Canada’s COVID-19 vaccination program is sputtering. Significant delays to both Pfizer’s and Moderna’s vaccine shipments have governments at all levels scrambling to meet needs and have forced the cancellation of second-dose appointments for numerous physicians and frontline healthcare workers.
Political tensions also have flared in the European Union, with Germany formally demanding the monitoring of vaccine exports manufactured in Europe as AstraZeneca fails to deliver on its production targets. The United States, our closest trading partner, continues to insist on a U.S.-first vaccination plan, blocking exports of Pfizer/Moderna vaccines across the border.
Moreover, our federal government continues to heavily market its diversified vaccine portfolio, bought for well over $1 billion after the failure of the CanSino vaccine and the delayed domestic testing and manufacturing of a vaccine candidate.
Meanwhile, Astra-Zeneca’s vaccine trials are facing serious questions after being rejected by Swiss regulators, the Novavax vaccine has been found to be less than 50 per cent effective against the South African variant, Janssen’s vaccine is about 66 per cent effective, and other major manufacturers such as Merck and Sanofi have either delayed or suspended their own programs. Even Ottawa’s announcement that the National Research Council (NRC) facility will produce the Novavax’s vaccine has a catch: it will be ready by 2022.
And to our embarrassment, Canada is the only G7 country to dip into the COVAX vaccine fund dedicated for developing countries.
As the virus continues to mutate, several strategies have been suggested to ensure that the vaccines remain effective against emerging variants. Moderna recently announced that it could add a booster for the South African variant within six weeks. British researchers have launched a trial involving vaccine cocktails, combining Pfizer and AstraZeneca’s vaccines, to improve effectiveness against the new variants.
The emergence of such efforts indicates that the future may require us to quickly secure modifiable vaccines, likely in the form of mRNA vaccines. The U.K. has taken such a step with its CureVac partnership that will rapidly create new vaccine boosters based on aggressive genomic sequencing of COVID-19 variants.
Meanwhile, in Canada we are mollified by our “contractual guarantees” for 6 million doses of the vaccine by the end of March, assured by our European partners that they will not delay exports of the Pfizer/BioNTech vaccines. Of course, no one knows the terms of those contracts or much else.
All of this begs simple questions: What is our Plan B if future disruptions arise this year? Are we going to continue to wait, allowing community spread, more variants and more deaths? Why are we not considering retooling and scaling our existing manufacturing facilities to get us mRNA vaccines, which are highly effective?
Some have argued that this is easier said than done. There is hyper-specialized technical know-how in each step and the rate-limiting step is the manufacture of lipid nanoparticles that ensconce the mRNA. As always, here lies another missed opportunity: a Canadian company, Acuitas Therapeutics, is one of the few companies in the world credited for developing lipid nanoparticle technology. Given that only a handful of companies are capable of developing this sophisticated technology, we certainly could have leveraged this to produce a share of our vaccines at home. Instead, Acuitas Therapeutics produces the lipid nanoparticles in Pfizer/BioNTech’s U.S. and European plants.
There are labs across the country such as Alberta’s Providence Therapeutics and Northern RNA that could produce small-scale batch production of an mRNA based vaccine. In fact, Providence recently signed a deal with the government of Manitoba to supply 2 million doses of a made-in-Canada mRNA vaccine by the end of the year. While this is certainly promising, similar efforts need to be scaled on a national level.
Ottawa has very recently and belatedly made small investments into the clinical testing of domestic mRNA vaccine candidates, such as with a $25.1 million investment into Precision Nanosystems. However, similar to the NRC facility, it will not be ready for production before 2023.
Altogether, it seems that Canada does indeed have the know-how and necessary capacity to at least produce mRNA vaccines on a small-scale basis, so why are we betting on uncertainty? This question is particularly significant since small-scale production could be employed, on a short-term basis, to vaccinate our frontline medical workers or long-term care residents until Pfizer’s vaccines come through or in case there are further supply disruptions.
Given that Moderna has already declared that it will not enforce its COVID-19 vaccine patent rights during the pandemic and that Sanofi has publicly agreed to dedicate its Frankfurt facility to produce 100 million more Pfizer doses for the EU by the end of the current year, Canada could build on our own existing vaccine manufacturing capabilities to make these same mRNA vaccines.
Vaccines are an important tool in the fight against the pandemic and their supply chains must be resilient. We have learnt this the hard way with the shortages of personal protective equipment and critical drugs, hampered by overseas production disruptions and politically motivated export restrictions.
Vaccine nationalism is a serious threat to our rollout. Canada must drive domestic mRNA vaccine production and make the best use of our advanced biotech capabilities to protect us in the short-term in cases of delays and disruptions and in the long-term by regaining our control over the production of our most essential therapeutic in the struggle against COVID-19.