Distribution, lack of national registry top hurdles for Canada’s COVID-19 vaccine rollout

Vaccine distribution, the inability to pull off a mass campaign that could spark crowds and the absence of a national immunization registry are among the top hurdles facing Canada’s COVID-19 vaccine rollout, says the head of the National Advisory Committee on Immunization (NACI).

“To me the challenge is … the distribution. So we make the recommendations, but between that and getting the vaccine into people’s arms is going to be quite a challenge,” Dr. Caroline Quach-Thanh told CBC’s Chief Political Correspondent Rosemary Barton on Sunday.

The independent committee is made up of experts tasked with advising the Public Health Agency of Canada (PHAC) on the use of vaccines. One of its goals is to help provinces and territories determine who should first receive the COVID-19 vaccine, considering some populations have higher needs and initial supply will be limited.

Key populations for prioritization include seniors, front-line workers and others at risk of contracting or transmitting the illness. The committee says other considerations, such as people who belong to multiple at-risk populations, the characteristics of approved vaccines and the severity of outbreaks should also be factored into the country’s distribution plan.

It’s up to specific jurisdictions to hammer out the logistics of those plans, Quach-Thanh said, adding that strategies used during 2009’s H1N1 pandemic won’t work today.

“We’re not going to be able to do the mass vaccination campaign like we were doing for H1N1, for instance, because … putting people together increases the risk of spreading COVID,” she said. The campaign was Canada’s largest vaccination program and drew crowds and lengthy lineups from those seeking a vaccine. 

Promising week for vaccine candidates

Quach-Thanh’s comments come after an encouraging week for COVID-19 vaccine candidates, with Moderna posting a 94.5 per cent success rate for its vaccine on Monday and Pfizer announcing a 95 per cent success rate two days later. 

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The physician said the NACI has yet to see data from either pharmaceutical company regarding their Phase 3 trials, but added that she hopes to see that information soon.

The federal government has agreements with the two companies, along with Novavax and Janssen, a subsidiary of Johnson & Johnson. It also has deals with Sanofi/GSK, AstraZeneca and Medicago.

Canada is to receive 20 million to 76 million doses of each vaccine should they make it through clinical trials and get the green light from Health Canada.

Another obstacle, Quach-Thanh said, is the fact that the country has no national immunization registry to oversee and track Canadians’ vaccination records — something that could prove useful given that the Pfizer and Moderna candidates must be administered twice. 

“It adds a challenge to this issue,” she said. “I think that most provinces have registries so that they’re able to follow up on who gets what, and it’s now the time to really be able to use it.”

On Tuesday, Dr. Howard Njoo, Canada’s deputy chief public health officer, said Ottawa’s goal is to cover the “vast majority of the Canadian population” by the end of 2021.

Quach-Thanh said it’s critical to keep that timeframe in mind.

“If people think that by March everybody is going to be out of the woods because we’re all going to get vaccinated, that doesn’t work,” she said.

“We expect that those non-pharmacological interventions like physical distancing, mask wearing … will likely need to still be in place for another year or so because we don’t expect most … Canadians to have been vaccinated before that time.”

WATCH | Ottawa gears up for vaccine distribution:

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The federal government is finalizing its plan to roll out COVID-19 vaccines once they are available in Canada. The plan needs to include how to transport, store and deliver millions of doses quickly and may involve military assistance. 1:54

Federal-provincial disconnect

Confusion over early access to a vaccine prompted a disconnect between federal and provincial officials this week about how many doses each province can expect to receive — and when.

PHAC officials told the House of Commons health committee on Friday that six million doses could be expected by the end of March 2021, but some provinces appear to have specific breakdowns for what they’ll receive.

Ontario Health Minister Christine Elliott suggested Wednesday that her province could be handed up to 2.4 million doses for distribution between January and March. About 1.6 million of those would come from four million doses slated for Canada from Pfizer during that time, she said, while 800,000 would come from two million doses anticipated from Moderna.

Alberta’s Dr. Deena Hinshaw also shared the number of doses her province could expect to see.

Federal officials, however, have kept mum on the details — dodging questions about provincial figures and refusing to confirm how many doses Canada might receive from Pfizer and Moderna by early next year. 

“I think the assertion of the various provinces around the number of doses that they are going to receive in their own jurisdictions is the area where we have not come to an agreement on yet,” Federal Health Minister Patty Hajdu said Friday. 

“We will be working out, and are working out, with the provinces and territories a sharing agreement on the number of doses each province and territory can expect to receive when those vaccines arrive in Canada,” she said. “There are a number of steps to continue to go through to receive those doses on Canadian soil.”

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National criteria necessary, Manitoba premier says

In an interview on Rosemary Barton Live, Manitoba Premier Brian Pallister called for “national criteria” to guide the country’s distribution efforts.

“Vulnerable people, and, of course, front-line workers, are going to get it first. We all agree with that. But we need to also come to a national agreement on those criteria because it isn’t going to be here all at the same time,” said Pallister, whose province is currently experiencing the country’s highest per-capita COVID-19 infection rate.

Hajdu said Ottawa and the provinces and territories have negotiated agreements for everything needed for the pandemic so far, “whether it’s personal protective equipment or testing,” and said vaccines are no exception.

But while external groups such as the NACI are working to identify who should get the first doses, it is still up to other jurisdictions to administer them.

“For heaven’s sakes, it’s a life and death thing to a lot [of people]. I’m a 66-year-old asthma sufferer. But I shouldn’t get it first, right?” Pallister said. “I mean, there’s a lot of other people that are going to need to get that vaccine ahead of me. I’m saying we need to have those criteria because people want to get this vaccine and they want to get it right away.”

WATCH | Manitoba premier on national vaccine criteria:

Brian Pallister cautions against ‘piecemeal’ plans for access to COVID-19 vaccines and wants a standard in place across all provinces and territories. 1:28

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