Honourable members of the committee, I'm pleased to speak to you today. It's been approximately one year since I last appeared before you, and it has been a year like no other. While we have had many surprises, perhaps most surprising to me is the degree to which this pandemic has met our pre-pandemic expectations of the origins and course of such an event.
As predicted, a virulent pandemic emerged at the human-animal interface when an animal virus crossed the species barrier. Our fear is focused on a pathogen that combines virulents and transmissibility, and SARS-CoV-2 has done that par excellence. The contours of this pandemic, both in terms of timing and societal disagreement around masks, business and school closures, also directly echoed the 1918-19 influenza pandemic.
I'm sure that many of you, like me, wish that we were further along in vaccinating all Canadians against SARS-CoV-2. As with the control of the pandemic itself, Canada is neither at the front nor the back of the pack. We are getting there. Long-term care facilities across the country are largely vaccinated, and that has led to a marked reduction in daily deaths from SARS-CoV-2. However, as a friend recently remarked, Canada doesn't have a “let's finish in the middle of the pack” program for the Olympics. We have an own the podium program. We have the smarts, and the resources to be at the front of the pack.
Better performance in a crisis like this depends on strong systems, which unfortunately can't be created overnight. As they say, it's hard to build the airplane when you're trying to land it. Public health funding in Canada may be a victim of its own success. When public health systems are functioning well, they are silent, but they allow other sectors of our economy to thrive.
Unfortunately, the conditions that created our current pandemic will not disappear when this is over. Environmental degradation, climate change, illicit trade in wildlife, and risky laboratory work are all likely to continue, making a recurrence of a similar event fairly likely. As such, I'd like to look forward rather than backward, and talk about what we might build out of this experience in order to protect Canadians in the event of a future severe pandemic, with a focus on vaccination.
Vaccines are the door out of the current crisis for the simple reason that it isn't the virus that creates a pandemic, but rather widespread susceptibility to a new virus. Vaccines remove that vulnerability. The frustrations related to COVID-19 reflect weaknesses in two major areas, neither of which appeared overnight, and neither of which can be resolved with a snap of the fingers.
First, vaccination data systems across the country are weak or non-existent. Second, while we have a rich history of vaccine-related innovation in Canada, the path from innovation to commercialization seems to be a challenging one, and our ability to manufacture vaccines in Canada is limited.
In discussions with colleagues, it has emerged that notwithstanding spending around half a billion dollars annually on vaccines, we lack national or even well-functioning provincial appointment systems, vaccine registries and adverse event surveillance systems. We even lack common terminology across provinces to create such systems. These systems are now being built perforce during a national crisis. They need to be strengthened, integrated and maintained when the pandemic is over, both because they'll allow us to immunize more efficiently and effectively in peacetime, and also because they'll be a key strategic asset when the next pandemic occurs.
Similarly, delays in acquisition of vaccine supply underscore the importance of building strong manufacturing capacity for vaccines here in Canada. The era of vaccine companies as university-owned entities or Crown corporations like Connaught is long gone, but we have tremendous innovation in the vaccine space in Canada.
The Pfizer-BioNTech mRNA vaccine may represent a new paradigm for partnerships between smaller companies and global vaccine manufacturers, and could provide a pathway for Canadian innovators too. I'm also delighted to see that we will soon be manufacturing the Novavax COVID-19 vaccine here in Canada.
A key advantage of partnering with global firms relates to the global nature of communicable diseases. For example, it's important for companies to trial vaccines in other countries where novel SARS-CoV-2 variants are emerging.
In closing, this pandemic has made it clear that strong public health systems and vaccines are strategic assets that need to be actively maintained for the protection of Canadians, just as we would maintain a strong and competent military. As with the military, we don't want to be strong so we can get into fights, we want strength so we can protect ourselves from threats like SARS-CoV-2 that are likely to continue to emerge in the years ahead.
Thank you for inviting me, honourable members of Parliament. I'm very happy to be in front of you this morning.
I don't have a formal presentation to give you this morning but I gave a few slides to the clerk. I'm sure he will be able to send you my presentation where you will have some data to cover what I will say.
Talking after my colleague Dr. David Fisman, whom I know well, I completely agree on many different topics and I want to underline a few important points.
I would summarize that Canadians did very well throughout this crisis. I think we have to be very proud of ourselves because if you look at all the G7 countries in terms of rates and mortality we're probably better than many others except Japan, but Japan is a very specific case. If you compare us to the United Kingdom, France, Italy, Germany and the United States, we did very well as Canadians. People were very disciplined throughout the crisis in general.
In terms of our global response as a country we didn't do that well. This is where we have a few challenges for the future, and these types of challenges will happen again. We're in a world where emerging infectious diseases will be on the menu for the next century. We travel more, and we have many ecological issues in deforestation, which is a big thing for emerging infectious diseases, because you have these viruses stuck in the middle of the Amazon jungle. Until you start destroying the forests you won't be able to see them.
We can travel around the world like never before. We're a country where one of its health.... This population comes from all over the world. Because of this, we're travelling all over the world. I think it challenges us in the future that we should have a system in place to be able to limit the impact of these emerging conditions.
There are a few things here.
The strength of our system is that we have federal and provincial levels. This is also a weakness of our system because we had a lot of bickering between the different provinces and the federal government in terms of who is responsible for what.
Personally, not as a physician, but as a Canadian, in the future I would expect my federal government to step in very quickly and use all its power to try to contain a pandemic like this. For example, we had great military forces that were deployed to a certain point. We had the experience of having our armed forces in Quebec, but having the potential and the availability of our soldiers helping the Canadian population with logistics whenever possible would have been great. I think there are examples around the world in immunization where the army played a very important role in logistics.
Closing the border was also a big thing. I understand from a political standpoint it was very difficult. It was probably the biggest challenge we had as a nation since the last world war. From that perspective for all of us who were born after 1945, and even for the others who were probably children during the Second World War, there hasn't been any challenge as big as this one in our lifetime. It's extremely difficult to go from an ordinary life to an extraordinary life very quickly.
From that perspective, having in place all the measures to be able to close the border quickly and to implement certain rules quickly in isolating people, quarantines, etc., will be very important.
The biggest challenge, and it's our only way to get out of this, is the reindustrialization of the Canadian economy, which is mostly for medical equipment. We had to struggle for masks, ventilators and tests, very simple things. We're testing hundreds of thousands of people every day in this country, but you have to realize that all the equipment needed for the tests is very difficult to get. Much of it is coming from abroad; sometimes you need a plastic pipe head, which was not available in this country, and we had to compete with the rest of the world to get them.
I think that strategically a country like ours should be able to muster this in the future and make sure we won't be caught a second time without an industrial base to be able to do this.
The second thing which is really important, and I think I will—
Fantastic. Thank you very much. Happy International Women's Day to you all.
Thank you for the invitation to appear on behalf of the People's Vaccine Alliance. As you may know, Oxfam is one of the founding members of this growing movement of health and humanitarian organizations, past and present world leaders, health experts and economists. We're calling for a COVID-19 vaccine to be made available for all people in all countries and free of charge.
We know that COVID-19 knows no borders and has impacted everyone's life. Canadians from coast to coast to coast are hurting. But we also know that the pandemic has hit certain groups harder than others. Here in Canada, Black, indigenous and racialized women, women with disabilities, and immigrant women have been hardest hit by the virus. In many cities, they have the highest infection rates. This is because so many of these women are frontline health care workers or work in what we now recognize as essential jobs. This is why Oxfam has labelled the coronavirus the “inequality” virus, to emphasize just how much COVID-19 is deepening and exacerbating existing inequalities.
The pandemic has demanded interventions on a scale and scope not seen in decades. Canada has invested unprecedented levels of resources to provide a safety net for people here in Canada, but it has also offered significant support to help developing countries weather this storm. This includes close to $940 million to support equitable access to COVID-19 tests, treatments and vaccines through the WHO access to COVID-19 tools accelerator. This funding also includes $325 million for the COVAX advance market commitment stream, which aims to help vaccinate 20% of people in 92 low- and middle-income countries, especially the most at-risk groups.
Unfortunately, at current trends, nine out of 10 people in low-income countries will miss out on a COVID-19 vaccine this year. Estimates show that poorer countries will not have widespread vaccination programs in place until 2024. We need to do better. The longer the virus is around, the more likely it is to mutate, making current immunization efforts ineffective.
The WHO initiatives that Canada is supporting are important. Unfortunately, they do not tackle the global problem of vaccine shortages. They are also undermined by wealthy countries cutting bilateral supply deals that drive up prices and limit supplies. Our best chance of us all staying safe is to ensure that COVID-19 vaccines are available for us all as a global common good. This will only be possible if we change the way in which vaccines are produced and distributed. Pharmaceutical companies need to allow COVID-19 vaccines to be produced as widely as possible by sharing vaccine technology free from intellectual property rights. We need to maximize production so that enough doses are available for the world to achieve herd immunity.
What's fantastic is that Canada can help end the scramble for vaccines. Canada became co-chair of the COVAX advance market commitment engagement group this past January. In her role as co-chair, can strengthen COVAX by pushing for increased transparency and inviting developing countries and civil society representatives to decision-making spaces. Canada should refrain from procuring vaccines from COVAX at this time. For many low-income countries, COVAX may be their one and only chance of receiving vaccines this year.
Ghana and Ivory Coast received their first vaccine shipments this past week through COVAX. This is worth celebrating as a first step to ensuring that their health care workers have the protection they need to do their jobs safely. Unfortunately, close to 80 other countries have yet to receive a single dose.
The world needs more vaccines, and fast. This week Canada has the opportunity to change the course of the pandemic. A waiver on trade-related aspects of intellectual property rights, otherwise known as TRIPS, is being brought to a vote at the World Trade Organization. Spearheaded by South Africa and India, and supported by more than 100 countries, this waiver would be a game-changer for increasing vaccine supplies, as it would allow countries with the manufacturing capacity to make COVID-19 vaccines.
We hope to see Canada vote in favour. This pandemic has shown us how interconnected we all are and how vital it is to have international co-operation and solidarity. By voting in favour of the TRIPS waiver at the WTO this week, Canada can help stop the pandemic in its tracks.
Thank you on behalf of Oxfam and the People's Vaccine Alliance for the opportunity to appear today.
Honourable members of the committee, I'm very pleased and honoured to be here today. My name is Agathe Demarais. I'm the global forecasting director at The Economist Intelligence Unit.
In January, we published a study presenting our forecasts for global coronavirus vaccination timelines around the world. I think this is the study that Lauren Ravon mentioned in her testimony. These projections presented the time when each country around the world can expect to have vaccinated 60% to 70% of its population.
There are three main conclusions that I'll present now before digging a little further into the data. The first conclusion is that vaccination will take a lot of time. Vaccinating the majority of the world's population will take until at least late 2022, and for many countries, the timelines will stretch until 2024 if vaccination happens at all.
The second conclusion is that production is the main bottleneck around the world. We studied seven criteria to make our timelines, and production was always the one that made timelines slip.
The third conclusion is that this poses two main risks. The first risk is for the global economic recovery because some countries will recover faster than others as they will have vaccinated faster than others. The second risk is obviously that while not every one is vaccinated, new variants of the coronavirus pandemic can emerge and could take us back to square one.
First, why did we do this study and what was our methodology? Until recently, the main variable for political and economic forecasts that we do at the EIU was the course of the pandemic. That's not the case anymore. Now it's all about global vaccination timelines.
What was our methodology? Briefly, we took seven factors into account. The first one was production. As I mentioned, it's the main bottleneck because 15% of the world's population have pre-booked around half of the supply of coronavirus vaccines that will be produced this year.
The second factor was supply deals.
The third factor was logistics with a special focus on two issues. The first issue was transportation, which is going to be very tricky because normally vaccines are shipped via passenger planes but there's no travel anymore because of travel restrictions. The second issue was the cold chain, because some countries do not have the required cold chain to use some of the vaccines that require ultra-low temperatures.
The fourth factor was the availability of health care personnel to administer the vaccines. This is going to be a bottleneck in some countries, for instance, in Asia.
The fifth factor was financing. It is crucial for many poorer countries.
The sixth factor was vaccine hesitancy, which is especially acute in some countries like France, Japan and Argentina.
Finally, there were some local factors because some countries simply do not want to vaccinate. This is the case in Tanzania, for instance.
The second thing that I wanted to mention is the main takeaways from our study. We mapped four different categories of countries. The first category is the fastest countries with timelines stretching into late 2021, so late this year. We have exceptionally fast countries such as Israel, the United Kingdom, Serbia and the Gulf countries, and other very fast countries in the EU, the U.S., Switzerland, Hong Kong and Singapore, for instance.
The second category of countries have timelines stretching into mid-2022. This is still very good by global standards. These are other OECD advanced countries such as Australia, Japan and South Korea, or middle-income countries that have production capacity such as Brazil, Russia and Mexico.
The third category of countries is where we found most middle-income countries, and India and China, with timelines stretching into late 2022.
Why are India and China taking until late 2022? It's because of the sheer size of their population, which is going to present a big challenge, and also because these countries are exporting vaccines in large quantities so they will find tensions between supplying their domestic markets and supplying exports.
Finally, the fourth and last category, where the majority of the world's population finds itself, is timelines stretching into 2023 and beyond, if vaccination even takes place. This is the rest of the world, mainly low-income countries. It includes most countries that will depend on COVAX, which will cover only 20% of the population of eligible countries with timelines that are non-binding and subject to change. There's a real risk in these countries that vaccination will not take place, because in some of these developing countries, governments could find that vaccination could be too costly or too difficult.
Finally, what does that mean for the global economic recovery, which is something that we forecast at the EIU? It will start from the third quarter of 2021, so the third quarter of this year, because that's the time when the U.S., Europe and many of the OECD countries will have vaccinated the bulk of their populations. China is the engine of global growth but vaccination timelines can stretch further because the pandemic is under control in China and so there is no real rush to vaccinate, which is quite different from the situation in many western countries.
That being said, the global economy will recover to pre-coronavirus GDP levels only in late 2021, so it will take time, and this forecast masks wide disparities. It's artificially boosted by China, where we forecast that growth will boom this year. For the U.S. and the EU, we will see a recovery to pre-coronavirus levels only in 2022 and in Japan in 2023. In emerging countries, timelines will be much slower for recovery, which reflects the slow vaccination timelines that we've just discussed and the lack of fiscal space to launch stimulus plans.
This poses two main risks, finally, for global economic recovery. The first one is that global vaccination timelines could slip even further, which would delay the recovery. The second one is, as I've mentioned, that, while not everyone is vaccinated, we could see new variants emerge that could prove resistant to vaccines.
Thank you very much for your attention and for having me today.
I can also possibly make a comment as a physician.
I think, to my mind, we're doing some good stuff. The marvellous observation over the last month or so is we've had long-term care facilities in Ontario serve as a major source of death during this pandemic and the Pfizer vaccine and then the Moderna vaccine have basically shut that down. Our science table has a brief that came out today looking at the impact of these vaccines in long-term care and it's nothing short of spectacular.
If there's a major failing that I see in Ontario that's holding us back, and I think we are starting to fail to keep up with vaccine supply as it comes into the province, we have about 8,000 or 9,000 family doctors in this province who vaccinate a few million Ontarians against influenza every flu season. I'm aware of the logistical issues with the mRNA vaccines, but we're starting to get into vaccines that don't have the same extreme cold requirements for storage. I think family doctors know how to do this. They know their patients. They know how to prioritize and how to get folks vaccinated.
I think there are some infection control concerns in terms of individual people's offices and not all doctors feel comfortable having a large crowd of folks pass through at this time. But I do think that as we try to do something new, we have to use the tools that we already have in our tool box. We do have this group of individuals who are very, very good at vaccinations who have been underutilized to date, so I hope that changes.
The thing I'm proudest of in terms of the Ontario science table, and it's brought me along a little bit.... We see this every year with the influenza vaccines. Usually the dilemma with vaccinations is that the vaccines are least good at protecting the individuals you most want them to protect. Most deaths from influenza each year occur in individuals over age 65, for whom traditional influenza vaccines—we have some better ones now—arguably have not worked at all in that demographic. We've directly tried to protect individuals with vaccines that are very unlikely to work in that age group, whereas we could probably protect them more effectively by going for the herd, as the flu vaccines work in younger people.
We don't actually have that dilemma with COVID vaccines, because the mRNA vaccines in particular are so potent that we can directly protect individuals over age 80, over age 70, individuals with underlying medical issues, by directly vaccinating them. To some extent, this decision has been a bit of a no-brainer in terms of who you vaccinate first. It's older people, and I think you see that in other countries.
The modification to that which has come out of our science table is this observation that about 90% of all of our COVID cases come from 10% of our postal codes in Ontario. Those have been overwhelmingly postal codes that are more densely populated urban areas, lots of people of colour, lots of new Canadians, lots of folks involved in essential work. What came out of the science table, and I think the province is now following this, is an attempt to sort of front-load, in addition to prioritizing older people and folks with underlying medical conditions, vaccinations in some of these zip codes that have been really the hardest hit, to try to get some of those herd effects as well.
I think it's a neat piece of nuance. I realize it raises equity concerns in other areas where people have said, “Hey, what about us over here? We're vulnerable, too.” These are hard decisions with a scarce resource, and I think they did pretty well with that.
Right. Increasingly, I think, public health has become a data-focused discipline. I mean that how we understand processes, how we see them, really depends on the data we have. It's unfortunate, I think, that in my province, Ontario, we have a bit of a track record where we've sunk billions of dollars into data systems and famously have had very little to show for that. I think that is sort of a caution to us if we say, “Let's just throw a bunch of money at this and build some good data systems.”
We have needs on a bunch of different fronts. In terms of public health surveillance systems, we could really use some upgrades that make surveillance systems interactive, to have a kind of crosstalk across the country, a shared vocabulary, and relatively user-friendly data systems and data systems that are actually linked into.... As you know, we have national health care in Canada. It would be great if we could actually have interactivity between our public health data system and our health care data system.
On the subject of vaccines in particular, because that's what I've been thinking about in heading into this meeting, we are really patchy, and to date we have very little that has been constructed. As far as I know, the only province in Canada—and I hope I'm right about this—that has an adult vaccine registry is Prince Edward Island. I think that's it. We really don't know.
As I mentioned in my remarks, we spend half a billion dollars annually on vaccines, but we actually have no means of tracking who got them or of linking back to health records so that we could look to see whether if you're vaccinated you're less likely to be hospitalized and so forth. We're really struggling in terms of appointment systems. We don't have a good national, nimble system to monitor vaccine adverse effects, which is a really big issue with brand new vaccines.
I want to thank the witnesses for taking the time to come and give us their presentations, which are very enlightening and relevant.
We're dealing with a global pandemic. The presentations given by Ms. Demarais and Ms. Ravon speak for themselves.
Professor Fisman and Professor Weiss, you are scientists. You spoke about the need to establish a more centrally coordinated approach. However, shouldn't this have been done on a global basis in the first place?
The vaccine protectionism that we're facing has led to a vaccine race. The findings of Doctors Without Borders, Ms. Ravon and Ms. Demarais show that this global pandemic is forcing us to review our methods. Variants will continue to pose a threat and may take us back to square one. This is a long-standing issue in third world countries, two-thirds of which are excluded.
Professor Weiss and Professor Fisman, I want to hear your thoughts on this.
Mr. Thériault, I'll answer you as best I can.
First, we're dealing with a virus that will persist. In other words, because the coronavirus has a non-human reservoir, it won't necessarily be eradicated. We'll probably have to live with the virus for a long time. This is different from smallpox, which was eradicated in 1977 through global vaccination.
We'll also be facing a situation where we'll need to administer flu-like vaccines on a regular basis. It's possible that we'll need to vaccinate people every year or two, worldwide, to protect them from new variants.
You must also understand that the variants aren't necessarily unexpected. The variants are a way for the virus to adapt to humans and to improve itself, so to speak. A variant isn't necessarily worse. We don't see all the failed variants. It's a bit like a cake. We don't see all the failed recipes, only the successful ones. This is somewhat the case with variants, which show the adaptability of the virus.
Obviously, the World Health Organization, like many large organizations, dropped the ball somewhat. The World Health Organization is subject to all sorts of political pressure. At first, the information on the extent of the pandemic wasn't very clear and straightforward, including the information on what happened in China. Later on, we learned a bit about the extent of the pandemic. From a purely technical perspective, we received information about the sequence of the virus from Australia, where a laboratory isolated the virus using people who had come from China. We can't rely too much on international organizations to show complete transparency, since the states that make up these organizations aren't transparent.
In Canada and Quebec, we must protect ourselves so that we have the pieces in place to protect our population as best we can under the circumstances. Of course, we can work with other countries. We must do so when we don't have the capacity to produce vaccines, for example.
For Canada, we must have a strong detection system. For example, we have a very good system of provincial laboratories. We also have, in Winnipeg, a national laboratory whose capabilities are world-renowned. However, in Canada, we must develop some sort of external warning and monitoring system to quickly identify threats and implement measures to counter them.
We're told that we must build the plane as we fly. I think that everyone agrees that, at the start of the pandemic, we were caught off guard on all fronts when it came to implementing measures to deal with the virus effectively.
We could discuss this matter at length. Let's just say that we'll need Canadian vaccine development and production capacity to meet the needs of the entire population. On a practical level, we're in a global competition. Both states and the European Union, which is a group of states, want to keep vaccines for themselves. China and India also manufacture their own vaccines.
In addition, there are geostrategic considerations involved in this situation, such as giving vaccines to poor countries when the vaccines are likely being used as a bargaining chip.
In Canada, where we have the expertise, we certainly have no choice but to produce these vaccines. We could do so together with other countries.
I've been critical because our current data shows that the AstraZeneca vaccine is potentially less effective than the other two vaccines, which are messenger RNA vaccines. That's the protection data.
The AstraZeneca vaccine isn't a bad vaccine. However, you must know that it has been much less widely used than the other vaccines. One issue right now is the perceived safety of the vaccine by some segments of the Canadian population.
We know that messenger RNA vaccines have been given to over 80 million people. We haven't seen many safety issues. That's one way to encourage vaccination.
There have been many technical issues with the AstraZeneca vaccine. We've heard that it isn't as effective in people over the age of 65. That's true. The vaccine is also less effective against the South African variant. This has been shown in studies.
I don't want to go into too much technical detail. If we didn't have any alternatives to the AstraZeneca vaccine, I would be the first to say that I'm willing to receive it. I wouldn't have any particular issue with receiving the vaccine. However, given that other vaccines seem better and more effective, if I had a choice of vaccine, I would opt for the more effective one.
The best example is Israel, which has vaccinated over 80% of its population with the same vaccine and has seen a significant decrease in severe cases, especially among seniors.
I call this meeting back to order.
We are resuming meeting number 23 of the House of Commons Standing Committee on Health. We are meeting today to study the emergency situation facing Canadians in light of the second wave of the COVID-19 pandemic.
I'd like to welcome the witnesses.
For this panel, we have Dr. Ève Dubé, researcher, Research Center, Université Laval; and Dr. Nathalie Grandvaux, professor, Université de Montréal. From Pfizer Canada we have Mr. Pinnow, president.
We will start with witness statements.
Dr. Dubé, please go ahead for six minutes.
I guess I am here as a medical anthropologist working on vaccine acceptance.
I'd like to emphasize that at this time our vaccine supply does not meet vaccine demand and that the work we're doing in Quebec looking at vaccine intentions indicates that most Canadians are willing to be vaccinated.
We can see vaccine acceptance in a continuum ranging from a very tiny minority of people who are strongly opposed to vaccination—it's fewer than 2%—to the vast majority of people who are willing to be vaccinated.
In the middle are the vaccine hesitant, the movable middle. Those groups are a bit more concerned about vaccine and maybe more reluctant to get their vaccination, and that's the group among whom we're seeing the most public health gains in ensuring confidence and acceptance.
Our regular surveys conducted in Quebec are similar to those done elsewhere in Canada. They indicate that three out of four people are willing to be vaccinated, but of course between an intention and actual behaviour there's a gap, and we need to ensure that barriers to vaccine acceptance are understood and well addressed.
These could be grouped in three main categories.
First is complacency. Depending where you live in Canada, if there are no COVID cases around you, you might be less willing to get the vaccination.
The second one is confidence. It's the level of trust that people have in the public health authority and the government to make good decisions concerning vaccination and to ensure that information is available to make an informed decision about vaccine.
The last one is convenience. It's something we tend to overlook, but the ease of getting access to a vaccination, of making an appointment, of being reminded that it's your turn to be vaccinated, is also important.
Good afternoon, Mr. Chair, members of the committee and fellow witnesses.
First of all, let me thank you for the opportunity to appear before you today.
Just to present myself a little bit, I am a full professor in biochemistry and molecular medicine at Université de Montréal, and I am also the director of the research laboratory on host-virus interaction at the Centre de recherche du CHUM, also in Montreal.
In that matter, I have been studying the mechanisms of human defence against respiratory viruses for 15 years now. Since April 2020, I have also been the co-director of the Québec COVID - Pandemic Network, which promotes research collaboration to accelerate discoveries and their applications.
At this point in the pandemic, I believe Canada faces several critical challenges for the immunization strategy to be successful. There would be plenty to discuss, but in the interest of time, I will only focus on two essential elements for which I see major inconsistencies these days, and for which I would like to propose avenues of improvement.
First of all, I would like to underline the work of the COVID-19 task force, with their recommendation of a diversified portfolio of vaccines. This was, in my opinion, an informed choice considering the impossibility of knowing a priori the success of each of these vaccines, and also because of our lack of production capacity. Likewise, the logistics for bringing vaccine doses to the provinces and territories is efficient, and I think this should be emphasized.
However, we now have four vaccines authorized by PHAC, and this is amazing. A major problem, however, is the confusion of messages regarding their use, as Canada, in my opinion, does not speak with a single, strong voice. PHAC authorizes vaccines based on the clinical trial data, and the NACI subsequently adjusts the recommendations for their use based on real-life data as it becomes available.
It goes without saying that the different messages emitted by these two organizations lately induce a major confusion that is incomprehensible for the majority of the population. This is without taking into account the additional confusion induced by the different opinions of the provincial advisory committees.
We are living in an exceptional crisis situation, but in the way our organizations operate, in my opinion, they have not been adjusting accordingly. NACI and PHAC should collaborate more closely and should unite their voices to deliver a single, clear and cohesive message. It is important to understand that inconsistent messages will likely lead to a loss of confidence in the population in the vaccination campaign and one cannot risk losing the adhesion of the population to immunization with the safe and effective vaccines that we have. I therefore urge the government to review the mandates of NACI and PHAC to include collaboration to reach a consensus to update the policies.
The most important problem, in my opinion, is undoubtedly that NACI's recommendations are not always based on scientific evidence, but in some cases on assumptions and expert opinions. This is particularly striking and worrisome with respect to the changing recommendation for the administration of mRNA vaccines.
These vaccines have been evaluated in clinical trials with two doses and should be administered after three or four weeks. There is currently no data demonstrating the consequences of postponing the second dose. NACI now recommends delaying the second dose for up to four months and, by the way, Canada is the only country to recommend this long delay. But there is absolutely no data to support this decision, and to do so without scientific evidence is equivalent to conducting a clinical trial without properly following up the participants and having their consent.
For the sake of transparency, the Government of Canada should make NACI's discussions public so that the actual data that was discussed to support the decisions and the outcome of the committee members' votes are known. The government should also require that all evidence taken into account in making the decision be made public at the time of the recommendation, not weeks later. We currently have no evidence regarding the consequences of delaying the second dose.
Finally, real-world data from the U.K. shows a differential response of individuals after the first dose of the Pfizer-BioNTech vaccine, depending on their age. From biological measurements carried out in the U.K., either from Dr. Gupta's laboratory or the REACT-2 study, some evidence shows that the first dose induces a good antibody response for people under the age of 69 years, but it is very different for the population over 69, reaching up to only 35% of people over 80 who will develop an antibody response, while all the people after the second dose develop an antibody response. There are therefore serious concerns about the extent of immunization of people over 70 years of age who are currently receiving only one dose in Canada.
I totally understand that the recommendations are made under the principle of equity in the context of limited supplies of vaccine doses. However, this recommendation may ultimately jeopardize the outcome of the vaccination campaign for the world population if expert opinions are wrong. The only good response to this situation is to do everything possible to make sure we get doses as quickly as possible, and to eliminate the propagation using sanitary measures during these times.
In conclusion, my take-home message is that Canadian policy on vaccine administration should evolve in real time, but only based on emerging scientific data. Of importance is that if the data is not available from countries that are leading the mass vaccination, Canada should consider mandating research to generate this data to support evidence-based decisions.
I thank you, and I will answer your questions
in English or French.
Thank you, Mr. Chair and members of the committee.
Bonjour. My name is Cole Pinnow, and I'm the president of Pfizer Canada.
It has been one year since this pandemic was declared. Since then, Pfizer-BioNTech successfully developed a safe and efficacious vaccine for the prevention of COVID-19 in record time, using a novel technology platform. To do that, Pfizer invested more than $2 billion at risk. We planned for success and scaled up a very complex supply chain. It requires more than 280 components, coming from 86 different suppliers, based in 19 different countries. We also established a highly innovative delivery system for a product requiring ultra-cold storage, and have shipped directly to hundreds of administration sites in Canada.
As we gather here three months after Gisèle Lévesque became the first Canadian to be vaccinated, I'd like to remind you about a small but important part of the effort it took to bring the first vaccine to Canadians as soon as science would allow.
In August we became the fourth country to complete an advance purchase agreement for the vaccine. We secured up to 76 million doses, while many other countries were also looking to lock in supply commitments. In September Health Canada introduced a rolling submission process that allowed us to file our vaccine data as soon as it became available. We initiated our application in October, and by mid-November we had made sufficient progress that a regulatory decision in December became a possibility. It wasn't until this time that we realized the need to accelerate both the initial delivery schedule and the provinces' readiness to administer the vaccine. This was not an easy task. Pfizer, PSPC, PHAC and the provinces all worked very hard to find a viable path forward so Canada could be ready.
As a result we became the second major country in the world to receive the vaccine when it arrived on December 14. This was almost two months earlier than originally anticipated. It's a tremendous accomplishment by so many, and we are very proud of this milestone achievement. Following the initial rollout, deliveries were temporarily reduced for three weeks as we worked on scaling up our Belgian manufacturing facility. It is important to note that this was a deliberate decision. We purposely chose to slow down production to make improvements that helped to increase our global annual capacity from 1.3 billion to two billion doses. Retooling our Belgian facility was the right thing to do: more vaccines produced, more countries receiving them and more people immunized.
Canadians benefited from these improvements as well. The complexity of both the scale-up of our manufacturing facility and our global supply chain is why we insisted that our contractual obligations for delivery be on a quarterly basis. This is not unique to Canada; Pfizer's delivery commitments around the world are on a quarterly basis.
We understand that Canadians want to know when they will be protected against the virus. We have gone above and beyond our original contractual obligations in two important ways to provide as much certainty as possible.
First, we share a rolling, weekly forecast as soon as we have confidence in its reliability. Today the public knows what to minimally expect from now through the middle of April.
Second, we are constantly working to accelerate our delivery. Canadians will now receive 12.75 million doses earlier than our original contract requirement. To date, we have supplied over 2.5 million doses, and have never missed a weekly delivery forecast. We remain confident that we will continue to be successful in delivering our forecasts going forward. By the end of this month we will have supplied 5.5 million doses. In Q2 we will have supplied 12.8 million doses, and in Q3 it will be 21.7 million. By the end of September, we will have provided Canadians with 40 million doses.
While we are optimistic about what this will mean as we emerge from this pandemic, we also need to reflect on how we can be better prepared for the next one. There are best practices and lessons to be learned. We have a unique opportunity to look back at Canada's pre-pandemic situation with clarity and work together to improve the life sciences sector in this great country.
Canadians have a new-found appreciation for the value of a resilient local biopharmaceutical industry. Past efforts to foster the life sciences sector had been undermined by detrimental policies of federal governments for more than a decade. If Canada wants to change course and succeed, it must put a stop to one-way consultations and engage in real dialogue with our industry. We stand ready to have this much-needed conversation and contribute to Canada's future.
As I end my remarks, I would like to reiterate that what has been accomplished so far is extraordinary. I express my sincere thanks to the 46,000 clinical trial participants, the hundreds of investigators, and the thousands of Pfizer and BioNTech scientists, clinicians and manufacturing professionals, many of whom have worked day and night. knowing that every moment matters.
I look forward to your questions.
The study in which Dr. De Serres participated is actually a second analysis of clinical data published as part of clinical trials. It's a different way of analyzing the data.
They removed the data from the first seven days of the clinical trial on the basis that it's well known that the vaccine isn't effective yet during that period. Their analysis showed that the effectiveness of the first dose was similar to the effectiveness of the second dose.
However, it should be noted that, in this analysis, the number of participants who received only the first dose was very limited, since this was a two-dose study. The data can be interpreted based on a very small sample.
Nevertheless, as I said earlier, if we look at the real-world data, such as the field data from the United Kingdom, we see a differential effect based on the age of the person who received the first dose. The data is perhaps justified based on the field data for younger people. I'm concerned about the data for older people. It gives us an immunization status, but it doesn't give us any information on the impact of the second dose over the long term or the wait time for the second dose. That's very different.
The study only shows us whether people are starting to develop immunity.