Doctor explains why Canada is hedging its bets when it comes to coronavirus vaccine

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Canada has made deals with four different drug companies to procure a potential vaccine against COVID-19, but an infectious disease specialist says it’s still too early to know what bet will be worth it.U.S. biotech company Novavax announced Monday that it has negotiated an agreement with the federal government to produce 76 million doses of its potential coronavirus vaccine, if it gets approval from Health Canada. Later today, the government said it has entered into a separate deal with Johnson & Johnson for 38 million doses of its potential vaccine.

This is in addition to existing deals with Pfizer and Moderna – and there could be more in the works.

“We have several contracts in place with several suppliers because at this stage, no one knows which vaccine will succeed,” Minister of Public Services and Purchasing Anita Anand said on Monday.

Dr. Michael Gardam, infectious disease specialist at Women’s College Hospital in Toronto, spoke with As it happens guest host Helen Mann on what we do and don’t know about possible vaccines. Here is part of their conversation.

How optimistic do you think Canadians should be right now, knowing that our government has pre-ordered millions of [potential] COVID-19 vaccine doses from four different companies?

I think most people believe that a vaccine will be available within the next year. And, you know, the first evidence suggests that vaccines are likely to work.

What we don’t know, of course, is which vaccines will work. So we don’t know which company will ultimately have the best vaccine and also the safest vaccine.

And of course, we also don’t know: is that something you get once? Do you receive a reminder every year? These are all questions that will be answered.

But I think at these early stages I certainly think we should be reasonably optimistic.

Health Minister Patty Hajdu told reporters that a COVID-19 vaccine will be more effective if a large number of people get it. 1:00

Novavax is a Maryland-based biotechnology company that has never put a vaccine on the market. It is still in phase 2 of the vaccine trials with a fairly small sample. What is encouraging about this particular vaccine?

They have first encouraging results. It is a slightly more traditional vaccine. And I think, you know, like the minister said, they’re hedging their bets.

[The government is] looking at different types of vaccines from four different manufacturers, you know, three of which are very well known manufacturers. And they’re just kind of playing the rules of the game when it comes to businesses to make sure they have a reasonable chance of at least one of them being successful.

You say that the Novavax version is a fairly traditional vaccine. How does that compare to, say, the Moderna vaccine that the government has also placed an order with?

Some of these vaccines we’re talking about actually use genetic material from the virus. So basically you are injecting genetic material. It could be directly. This may be due to a viral vector. And then your body actually makes the proteins that your body will then react to, compared to more traditional vaccines, which actually give you the protein that your body will react to.

So these are all different strategies for vaccines, and those that yield the genetic material are relatively new strategies.

Canada had collaborated with a Chinese company. It was called CanSino, the cooperation. There have been promising reports of this vaccine with clinical trials supposed to take place here in Canada. This was dropped last week. Did we lose a big player there?

It’s hard to know. I don’t know the inner workings of why they made this particular decision.

There are reports that the Chinese government has refused to ship this vaccine to Canada. I’m just wondering if there are any concerns about political tensions between China and Canada that play a role in this?

Honestly, I think the political tensions between Canada and several other countries should be of concern. I mean, we’ve seen this before in pandemics. And we even have, in our Canadian pandemic plan, the idea that we should have local national manufacturers, we should have local stocks for that exact reason.

When you encounter a global emergency, collaboration between countries can often be overlooked, and it’s a bit of every man for himself. And we’ve certainly seen that in the United States, for example, where they’ve been trying to corner the market with various antiviral drugs and, you know, probably also with vaccines made in the United States.

At this moment we see [U.S.] President [Donald] Trump started this thing called Operation Warp Speed ​​some time ago. And we saw how protectionist he was, making Americans his first motto. Should Canada take a similar approach, a more aggressive internal response?

I just think you have to make sure that your Canadian supply – whether it’s personal protective equipment, whether it’s a vaccine, whatever – that your supply is secure.

But I don’t want us to turn our backs on the rest of the world either. Because Canada, I mean, is still a very rich country, and we still have … a lot of help that we could potentially give to other countries that are less fortunate than us.

It has become kind of a joke that we are all amateur epidemiologists looking for little clues as to what might happen. But given your expertise, what are you looking for as clinical trials progress?

What we are looking for is a very clear benefit from being vaccinated in terms of the risk of infection, [and] your risk of serious illness is significantly reduced with the vaccine compared to the placebo.

And then what we want to see, of course, is that it’s safe. You want to know that after this phase 3 trial you gave it to tens of thousands of people and that there are no significant side effects beyond arm pain and the like thing.

We don’t have that information yet. And yet, that’s why I’m sort of saying I’m cautiously optimistic. We still have a way to go until we have a vaccine that has been shown to be safe, manufactured and then distributed to Canadians.

The other thing, of course, is the fear of betting on the wrong horse or the wrong horses and running out of the COVID-19 vaccine. Is this a legitimate concern?

Betting on multiple horses is a very smart strategy. I would be very worried if we only had one vaccine to line up behind. Obviously, you can’t bet on 100 different vaccines. So you have to draw the line somewhere.

It is difficult to know in advance if four is enough. It is reasonable to expect that at least, you know, one or more of these vaccines will be successful. So I think that’s reasonable coverage.

If it turns out that in a year none of this is working, then Canada will have completely dropped the ball. If all four of them turn out to be working, then we’ll look like geniuses, right?

Then there’s the whole deployment and making sure that we all get that vaccine, or that the people who need it get it first. Do you have any concerns or advice on how to do this in the most efficient way?

One of the challenges with vaccination strategies and emergencies like this is that it is not enough to have the vaccine. You actually have to pass it on to people. And we certainly saw in 2009 with the H1N1 pandemic that, you know, there were long lines, there was confusion where people could catch it, et cetera.

So I think a lot of planning early on to make sure that people can get this in as many different places as humanly possible would be very, very helpful.


Written by Sheena Goodyear with files from CBC News. Interview conducted by Jeanne Armstrong. The questions and answers have been edited for length and clarity.

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