If a COVID-19 vaccine is safe and gets approved, but there’s no one around to make it, does it still count?
It’s the question that sent sparks flying among federal politicians this week after Prime Minister Justin Trudeau admitted that Canadians are likely to be second in line after Americans when the companies with promising vaccines start handing out doses.
Noting that countries such as the United States, Germany and the U.K. have vaccine-production facilities within their borders, Trudeau noted that companies in those countries are “obviously going to prioritize helping their citizens first.”
Furthermore, lacking the capacity to make vaccines, Canada has not even negotiated to right to manufacture doses of them here at home, meaning we’re now waiting on shipments from the companies, once they’re approved by Canadian regulators.
A member of Canada’s Vaccine Task Force — the group tasked with advising the government on locking down doses for Canadians — says our lack of manufacturing ability is the result of the “hollowing out” of the biopharmaceutical industry in this country over the past 25 years.
While it’s too late to be ready for the first run of COVID-19 vaccines, there will be no excuse the next time Canada and the world face a pandemic.
And there will be a next time, stresses Alan Bernstein, who is also the president and CEO of CIFAR, a Canadian-based global research organization.
“We’ve let it slide,” said Bernstein. “It’s like PPE. It’s been just as easy, if I can put it that way, to buy vaccines off shore.”
“The problem has been that governments are driven by short-term needs … and, in the absence of COVID-19, there was no obvious, immediate need to have a national vaccine facility. We were getting all the vaccines we needed; everything was fine. Now, we know there’s a problem.
“And I think, ‘shame on us,’ if we don’t fix it right away.”
Trudeau was pressed on the country’s lack of domestic manufacturing capacity Wednesday by Conservative health critic Michelle Rempel Garner, who asked why Canada hadn’t tried to get licences to produce vaccines in this country. She has previously argued Trudeau lied about Canada’s ability to make vaccines, citing federal investments in facilities in Saskatchewan and Montreal, announced in the spring.
One of those was $44 million for upgrades to a National Research Council facility in Montreal that was initially expected to produce as many as 250,000 vaccine doses per month, though Trudeau said the facility is still under construction.
A few months later, the government committed $126 million to a separate Montreal facility that will eventually be able to produce as many as two million doses per month, but not until next year.
For context, Canada would eventually need somewhere in the neighbourhood of 70 million doses to vaccinate the whole country against COVID-19.
“In signing the contracts, yes, we looked at different ways of ensuring domestic production as much as we were able to, but that, unfortunately, is not something we can move forward on,” Trudeau said Wednesday.
He also argued that manufacturing capacity suffered most under Conservative governments, rattling off a list of facilities, run by AstraZeneca, Johnson & Johnson and Sanofi, among others, that had shuttered their Canadian operations under previous governments.
Bernstein said the weakening of the industry dates back years, and by the time the task force sat down to begin its work this spring, it was already too late to consider making the first COVID-19 vaccines here. Vaccine manufacturing facilities take a long time to build, even when you know what kind of vaccine you need to make, which, even last spring, was a mystery.
So, he said, the group took the problem into consideration and added manufacturing capacity to its list when it began talking to potential companies. “It was one of the criteria, you know. It wasn’t just that the science was great and looked promising. It was, is this vaccine going to be ready for this pandemic and not the next one?”
Based in part on task force advice, the Canadian government locked down agreements for seven different vaccine candidates, including one Canadian-made option from a company called Medicago. The Quebec-based biotechnology company has been given $173 million in federal money, not only for 76 million doses of its vaccine, should it prove successful, but to build a vaccine-production facility that is expected to come online in 2024.
The reason there is concern about who will get vaccines first, despite the fact that Canada has deals in hand, is that each agreement includes delivery windows, Bernstein said. Officials have previously said that vaccine doses will likely arrive in stages, and Canada’s first shipments are scheduled to arrive during the first few months of 2021.
Critically, the exact dates have not been decided. It’s not even really possible to decide those dates yet, he added, as much will depend on when vaccines are approved — each country will make the decision about whether to greenlight a vaccine for its own citizens.
But there will come a day when company officials are making decisions about where to send those first shipments. Bernstein said it makes sense that they’d give first dibs to the country that helped develop them. Sure, Canada is paying for the doses it has ordered — and in some cases has offered to pay more in order to be near the front of the line — but a lot of public money has also gone into these candidates.
Moderna is a U.S. company that did its human testing in partnership with the American National Institutes of Health, for example, while AstraZeneca is a British-Swedish multinational that is working with Oxford University, which gets public funding from the U.K.
“Just think if the Canadian government put money into Medicago, the vaccine was made in Canada and the first batches went to the United States. How would we feel about that? We would not be happy,” he said.
That said, government officials have said that deliveries will be staggered, so it’s likely not a matter of waiting until all of America is vaccinated before Canada gets a turn. American officials have said that doses could be available in the U.S. as early as December — assuming vaccines pass regulatory approval there — while Canadian officials have said we will see shots here in the first few months of the new year.
Manufacturing was always going to be an issue globally, says Andrew Casey, the head of BIOTECanada, a national association that represents Canada’s biotechnology sector.
The vaccines Canada is looking at alone represent four different platforms, or ways of making vaccines. They represent huge differences in technology and just because you can manufacture one, doesn’t mean you can make the others, he said.
“It’s like saying to Ford’s motor plant, ‘Why don’t you make Apple iPhones?’”
He noted two front-running vaccine candidates — from Moderna and Pfizer — use a brand new technology based on mRNA that a normal facility likely couldn’t manufacture anyway. Casey pointed to the Bill and Melinda Gates Foundation, which set out to build multiple vaccine-manufacturing facilities, not knowing which type of vaccine candidate would end up being successful. Those facilities still won’t be online for another year, he said.
Trudeau said the sites that Rempel Garner referenced can’t make mRNA vaccines and have a relatively small output. They may, however, be able to make other vaccines down the road, he said.
The question then, is how to avoid this next time.
“You know, I hate to say this, but there might be COVID-22. Who knows? I can’t predict the future. But I think what we can predict, for sure, is there will be another pandemic,” Bernstein said.
While he said it’s important Canada bolster the manufacturing capability for a future pandemic, it’s equally critical that this country support the brainpower that will invent it.
A lot of the new technology that’s being used for COVID-19 has roots in academia. For example, he said, one of the reasons the team from Oxford University was so fast out of the gate was it had access to a facility where it could make a small batch of experimental vaccines. Canada doesn’t have that, he said.
He said Canada needs a national facility that can adapt to new technologies and be used to train new experts in the field.
Still, Bernstein contends Canadians need to lose sleep over this.
“I still think the good news in all of this is that we’re worrying about whether we’re going to be first and or second or third to get a vaccine,” he said, and pauses.
“But we know we have a vaccine.”