Canada plans to vaccinate everyone who wants it by the end of 2021

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OTTAWA — The first vaccine to protect against COVID-19 has been approved for use in Canada, which has set in motion the first round of distribution and plans for how future vaccines will be administered, including a plan to have everyone who wants to be, immunized by the end of 2021.

While touting Health Canada’s approval of the Pfizer-BioNTech vaccine, federal officials unveiled a new document outlining the overall timeline and approach to Canada’s national mass vaccination effort.

The target? Immunizing as many people as possible, as quickly as they can in 2021.

The plan is to focus on priority groups between December and March 2021, begin vaccinating the general population in April, and have all Canadians immunized by the end of next year, with one of the seven vaccines Canada has signed deals to secure.

“Our goal is to have Canadians be vaccinated to the greatest degree possible, because again, vaccination saves lives, and it protects us from spread and this is the goal. The goal is that we can deliver vaccines to provinces and territories, that they can immunize Canadians as quickly as we can actually approve and acquire those vaccines, because we're all looking forward to a faster to normal,” said Health Minister Patty Hajdu on Wednesday.

By the end of March, Canada is planning to have three million Canadians—or eight per cent of the population—immunized. From April to June, between 15 and 19 million Canadians will be immunized, which equates to between 40 and 50 per cent of the population.

Then, between September and December the plan is to see all 38 million Canadians vaccinated, though getting vaccinated will not be mandatory.

These latest projections are based on anticipated delivery schedules and are dependent on regulatory approvals of additional vaccines. COVID-19 vaccines will be offered to Canadians free of charge.

“As we roll into spring and summer we anticipate a steep increase in vaccine availability. Distribution will also become easier as additional vaccines are approved, and that can be transported outside of the ultra-low temperature and frozen cold chains,” said Maj.-Gen. Dany Fortin, the top military general leading the rollout from the Public Health Agency of Canada.

“Some vaccines will become easier over time, easier to handle, and to distribute over time, as we get more stability data.”

In total, Canada has signed contracts with seven companies, guaranteeing access to 194 million doses of potential COVID-19 vaccines with the option to purchase 220 million more, meaning if all trials pan out, we’d have access to 414 million doses. It’s just a matter of when these approvals will be granted, but the government says Canada is “well positioned” to meet its target.

“If all goes well… we will have a suite of approved vaccines,” said Deputy Chief Public Health Officer Dr. Howard Njoo.

SHIPPING THIS WEEKEND

Prime Minister Justin Trudeau announced on Wednesday that 30,000 doses will be in the first Pfizer shipment.

Fortin said that the first round will be shipped on Friday, and arrive early next week, with initial vaccinations happening by the middle of the week.

“So, we expect vaccines to be shipped, very soon. By the end of the week… Pfizer indicated that it would be prepared to ship by Friday. So assuming Friday, we could see vaccines arrive Monday, probably Tuesday, we'll know more as we move forward in the next 36 hours,” he said.

Because Pfizer’s vaccine requires ultra-cold storage—it needs to be stored at temperatures below -70 C—the logistics of the rollout are complex.

To start, Pfizer is requesting the first doses be given on-site at 14 medical facilities in major cities, where there are ultra-cold freezers in place, to avoid as much wastage as possible from transporting the vials elsewhere.

By the end of December, Canada is set to receive up to 249,000 doses of the Pfizer vaccine, or enough to vaccinate 124,500 people, given it requires two 0.3 ml shots into the muscle of the arm, 21 days apart.

Pfizer Canada’s Vaccines Medical Lead Dr. Jelena Vojicic said she anticipates most vaccines destined for Canada will be coming out of Belgium.

Based on the dry run conducted this week—which allowed Canada to confirm the shipping and receiving processes—it took around 36 hours for the first temperature-controlled box to arrive in Canada.

“This is very much, as when you order stuff online that comes from overseas, you have an ability to track when things arrive. And of course this is closely followed,” said Fortin.

On Friday, as they await the arrival of the first vaccines, the National Operations Centre will be conducting another exercise, this time with more than 100 participants from federal, provincial, and territorial governments, as well as Indigenous and industry partners.

Fortin said this will allow each organization and entity “to visualize their role in a vaccine distribution process, to confirm responsibilities, the critical handoffs, to create common understanding amongst the group, and to build confidence in the overall conduct and execution of this complex multifaceted plan,” both for the initial vaccines and doses to come in the months ahead.

PRIORITY GROUPS FIRST

Because of the limited number of initial doses—up to six million by the end of March 31—the main focus during the first part of 2021 will be on vaccinating priority groups, such as seniors, health-care workers, and Indigenous communities.

It is also requires ongoing coordination across the country, as doses will be doled out on a per capita basis and each province is able to modify the national recommendations for prioritization based on their regional situation.

Of those six million doses, four million will be Pfizer vaccines, and the other two million would be Moderna’s vaccine candidate, which is still pending regulatory approval but is now the farthest along in that process.

Given the initial Pfizer doses are being doled out at central locations and not able to easily be transported, this means Canadians who live in the territories and other remote areas will largely be waiting until the Moderna vaccine—which can be stored at -20 C— is approved, before they are able to receive a COVID-19 vaccine.

There isn’t a date or estimate yet for when it may be approved, but Njoo said Wednesday that across the provinces and territories a consensus was reached that it “doesn't make practical sense” to use the Pfizer vaccine in northern communities, so they will have proportional first access to Moderna should it be approved.

“Moving forward, as we learn more about the vaccine and ability to transport it frozen, un-frozen and so on, we will be able to explore other options, and more points of use will be added,” said Fortin.