. Lonza was established under that name in ...
facility producing under contract). the NRC earmarked $45 million to upgrade its laboratories in Montreal in anticipation of vaccine production.
On May 6, 2020, the NRC reached an agreement with Chinese pharmaceutical company
CanSino Biologics
CanSino Biologics (), often abbreviated as CanSinoBIO, is a Chinese vaccine company.
History
CanSino Biologics was founded in 2009 in Tianjin by Yu Xuefeng, Zhu Tao, Qiu Dongxu and Helen Mao Huihua.
In July 2018, it filed an application to l ...
to conduct clinical trials for its COVID-19 vaccine candidate
Ad5-nCoV
AD5-nCOV, trade-named Convidecia, is a single-dose viral vector vaccine for COVID-19 developed by CanSino Biologics. It conducted its Phase III trials in Argentina, Chile, Mexico, Pakistan, Russia, and Saudi Arabia with 40,000 participants.
I ...
at
Dalhousie University
Dalhousie University (commonly known as Dal) is a large public research university in Nova Scotia
Nova Scotia ( ; ; ) is one of the thirteen provinces and territories of Canada. It is one of the three Maritime provinces and one of the fou ...
in Nova Scotia.
The NRC cited its "strong collaborative history" with CanSino, and past work on
adenovirus vaccine
An adenovirus vaccine is a vaccine against adenovirus infection.
It was used by the United States military from 1971 to 1999, but was discontinued when the only manufacturer stopped production. This vaccine elicited immunity to adenovirus seroty ...
s, as part of its decision.
CanSino's candidate was the first to enter phase II trials, and was considered by the VTF to be one of the top candidates.
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
Justin Pierre James Trudeau ( , ; born December 25, 1971) is a Canadian politician who is the 23rd and current prime minister of Canada. He has served as the prime minister of Canada since 2015 and as the leader of the Liberal Party since 2 ...
on May 12 during a press briefing, and trials were expected to begin within the next two weeks.
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.
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
The State Council, constitutionally synonymous with the Central People's Government since 1954 (particularly in relation to local governments), is the chief administrative authority of the People's Republic of China. It is chaired by the p ...
refused to authorize the shipment.
In July 2020, after reports emerged over the delays, the NRC stated that CanSino "
emainedvery committed to the Canadian clinical trials."
Agreements with Moderna, Pfizer, and AstraZeneca
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
The minister of public services and procurement (french: ministre des services publics et de l’approvisionnement) is the minister of the Crown in the Canadian Cabinet who is responsible for overseeing the Government of Canada's "common service ...
Anita Anand
Anita Anand (born May 20, 1967) is a Canadian lawyer and politician who serves as the minister of national defence since 2021. She has represented the riding of Oakville in the House of Commons since the 2019 federal election, sitting as ...
announced on August 5, 2020, that the federal government had committed to purchasing doses of the
Moderna
Moderna, Inc. ( ) is an American pharmaceutical and biotechnology company based in Cambridge, Massachusetts that focuses on RNA therapeutics, primarily mRNA vaccines. These vaccines use a copy of a molecule called messenger RNA (mRNA) to produ ...
and
Pfizer–BioNTech vaccines.
In anticipation of a COVID-19 vaccine, the Canadian government purchased more than 75 million
hypodermic needles
A hypodermic needle (from Greek ὑπο- (''hypo-'' = under), and δέρμα (''derma'' = skin)), one of a category of medical tools which enter the skin, called sharps, is a very thin, hollow tube with one sharp tip. It is commonly used w ...
and
syringes
A syringe is a simple reciprocating pump consisting of a plunger (though in modern syringes, it is actually a piston) that fits tightly within a cylindrical tube called a barrel. The plunger can be linearly pulled and pushed along the inside ...
.
After the NRC found that its current lab would not meet
good manufacturing practice
Current good manufacturing practices (cGMP) are those conforming to the guidelines recommended by relevant agencies. Those agencies control the authorization and licensing of the manufacture and sale of food and beverages, cosmetics, pharmaceutica ...
s 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.
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".
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
COVID-19 Vaccines Global Access, abbreviated as COVAX, is a worldwide initiative aimed at equitable access to COVID-19 vaccines directed by the GAVI vaccine alliance, the Coalition for Epidemic Preparedness Innovations (CEPI), and the World Hea ...
initiative, to help fund the equitable procurement of COVID-19 vaccines worldwide.
In November 2020,
Conservative Party
The Conservative Party is a name used by many political parties around the world. These political parties are generally right-wing though their exact ideologies can range from center-right to far-right.
Political parties called The Conservative P ...
leader
Erin O'Toole
Erin Michael O'Toole (born January 22, 1973) is a Canadian politician who has been the member of Parliament (MP) for Durham since 2012. A member of the Conservative Party, O'Toole served as the party's leader and the leader of the Official ...
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."
On November 20, 2020, Pfizer-BioNTech submitted it's vaccine for emergency authorization to Health Canada.
Initial approvals and rollout
![FEDEX-TOR (51254317358)](https://upload.wikimedia.org/wikipedia/commons/7/73/FEDEX-TOR_%2851254317358%29.jpg)
On December 9, 2020,
Health Canada
Health Canada (HC; french: Santé Canada, SC)Health Canada is the applied title under the Federal Identity Program; the legal title is Department of Health (). is the Structure of the Canadian federal government#Departments, with subsidiary unit ...
authorized emergency use of the Pfizer–BioNTech COVID-19 vaccine under the ''Interim Order Respecting the Importation, Sale and Advertising of Drugs for Use in Relation to COVID-19''. The
Public Health Agency of Canada
The Public Health Agency of Canada (PHAC; french: Agence de la santé publique du Canada, ASPC) is an agency of the Government of Canada that is responsible for public health, emergency preparedness and response, and infectious and chronic diseas ...
supervises the rollout and administration of the vaccine. By mid-December 2020, Pfizer had agreements to supply 20million doses to Canada.
Healthcare institutions began administering the first 30,000 doses of the Pfizer–BioNTech COVID-19 vaccine in Canada on December 14. A total of 249,000 doses was expected to be delivered by the end of 2020.
Because of the
cold storage logistics, the initial doses were delivered to 14 distribution sites in the provinces, with none being sent to the
Canadian territories
Within the geographical areas of Canada, the ten provinces and three territories are sub-national administrative divisions under the jurisdiction of the Canadian Constitution. In the 1867 Canadian Confederation, three provinces of British North ...
since they could not properly store the vaccine. The 14 original distribution sites are located in
St. John's,
Halifax,
Charlottetown
Charlottetown is the capital and largest city of the Canadian province of Prince Edward Island, and the county seat of Queens County. Named after Queen Charlotte, Charlottetown was an unincorporated town until it was incorporated as a city in ...
,
Miramichi The name "Miramichi" was first applied to a region in the northeast of New Brunswick, Canada, and has since been applied to other places in Canada and the United States. Although other interpretations have been suggested, it is believed that "Mirami ...
,
Quebec City
Quebec City ( or ; french: Ville de Québec), officially Québec (), is the capital city of the Provinces and territories of Canada, Canadian province of Quebec. As of July 2021, the city had a population of 549,459, and the Communauté métrop ...
,
Montreal
Montreal ( ; officially Montréal, ) is the List of the largest municipalities in Canada by population, second-most populous city in Canada and List of towns in Quebec, most populous city in the Provinces and territories of Canada, Canadian ...
,
Ottawa
Ottawa (, ; Canadian French: ) is the capital city of Canada. It is located at the confluence of the Ottawa River and the Rideau River in the southern portion of the province of Ontario. Ottawa borders Gatineau, Quebec, and forms the core ...
,
Toronto
Toronto ( ; or ) is the capital city of the Canadian province of Ontario. With a recorded population of 2,794,356 in 2021, it is the most populous city in Canada and the fourth most populous city in North America. The city is the ancho ...
,
Winnipeg
Winnipeg () is the capital and largest city of the province of Manitoba in Canada. It is centred on the confluence of the Red and Assiniboine rivers, near the longitudinal centre of North America. , Winnipeg had a city population of 749,6 ...
,
Regina,
Edmonton
Edmonton ( ) is the capital city of the Canadian province of Alberta. Edmonton is situated on the North Saskatchewan River and is the centre of the Edmonton Metropolitan Region, which is surrounded by Alberta's central region. The city ancho ...
,
Calgary
Calgary ( ) is the largest city in the western Canadian province of Alberta and the largest metro area of the three Prairie Provinces. As of 2021, the city proper had a population of 1,306,784 and a metropolitan population of 1,481,806, makin ...
, and two in the
Greater Vancouver
Greater Vancouver, also known as Metro Vancouver, is the metropolitan area with its major urban centre being the city of Vancouver, British Columbia, Canada. The term "Greater Vancouver" is roughly coterminous with the geographic area governed b ...
area. The Canadian government expects the vaccine to be administered to high-priority groups, designated by each province, until the end of March.
Most provinces were first prioritizing some subset of healthcare workers, except for Quebec, which is prioritizing residents of
long-term care homes, as well as British Columbia, New Brunswick, and Prince Edward Island, which are prioritizing both. Most provinces also have plans to expand priority status to additional groups—such as the elderly, or adults in Indigenous communities—before expanding to the general public.
In the same week as initial vaccinations for the Pfizer–BioNTech COVID-19 vaccine,
Health Canada
Health Canada (HC; french: Santé Canada, SC)Health Canada is the applied title under the Federal Identity Program; the legal title is Department of Health (). is the Structure of the Canadian federal government#Departments, with subsidiary unit ...
authorized the
Moderna vaccine
The Moderna COVID19 vaccine (INN: elasomeran), sold under the brand name Spikevax, is a COVID-19 vaccine developed by American company Moderna, the United States National Institute of Allergy and Infectious Diseases (NIAID), and the Biomedi ...
on December 23, and it was announced that Canada would receive 168,000 doses of the Moderna vaccine before the end of 2020.
Unlike the Pfizer–BioNTech vaccine, the Moderna vaccine does not require extreme cold temperature storage
which meant that as of December 28,
Northwest Territories
The Northwest Territories (abbreviated ''NT'' or ''NWT''; french: Territoires du Nord-Ouest, formerly ''North-Western Territory'' and ''North-West Territories'' and namely shortened as ''Northwest Territory'') is a federal territory of Canada. ...
and
Yukon
Yukon (; ; formerly called Yukon Territory and also referred to as the Yukon) is the smallest and westernmost of Canada's three territories. It also is the second-least populated province or territory in Canada, with a population of 43,964 as ...
had received their first shipments of 7,200 each of the Moderna vaccine. Vaccinations in each territory are not scheduled to occur until mid-January.
On February 2, 2021, Trudeau announced a deal with
Novavax
Novavax, Inc. is an American biotechnology company based in Gaithersburg, Maryland that develops vaccines to counter serious infectious diseases. Prior to 2020, company scientists developed experimental vaccines for influenza and respiratory sy ...
to produce COVID-19 vaccines at the Biologics Manufacturing Centre, making it the first to be produced domestically.
At that time, the
Novavax COVID-19 vaccine
The Novavax COVID-19 vaccine, sold under the brand names Nuvaxovid and Covovax, among others, is a subunit COVID-19 vaccine developed by Novavax and the Coalition for Epidemic Preparedness Innovations (CEPI). Full results from Nuvaxovid's pi ...
was awaiting approval by
Health Canada
Health Canada (HC; french: Santé Canada, SC)Health Canada is the applied title under the Federal Identity Program; the legal title is Department of Health (). is the Structure of the Canadian federal government#Departments, with subsidiary unit ...
. This is the first deal signed by Canada that allows a domestic manufacturing of a foreign vaccine. The contract with Novavax is for 52 million doses of the vaccine.
Following VTF and TTF recommendations, the federal government announced investment in two biomanufacturing companies—Vancouver-based Precision NanoSystems Incorporated (PNI) and Markham, Ontario-based Edesa Biotech Inc. (Edesa).
PNI, biotechnology company, will receive up to $25.1 million to build a "$50.2 million biomanufacturing centre to produce vaccines and therapeutics for the prevention and treatment of diseases such as infectious diseases, rare diseases, cancer and other areas of unmet need". Edesa will receive up to $14 million to Edesa Biotech to "advance work on a monoclonal antibody therapy for acute respiratory distress syndrome, which is the leading cause of COVID-19 deaths.
By February 2021, the NRC and the ISED support for domestically-produced vaccines and therapeutics for COVID-19 included $37 million in stage 1 funding for six vaccine candidates, and seven therapeutics candidates.
Manufacturing delays
![Vaccination Montréal Covid 19](https://upload.wikimedia.org/wikipedia/commons/9/94/Vaccination_Montr%C3%A9al_Covid_19.jpg)
In mid to late January, details emerged about manufacturing delays by both authorized vaccines made by Pfizer and Moderna affecting the country's vaccine rollout in late January through the month of February. On February 3, the European Commission approved delivery of COVID-19 vaccines to Canada, in spite of production constraints in Europe. Canada was one of many countries that applied for delivery and does not have its own manufacturing capacity.
By February 4, Major General Fortin said while that Pfizer explained its dramatically lower vaccine shipments—with a decrease of 80% in all Pfizer shipments—as caused by "plant upgrades at a facility in Belgium", Moderna has offered no explanation for similar delays.
By early 2021, the speed of Canada's deployment of COVID-19 vaccines had become the topic of widespread public discussion, along with the related question of why the vaccines were not being produced in Canada.
Fortin said that 180,000 Moderna doses had arrived in Canada on the morning of February 4 and Canada is "still expecting 2 million Moderna doses by the end of March.
On February 4, Fortin said that about 70,000 Pfizer-BioNTech doses will arrive in the next week.
On February 3,
COVAX
COVID-19 Vaccines Global Access, abbreviated as COVAX, is a worldwide initiative aimed at equitable access to COVID-19 vaccines directed by the GAVI vaccine alliance, the Coalition for Epidemic Preparedness Innovations (CEPI), and the World Hea ...
published the country-by-country vaccine distribution forecast to COVAX participants—Canada will receive 1,903,200 doses of the Oxford–AstraZeneca vaccine by the end of the first half of 2021.
On February 12, the minister of
Public Services and Procurement Canada
Public Services and Procurement Canada (PSPC; french: Services publics et Approvisionnement Canada)''Public Services and Procurement Canada'' is the applied title under the Federal Identity Program; the legal title is Department of Public Works ...
(PSPC) announced that Canada had "negotiated an accelerated delivery schedule for Pfizer-BioNTech’s COVID-19 vaccine."
By the end of September, Canada will receive the 40 million Pfizer-BioNTech doses.
Return to regular shipments
![Vaccin Moderna, boîte de 10 fioles (100 doses)](https://upload.wikimedia.org/wikipedia/commons/2/2c/Vaccin_Moderna%2C_bo%C3%AEte_de_10_fioles_%28100_doses%29.jpg)
Major General Fortin announced on February 18, that the period in which Canada experienced limited supplies, is now over and there will be an "abundance of supplies" in the spring and summer months. This will result in a "significant scaling-up of immunization plans in provinces."
Pfizer's new "locked in" delivery schedule includes 475,000 doses in February and 444,600 per week in March, according to the PHAC's vaccine distribution tracker.
A February 18, 2021 article in ''New York Times'' said that Canadians were concerned about the rollout of the vaccination program.
According to the same ''Times'' columnist, who had interviewed those involved in "vaccine development, epidemiology, infection control and medical supply chains", they all said it was not surprising that Canada's rollout was not happening as planned. While they could understand why Canadians were frustrated, they said, this is the "nature of new vaccines".
Approval of Oxford-AstraZeneca and Johnson & Johnson
On February 26, Health Canada authorized the
Oxford–AstraZeneca COVID-19 vaccine
The Oxford–AstraZeneca COVID19 vaccine, sold under the brand names Covishield and Vaxzevria among others, is a viral vector vaccine for prevention of COVID-19. Developed in the United Kingdom by Oxford University and British-Swedish comp ...
for use.
The agency authorized the use of two versions of the same vaccine, one to originate from the
United Kingdom
The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom (UK) or Britain, is a country in Europe, off the north-western coast of the continental mainland. It comprises England, Scotland, Wales and North ...
, and the other produced in
India
India, officially the Republic of India (Hindi: ), is a country in South Asia. It is the seventh-largest country by area, the second-most populous country, and the most populous democracy in the world. Bounded by the Indian Ocean on the so ...
by the
Serum Institute of India
Serum Institute of India (SII) is an Indian biotechnology and biopharmaceuticals company, based in Pune. It is the world's largest manufacturer of vaccines. It was founded by Cyrus Poonawalla in 1966 and is a part of Cyrus Poonawalla Group.
O ...
(trade name "Covishield").
The first shipment of 500,000 doses of Oxford-AstraZeneca arrived on March 3, 2021. The doses were marked with an April 2, 2021 expiry date, necessitating speedy administration.
The
Janssen COVID-19 vaccine
The Janssen COVID19 vaccine, sold under the brand name Jcovden, is a COVID19 vaccine that was developed by Janssen Vaccines in Leiden, Netherlands, and its Belgian parent company Janssen Pharmaceuticals, a subsidiary of American company Joh ...
was authorized on March 5, 2021, to become the fourth vaccine to receive Health Canada approval.
The vaccine was the first single-dose vaccine to be authorized in Canada.
Delivery times for the vaccine remain unknown.
After an agreement was reached with Pfizer to move up some deliveries, it was projected a total of 8 million vaccine doses (from three suppliers) will be available in Canada by the end of March 2021.
To maximize distribution of first doses, NACI issued a recommendation that second doses be administered up to four months after the first dose.
Minister Anand confirmed on March 26, 2021, that 1.5 million Oxford-AstraZeneca shots would arrive from the United States on March 30, 2021, and that 10 million shots of the Johnson & Johnson vaccine would arrive between April and September 2021.
Vaccination ramp-up and increase in deliveries
![Vaccine Hunters Canada Logo](https://upload.wikimedia.org/wikipedia/commons/d/dc/Vaccine_Hunters_Canada_Logo.png)
In mid-April 2021, the Government of Canada reached a deal with Pfizer to receive 8 million more vaccines on top of what was already ordered, with more than 2 million vaccines coming into the country per week beginning in the month of May. Moderna however continued to delay deliveries and slashed an order for the end of April from 1.2 million vaccines to 650,000.
Due to public frustration with variable vaccine booking systems across the country, a small volunteer group known as
Vaccine Hunters Canada
Vaccine Hunters Canada was a Canadian volunteer-run nonprofit organization with a mandate of "helping eligible Canadians find vaccines" during the COVID-19 pandemic in Canada. The group was involved in helping Canadians navigate various booking s ...
created a website,
Twitter
Twitter is an online social media and social networking service owned and operated by American company Twitter, Inc., on which users post and interact with 280-character-long messages known as "tweets". Registered users can post, like, and ...
and
Facebook
Facebook is an online social media and social networking service owned by American company Meta Platforms. Founded in 2004 by Mark Zuckerberg with fellow Harvard College students and roommates Eduardo Saverin, Andrew McCollum, Dustin M ...
page to help "eligible Canadians find vaccines." The group posts relevant information on appointments available, eligibility requirements and other tips to the public that might otherwise not be common knowledge. On April 28, 2021, the
City of Toronto
Toronto ( ; or ) is the capital city of the Provinces and territories of Canada, Canadian province of Ontario. With a recorded population of 2,794,356 in 2021, it is the List of the largest municipalities in Canada by population, most pop ...
officially partnered with the group to provide them end of day information in regards to vaccine availability and appointments that are currently unused, as well as information for pop-up vaccine clinics.
The first shipment of the Johnson & Johnson vaccine arrived in Canada on April 28, 2021. The country received 304,800 doses of the single-shot vaccine in its first shipment. However, Health Canada held the shipment for a safety review, citing production issues at the facilities of
Emergent BioSolutions
Emergent BioSolutions Inc. is an American multinational specialty biopharmaceutical company headquartered in Gaithersburg, Maryland. It develops vaccines and antibody therapeutics for infectious diseases and opioid overdoses, and it provides me ...
.
In May 2021, NACI stated a recommendation that mRNA-based vaccines were preferred over viral vector vaccines such as the AstraZeneca and Johnson & Johnson vaccines due to the rare risk of
post-vaccination embolic and thrombotic events
Post-vaccination embolic and thrombotic events, termed vaccine-induced immune thrombotic thrombocytopenia (VITT), vaccine-induced prothrombotic immune thrombocytopenia (VIPIT), thrombosis with thrombocytopenia syndrome (TTS), vaccine-induced imm ...
, with vice-chairman Shelly Deeks stating that "individuals need to have an informed choice to be vaccinated with the first vaccine that’s available, or to wait for an mRNA vaccine." NACI received criticism for the recommendation, with critics arguing that it contradicted the view that patients should receive the first vaccine they are offered, and that the statement was mixed messaging over the safety of the vaccines that could lead to increased
hesitancy.
On May 5, 2021, Canadian health officials authorized Pfizer's vaccine for adolescents 12 to 15 years old, becoming the first country in the world to do so.
On May 11 and 12, multiple provinces, including Alberta, Manitoba, Nova Scotia, Ontario, and Saskatchewan, announced that they would suspend their use of the AstraZeneca vaccine for first doses, citing supply shortages, with some provinces also citing the blood clot risk.
Deliveries from manufacturers continued to accelerate in mid-May. In the week of May 16, Canada was expected to receive a record 4.5 million doses of the two mRNA vaccines from Pfizer and Moderna.
In British Columbia, the
Vancouver Coastal Health
Vancouver Coastal Health (VCH) is a regional health authority that provides health services including primary, secondary, tertiary and quaternary care, home and community care, mental health services, population and preventive health and addictio ...
authority apologized on May 31 after accidentally administering the Moderna vaccine to 12 adolescents who were to receive the Pfizer vaccine per the approval.
50% vaccination milestone and second doses
![COVID19VaccineBookingOntario2](https://upload.wikimedia.org/wikipedia/commons/d/d4/COVID19VaccineBookingOntario2.jpg)
By May 22, 2021, at least half of the overall population had received at least one vaccine dose, with Canada having administered 20.328 million vaccine doses overall. The country has passed other large countries in coverage like the
U.S. vaccination program.
As new arrivals of the Oxford-AstraZeneca vaccine came into the country in late May, provinces chose whether to administer second doses, for example as Ontario is going forward with, or providing people who took a first dose to choose a different second vaccine, as in British Columbia.
The country's percentage of single doses had been disproportionately high in comparison to second doses, due to NACI's earlier recommendations for intervals of up to four months. This led to calls from medical experts for provinces to prioritize second doses, citing the possibility having only one dose would make populations vulnerable to
SARS-CoV-2 variants
There are many variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19). Some are believed, or have been stated, to be of particular importance due to their potenti ...
. By late-May, amid an increased supply, several provinces had begun to shorten their intervals for second doses. NACI followed suit on May 28, issuing new guidance that second doses should be administered "as soon as possible", especially to high-risk individuals.
For the week following the
Victoria Day
Victoria Day (french: Fête de la Reine, lit=Celebration of the Queen) is a federal Canadian public holiday celebrated on the last Monday preceding May 25. Initially in honour of Queen Victoria's birthday, it has since been celebrated as the offi ...
weekend, Canada expected a smaller vaccine shipment than normal, as Pfizer–BioNTech sent more vaccine the previous week.
The government had previously indicated that Canada would have 55 million doses delivered by the end of July 2021, but this mostly included Pfizer distributions. Moderna had now committed to delivering 11 million doses in July 2021, with 5 million of those doses potentially arriving in June. Combined with an expected 9 million Pfizer doses to be delivered, this would be enough to give Canada 68 million doses by the end of July.
Vaccine mandates and full approval
On August 13, 2021, Minister of Intergovernmental Affairs
Dominic LeBlanc
Dominic A. LeBlanc (born December 14, 1967) is a Canadian lawyer and politician who has served as the minister of intergovernmental affairs since 2020 and also became the minister of infrastructure and communities in 2021. A member of the Liber ...
and Transport Minister
Omar Alghabra
Omar Alghabra ( ar, عمر الغبرا, ʿUmar al-Ḡabrā; born October 24, 1969) is a Saudi-born Syrian-Canadian politician who has served as Canada's Minister of Transport since January 2021. A member of the Liberal Party, he has represented ...
announced that the federal government plans to mandate the vaccination of all federal public servants, employees in federally-regulated transport industries, and passengers of commercial air travel, interprovincial rail service, and large marine vessels with overnight accommodations (e.g. cruise ships). The government will also "expect" the vaccination of all employees in industries regulated by the ''
Canada Labour Code
The ''Canada Labour Code'' (french: Code canadien du travail) (the Code) is an Act of the Parliament of Canada to consolidate certain statutes respecting labour. The objective of the Code is to facilitate production by controlling strikes & l ...
''. At the time of the announcement, the Government of Canada estimated that there are approximately 19,000 employers and 1,235,000 employees (8% of all workers in Canada) subject to the vaccine mandate.
Soon after the announcement by the Government of Canada, some provinces began mandating vaccination for their public servants, starting with the Ontario government, who announced on August 17 that public health services and school boards will be required to have a "vaccination policy" in place that would require an employee to either be fully vaccinated or undergo regular testing. The same day, the Quebec government announced that healthcare workers in both the public and private sector must be fully vaccinated by October 1, 2021. New Brunswick was the next province to follow, mandating vaccination or regular testing for provincial public servants.
On August 27, 2021, the Moderna vaccine was authorized for emergency use in children aged 12 and up.
On September 16, 2021, with the expiration of the aforementioned ''Interim Order'', Health Canada officially granted full approval to the Moderna and Pfizer vaccines for individuals aged 12 and older.
Approval for younger children and boosters
On October 18, 2021, Pfizer-BioNTech submitted the vaccine for approval to Health Canada for children aged five to eleven. The submission called for smaller doses of the same vaccine used for adults. A few days later, Canada ordered 2.9 million child-dose Pfizer vaccines.
In late October, NACI recommended the use of booster shots (third doses) of vaccines for certain immunocompromised peoples, people over the age of 70, people who had received a full series of the Oxford-AstraZeneca vaccine or Janssen vaccine and those in healthcare following 6 months of full vaccination. Many provinces then followed suit.
On November 19, Health Canada approved the Pfizer-BioNTech vaccine for children aged five to eleven. Health Canada recommended children receive the smaller doses, with an interval of at least 8 weeks between vaccinations.
Doses began to arrive several days later.
Amid the discovery of the
Omicron variant
Omicron (B.1.1.529) is a variant of SARS-CoV-2 first reported to the World Health Organization (WHO) by the Network for Genomics Surveillance in South Africa on 24 November 2021. It was first detected in Botswana and has spread to become the ...
, NACI will review information on recommendations for booster shots for most adults. Prime Minister Trudeau said that if boosters were offered to all, Canada would have ample supply. Some provinces have begun offering boosters to those outside of NACI recommendations in advance.
On January 28, 2022,
truckers from across Canada drove to Ottawa to protest against mandatory vaccination for truckers crossing the border from the U.S. to Canada.
On April 5, 2022, NACI began recommending that fourth doses be given to vulnerable populations, namely seniors living in long-term care homes and people aged 80 and up.
On July 14, 2022, Health Canada approved the Moderna vaccine for children aged between six months and five years, rendering an additional 1.7 million people eligible for vaccination. Children in this age group will receive approximately a quarter of the dose given to adults.
On September 1, 2022, Moderna's new bivalent vaccine, which targets both the original strain of COVID-19 and the
Omicron BA.1 variant, received authorization from Health Canada. A week later, the first shipments arrived in Quebec, followed by Ontario and other provinces shortly after. The bivalent vaccine is not currently set to replace the original Moderna vaccine, but will instead coexist with it, with the federal government maintaining stocks of both.
On October 7, 2022, Pfizer's new bivalent vaccine, which targets the original strain of COVID-19 as well as the Omicron BA.4 and BA.5 subvariants, was approved by Health Canada for individuals aged 12 years and up. According to Health Canada, 97% of COVID-19 cases in Canada were either of the BA.4 or BA.5 subvariant as of mid-September 2022. As such, NACI issued a recommendation for people to use one of the approved bivalent vaccines as their upcoming booster shot. The Pfizer bivalent vaccine was later approved for children aged 5 to 11 years old on December 9.
Vaccination by province and territory
Vaccine rollout
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
In medicine, comorbidity - from Latin morbus ("sickness"), co ("together"), -ity (as if - several sicknesses together) - is the presence of one or more additional conditions often co-occurring (that is, concomitant or concurrent) with a primary c ...
, before opening up to the wider general public.
Additionally, 198,370 Moderna, 5,850 Pfizer-BioNTech and 460 Oxford-AstraZeneca vaccine doses have been kept for "Federal Application" for use with the
Public Health Agency of Canada
The Public Health Agency of Canada (PHAC; french: Agence de la santé publique du Canada, ASPC) is an agency of the Government of Canada that is responsible for public health, emergency preparedness and response, and infectious and chronic diseas ...
(PHAC),
Canadian Armed Forces
}
The Canadian Armed Forces (CAF; french: Forces armées canadiennes, ''FAC'') are the unified military forces of Canada, including sea, land, and air elements referred to as the Royal Canadian Navy, Canadian Army, and Royal Canadian Air Force.
...
and the
Correctional Service of Canada
The Correctional Service of Canada (CSC; french: Service correctionnel du Canada), also known as Correctional Service Canada or Corrections Canada, is the Canadian federal government agency responsible for the incarceration and rehabilitation of ...
.
Vaccine mandates, policies and measures
![Canada provinces and territories with COVID-19 Vaccine Passports](https://upload.wikimedia.org/wikipedia/commons/2/26/Canada_provinces_and_territories_with_COVID-19_Vaccine_Passports.svg)
On a federal scale, the Government of Canada mandated all federal workers be vaccinated by October 29, 2021, or face termination.
Travellers over the age of 12 on all federally regulated modes of transportation (such as domestic and international flights departing from most airports in Canada, those riding on
Via Rail
Via Rail Canada Inc. (), operating as Via Rail or Via, is a Canadian Crown corporation that is mandated to operate intercity passenger rail service in Canada. It receives an annual subsidy from Transport Canada to offset the cost of operating ...
and
Rocky Mountaineer
Rocky Mountaineer is a Canadian rail-tour company based in Vancouver that operates luxury scenic trains on four rail routes in British Columbia, Alberta, Colorado, and Utah.
History
Via Rail Canada
The Rocky Mountaineer concept was created b ...
trains as well as cruise ships) were required to show proof of full vaccination against COVID-19 beginning October 30, 2021. Although up until November 30, 2021, the government offered a one-month grace period to offer those who were not yet fully vaccinated against COVID-19 to provide a recently negative test prior to boarding.
Since the implementation of the vaccine mandate, wrongful dismissal lawsuits from fired unvaccinated workers have been piling up. Legal scholars also questioned the constitutionality of vaccine mandates, not only on the basis of individual exemptions, but also the extent of the impact that firing so many workers would have on the Canadian population at-large. Alternatively, Si Wen Shen from the
Université de Montréal Faculty of Law
The Faculty of Law at Université de Montréal was officially founded in 1892. In 2018, the Faculty was ranked as the best francophone law school in the world. In addition to its civil law degree (LL.B.), the Law School offers a one-year J.D. in c ...
proposed the idea of provincial governments invoking Section 33 (
notwithstanding clause
Section 33 of the ''Canadian Charter of Rights and Freedoms'' is part of the Constitution of Canada. It is commonly known as the notwithstanding clause (french: clause dérogatoire, links=no or ), sometimes referred to as the override power, and ...
) of the ''
Canadian Charter of Rights and Freedoms
The ''Canadian Charter of Rights and Freedoms'' (french: Charte canadienne des droits et libertés), often simply referred to as the ''Charter'' in Canada, is a bill of rights entrenched in the Constitution of Canada, forming the first part o ...
'' in order to circumvent any legal challenges on constitutional grounds.
Many private companies nationwide like
Air Canada
Air Canada is the flag carrier and the largest airline of Canada by the size and passengers carried. Air Canada maintains its headquarters in the borough of Saint-Laurent, Montreal, Quebec. The airline, founded in 1937, provides scheduled and ...
and major accounting firms have mandated vaccination policies internally. Most education institutions like colleges and universities nationwide have announced mandates for employees and students and for-profit long-term care home companies such as
Chartwell Retirement Residences
Chartwell Retirement Residences is the largest provider of seniors' housing in Canada, with over 200 locations across Quebec, Ontario, Alberta, and British Columbia. Chartwell offers independent living (IL), independent supportive living (ISL), as ...
,
Revera
Revera may refer to:
* Revera (company), a Canadian company that provides accommodation, care and services for seniors
* Revera (event), an intercollegiate sports event conducted by Students Union of Govt Medical College Ernakulam
* Ulmus 'Revera' ...
and
Sienna Senior Living
Sienna Senior Living Inc. is a Canadian publicly traded senior housing company based in Markham, Ontario. As at 31 December 2019, the company owned and operated 70 seniors’ living residences in addition to managing 13 residences for third partie ...
have all announced mandates for vaccination for employees.
The following is a table representing individual provincial measures, policies and mandates for vaccination requirements by province and territory:
National vaccination progress and orders
There are several
COVID-19 vaccine
A COVID19 vaccine is a vaccine intended to provide acquired immunity against severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2), the virus that causes coronavirus disease 2019 ( COVID19).
Prior to the COVID19 pandemic, an e ...
s at various stages of development around the world. the Canadian government had invested over $1 billion,
including pre-placed orders for seven different vaccines, four of which are now authorized for use by
Health Canada
Health Canada (HC; french: Santé Canada, SC)Health Canada is the applied title under the Federal Identity Program; the legal title is Department of Health (). is the Structure of the Canadian federal government#Departments, with subsidiary unit ...
. These pre-orders total more than 400 million doses.
Six of the seven vaccines require two doses each to be effective, with the exception of the
Janssen Pharmaceutica
Janssen Pharmaceuticals is a pharmaceutical company headquartered in Beerse, Belgium, and wholly-owned by Johnson & Johnson. It was founded in 1953 by Paul Janssen.
In 1961, Janssen Pharmaceuticals was purchased by New Jersey-based American c ...
(Johnson & Johnson) vaccine which only requires one dose.
Pharmacological data and developments
As the COVID-19 vaccines are relatively new, certain aspects of delivery and pharmacological care of the products have changed rapidly over the course of the vaccination program.
Second dose administration
Early in the vaccination effort, debate on when to administer the second dose of the approved vaccines appeared medically and politically. Each manufacturer had recommended respectively 21 days apart for Pfizer-BioNTech; 28 days apart for Moderna; and 4–12 weeks apart for Oxford-AstraZeneca. New data suggested the manufacturer's recommendation could be lengthened, in theory allowing for more people to be vaccinated as supply efforts ramped up.
Stanley Plotkin and
Neal Halsey wrote an article published by Oxford
Clinical Infectious Diseases
''Clinical Infectious Diseases'' is a peer-reviewed medical journal published by Oxford University Press covering research on the pathogenesis, clinical investigation, medical microbiology, diagnosis, immune mechanisms, and treatment of diseases ...
that urged single dose interim use in order to extend vaccination to as many people as possible until vaccine availability improved. Several other articles and media provided evidence for delaying 2nd doses in the same line of reasoning. The province of Quebec began to withhold second dose administration,
and eventually adopted a 90-day strategy. The National Advisory Committee on Immunization (NACI) had initially only recommended a maximum of 42 days in between doses.
The province of British Columbia had also followed suit and began plans to extend second dose administration to a four-month delay.
On March 4, 2021, the National Advisory Committee on Immunization (NACI) recommended that a maximum of four months or 112 days could be achieved effectively between second doses. Other provinces began to adjust their administration programme based on the federal-level recommendation.
Quebec no longer recommends a second dose for those previously infected with COVID-19, as the immunity is considered strong enough. People still wanting to receive a second dose will be allowed to get it.
Beginning May 24, 2021, Saskatchewan became one of the first provinces to offer second dose administration on a shortened interval timeline, allowing people to book second dose appointments based on their age (beginning 80+) or first dose administration date. Meanwhile, Ontario allowed people who received their first dose of the Oxford-AstraZeneca vaccine between March 10 and 19, 2021 to book second dose appointments of the same vaccine.
Pfizer-BioNTech vial capacity
In January 2021, the province of Saskatchewan discovered it could draw extra doses of the Pfizer vaccine out of vials labelled as having 5 doses.
As Pfizer prepared for industrial retooling to match international demands for its vaccine, causing a supply slowdown in Canada in January and February 2021, the company announced that their vials indeed contained 6 doses of vaccine, rather than 5. Health Canada accepted the relabelling of the product, however the revelation required the acquisition of millions of
low dead space syringes in order to extract the last dose from the vial.
Pfizer-BioNTech storage requirements
Initially the Pfizer-BioNTech vaccine was required to be stored at
ultra-cold temperatures (between -80 and -60 °C) in perpetuity, until application (in which time after dilution, the vaccine must be used within 6 hours).
On February 25, Health Canada recommended that the vaccine could be stored at regular freezer temperatures (between -25 and -15 °C) for up to two weeks.
Oxford-AstraZeneca age range
On March 1, 2021, two days after the first delivery of the vaccine, the NACI announced that it would recommend that the Oxford-AstraZeneca vaccine not be given to patients older than 65 due to “the insufficiency of evidence of efficacy in this age group at this time.” This recommendation was based on clinical trial data that only went as far as December 7, 2020.
Quebec did not follow this recommendation, but its own Immunization Committee recommended that the Pfizer and Moderna vaccines be given to higher-priority groups in the event of limited vaccine availability (with the AstraZeneca vaccine given to lower-priority groups). On March 16, NACI revised its recommendations based on newly obtained efficacy data from other countries.
On March 29, 2021, NACI recommended that the Oxford-AstraZeneca vaccine not be given to patients younger than 55, citing reports of a rare, increased risk of
blood clots
A thrombus (plural thrombi), colloquially called a blood clot, is the final product of the blood coagulation step in hemostasis. There are two components to a thrombus: aggregated platelets and red blood cells that form a plug, and a mesh of cr ...
with low levels of blood platelets (
post-vaccination embolic and thrombotic events
Post-vaccination embolic and thrombotic events, termed vaccine-induced immune thrombotic thrombocytopenia (VITT), vaccine-induced prothrombotic immune thrombocytopenia (VIPIT), thrombosis with thrombocytopenia syndrome (TTS), vaccine-induced imm ...
). Most provinces adhered to this recommendation. In April 2021, due to the ''third wave'' of infections, and increased hesitancy towards the vaccine due to these side effects, multiple provinces (including Alberta and Ontario) went against NACI guidance and began to distribute the vaccine to people as young as 40. On April 23, NACI changed its guidance to recommend the vaccine be offered to patients as young as 30 years old if benefits outweigh the risks, and the patient "does not wish to wait for an mRNA vaccine".
Cessation of Oxford-AstraZeneca in certain provinces
Due to increased reports of
post-vaccination embolic and thrombotic events
Post-vaccination embolic and thrombotic events, termed vaccine-induced immune thrombotic thrombocytopenia (VITT), vaccine-induced prothrombotic immune thrombocytopenia (VIPIT), thrombosis with thrombocytopenia syndrome (TTS), vaccine-induced imm ...
, on May 11, 2021, the provinces of Alberta and Ontario decided to cease offering first dose appointments of the Oxford-AstraZeneca vaccine. On May 12, Nova Scotia and Manitoba also announced similar restrictions, with Quebec following the next day.
Mixing of vaccines
Health Canada and NACI began looking into the possibility of mixing different vaccines in about April 2021. As the future of AstraZeneca vaccines in Canada became increasingly uncertain, due to both shipment delays and the risk of rare blood clots, and preliminary data on the subject became increasingly available, provincial governments' interest in the proposal grew. In early May, Quebec became the first province to approve of the mixing of an
adenovirus vaccine
An adenovirus vaccine is a vaccine against adenovirus infection.
It was used by the United States military from 1971 to 1999, but was discontinued when the only manufacturer stopped production. This vaccine elicited immunity to adenovirus seroty ...
(AstraZeneca) with an mRNA vaccine (Pfizer-BioNTech or Moderna), albeit only under certain circumstances: only people under 45 who have received a first dose of the AstraZeneca vaccine would be able to receive one of the mRNA vaccines as their second dose.
A couple of weeks earlier, Quebec had exceptionally allowed for the mixing of Moderna and Pfizer vaccines to go ahead in long-term care homes, as the supply of Moderna doses was low.
On May 20, it was announced that Canada would be performing its own country-wide study on the effectiveness of mixing vaccines.
On June 1, NACI approved the mixing of the three approved vaccines in Canada (Pfizer-BioNTech, Moderna, and AstraZeneca-Oxford). Specifically, they recommended mixing a first dose of the AstraZeneca vaccine with a second dose of one of the mRNA vaccines and mixing a first dose of a Pfizer or Moderna vaccine with a second dose of either mRNA vaccine. Two weeks later, they changed their recommendations to suggest that a second dose of one of the mRNA vaccines after a first shot of AstraZeneca is "preferred", due to new evidence that seems to demonstrate an improved immune response on a mixed vaccine schedule.
Rollout strategies
In December 2020, the NACI issued initial recommendations for a multi-stage rollout of vaccines that would prioritize specific populations in sequence, beginning with residents 70 and older, health care workers, and the employees and residents of long-term care facilities (due to the pandemic's
disproportionate impact on them); and progressing towards wider age ranges, first responders, essential workers, and residents with
comorbidities
In medicine, comorbidity - from Latin morbus ("sickness"), co ("together"), -ity (as if - several sicknesses together) - is the presence of one or more additional conditions often co-occurring (that is, concomitant or concurrent) with a primary c ...
, before progressing towards the wider general public.
Key people
*
Brigadier-General
Brigadier general or Brigade general is a military rank used in many countries. It is the lowest ranking general officer in some countries. The rank is usually above a colonel, and below a major general or divisional general. When appointed ...
Krista Brodie, Vice President Logistics and Operations,
PHAC
The Public Health Agency of Canada (PHAC; french: Agence de la santé publique du Canada, ASPC) is an Government agency, agency of the Government of Canada that is responsible for public health, emergency preparedness and response, and infectious ...
(began role May 17, 2021)
*
Patty Hajdu
Patricia A. Hajdu (; born November 3, 1966) is a Canadian politician who has served as the minister of Indigenous services since October 26, 2021. A member of the Liberal Party, she also serves as the member of Parliament for Thunder Bay—Super ...
,
Minister of Health A health minister is the member of a country's government typically responsible for protecting and promoting public health and providing welfare and other social security services.
Some governments have separate ministers for mental health.
Coun ...
*
Harjit S. Sajjan,
Minister of National Defence
*
Anita Anand
Anita Anand (born May 20, 1967) is a Canadian lawyer and politician who serves as the minister of national defence since 2021. She has represented the riding of Oakville in the House of Commons since the 2019 federal election, sitting as ...
,
Minister of Public Services and Procurement
The minister of public services and procurement (french: ministre des services publics et de l’approvisionnement) is the minister of the Crown in the Canadian Cabinet who is responsible for overseeing the Government of Canada's "common service ...
*
Brigadier-General
Brigadier general or Brigade general is a military rank used in many countries. It is the lowest ranking general officer in some countries. The rank is usually above a colonel, and below a major general or divisional general. When appointed ...
Simon Bernard, logistics
Former
*
Major-General
Major general (abbreviated MG, maj. gen. and similar) is a military rank used in many countries. It is derived from the older rank of sergeant major general. The disappearance of the "sergeant" in the title explains the apparent confusion of a ...
Dany Fortin, Vice President Logistics and Operations,
PHAC
The Public Health Agency of Canada (PHAC; french: Agence de la santé publique du Canada, ASPC) is an Government agency, agency of the Government of Canada that is responsible for public health, emergency preparedness and response, and infectious ...
(left the role on May 14, 2021, due to an unspecified military investigation
)
See also
*
COVID-19 vaccination in Quebec
The COVID-19 vaccination campaign in Quebec (french: Campagne de vaccination contre la Covid-19 au Québec) is an ongoing provincial effort to distribute and administer vaccines against COVID-19.
Quebec received their first shipments of COVID- ...
*
Deployment of COVID-19 vaccines
, 12.7billion COVID-19 vaccine doses have been administered worldwide, with 67.9 percent of the global population having received at least one dose. While 4.19million vaccines were then being administered daily, only 22.3 percent of people i ...
Notes
References
External links
*
*
{{North America topic, COVID-19 vaccination in
COVID-19 pandemic in Canada
Canada
Canada is a country in North America. Its ten provinces and three territories extend from the Atlantic Ocean to the Pacific Ocean and northward into the Arctic Ocean, covering over , making it the world's second-largest country by tot ...