With the third wave of the COVID-19 pandemic raging on, the demand for vaccine doses continues to outstrip Canada's relatively thin supply.
Canada's domestic vaccine manufacturing capability has been hollowed out, leaving the country entirely dependent on foreign sources for the doses that promise an eventual return to normal life.
When the pandemic began, Canada — unlike many other countries — lacked a facility that could be retooled easily to produce the viral vector COVID-19 vaccines from AstraZeneca or Johnson & Johnson, or the mRNA products offered by Pfizer and Moderna.
The nation's vaccination campaign has improved in recent weeks after a slow start marred by production delays and missed deliveries. Canada is now performing better than most other countries in the G20 but it's still being outpaced by at least two other countries: the United Kingdom and the United States.
An estimated 231 million vaccine doses have been administered so far in the U.S. and 37 per cent of the American adult population has been fully vaccinated with two doses. Among people over the age of 18, 54 per cent of Americans have had at least one dose.
In the U.K., more than 47 million doses have been deployed and 64 per cent of all Britons have had at least one dose.
Canada has fully vaccinated just three per cent of its population — a low figure explained in part by the long interval between shots — while 30 per cent have had at least one shot.
The two countries that easily outpaced Canada's vaccination effort have one thing in common: they have homegrown pharmaceutical companies that make their own products at domestic facilities — a bulwark against the vaccine nationalism that has disrupted global supply chains.
Canadians have noticed. CBC News has received hundreds of emails from readers about vaccine production in recent weeks.
"Why doesn't Canada have its own vaccine? Are we always to rely on the USA for everything?" Tim Williams asked in an email. "Why has Canada fallen short behind our allies and the rest of the world with research and innovation?"
"Why on earth do we not make our own vaccine for Canadians? Even the Russians and Chinese did it. This incompetency and low level IQ is killing me more than the virus," Meredith Rodney Mckay said in another email.
Here are some answers to the questions CBC News has received from viewers, listeners and readers.
Did we ever have large-scale vaccine manufacturing capacity in Canada?
Absolutely. Connaught Laboratories — founded in 1914 by Dr. John G. FitzGerald as the Anti-Toxin Laboratories at the University of Toronto — was at the forefront of global vaccine development for decades.
FitzGerald started his enterprise in a horse barn, using animals saved from the glue factory. There he churned out diphtheria treatments for the country's poor.
The laboratory grew dramatically during the First World War when it started producing a steady supply of low-cost tetanus shots for Canadian soldiers.
After Frederick Banting and Charles Best discovered insulin in 1921, Connaught offered lab space and funds to the Nobel Prize-winning researchers to continue their groundbreaking work. Connaught produced large quantities of insulin, a breakthrough treatment for diabetes.
Connaught also would be central to the worldwide effort to eradicate common childhood diseases like polio after the Second World War.
While the polio vaccine was discovered by American medical researcher Albert Sabin, Connaught was the first lab to safely produce it in bulk using techniques developed by Canadian researchers, according to Dr. Earl Brown, a professor emeritus at the University of Ottawa's school of medicine and an expert in virology and microbiology.
"This was the beginning of the heyday of vaccines," Brown said, adding that Connaught would also become a leading producer of the smallpox vaccine.
"They had a lot of successes and, as a result, infectious diseases were down so much. The war was declared won in the 1960s and the concern about vaccines waned," he told CBC News. "The market for vaccines was on the decline and it was never a very lucrative market to begin with."
Connaught was in a "financially weak position" when then-prime minister Pierre Trudeau nationalized the operation in the 1970s, Brown said.
As a Crown corporation, the lab was pushed to make a profit rather than focus on research and development efforts — and the enterprise was surpassed by other pharmaceutical companies with deeper pockets, Brown said.
"They lost their market share and then along came the Conservatives and they sold it off," he said.
The company, with its sprawling production facility in Toronto, was privatized by then-prime minister Brian Mulroney in the late 1980s.
While the sale was widely criticized at the time, the government said it would deliver a "net benefit" to Canadians. The French pharmaceutical giant now known as Sanofi controls what's left of Connaught.
Another major Canadian vaccine operation, Institut Armand Frappier, started at McGill University in Montreal. It produced the DPT vaccine for diphtheria, whooping cough and tetanus, a tuberculosis vaccine and penicillin.
After decades of success, that institute was also sold off in the 1990s to a company now known as GSK, which is based in the U.K.
Is there anything left of those companies?
Sanofi, one of the largest vaccine makers in the world, continues to operate the Connaught campus in Toronto, where it produces the diphtheria and tetanus vaccines. The Canadian operation also packages the polio vaccine using material from the company's French factories. Most of those shots are destined for countries abroad.
The facility couldn't easily be retooled now to tackle COVID-19, Brown said.
"They really don't have any culture of animal cell lines going here in Canada," he said of the material needed to make some of the COVID-19 vaccines.
And with so many of its current products on the World Health Organization's list of essential medicines, Sanofi couldn't retool the Toronto plant to focus on COVID-19 alone — not when its vaccines are needed to address other health concerns. (A recent $415-million federal investment will expand Sanofi's production capacity for future pandemics.)
"That's where we were when the pandemic struck. It's really too bad we lost our onshore vaccine production ability while we're the middle of a health crisis," Brown said.
GSK, commonly known as GlaxoSmithKline, is Canada's largest biopharmaceutical employer and maintains a production site in Laval, Que. According to the company, that plant supplies roughly 75 per cent of the country's influenza vaccine each year.
By an odd coincidence, the two companies with major operations in Canada, GSK and Sanofi, co-developed a COVID-19 vaccine product but announced a "delay" last year after it failed to produce sufficient results in clinical trials.
Canada approached some companies — notably AstraZeneca — asking them to make their products here. Brown said those companies likely rejected Canada's appeals because of the country's "dicey" pharmaceutical landscape.
He said federal health policy typically favours generic drug manufacturers, which make cheaper varieties of products that are no longer patent-protected. As a result, he added, research-intensive pharmaceutical companies are reluctant to invest in Canada.
Brown said Canada should have "nurtured the industry better than it did."
"There wasn't an urgency to deal with infectious diseases because it wasn't really a burden — until now," he said.
"The U.S. and the U.K. started at a much better point than us. They had many more vaccine facilities ready. They did have to retrofit some facilities but they were working from a much stronger base of technology."
So where does that leave us now?
To lessen Canada's dependence on foreign pharmaceutical production — "We never want to be caught short again," Prime Minister Justin Trudeau said last fall — the government has announced millions of dollars in new spending to build a new vaccine production plant at the National Research Council's Royalmount facility in Montreal.
When making the announcement in August, Trudeau said the NRC facility could produce 250,000 shots a month starting in November 2020 — but there have been construction delays due to the complexity involved in building this sort of site.
The NRC's failed partnership with China-based firm CanSino also disrupted Canadian efforts to produce a vaccine at this facility.
In February, the government announced a partnership with the Maryland-based company Novavax to produce its promising COVID-19 vaccine at this government-owned plant.
But the first Canadian-made Novavax vials won't be produced until the end of this year at the earliest — well after the point when every Canadian is supposed to be inoculated against COVID-19, according to the federal government's timeline.
A spokesperson for the National Research Council (NRC) told CBC News "construction for the biologics manufacturing centre, which is happening at an accelerated rate, is proceeding very well and is on schedule to be completed by end of July 2021."
"Novavax and the NRC are working closely together to prepare for the production of the vaccine … once the vaccine candidate and the facility and the production process itself receive the required Health Canada approvals," the spokesperson said.
While this facility will be useful if COVID-19 booster shots are required, Brown said, "it's an investment that we won't see the benefit of for a year-plus."
Novavax hasn't yet secured regulatory approval from any jurisdiction — but early clinical trial data suggest the company's shot is highly effective against COVID-19.
Health Canada regulators are reviewing that data on a rolling basis — a company can submit information as soon as it becomes available — and a final decision could be made as soon as this summer.
What about Medicago — is it producing a vaccine?
The federal government is spending $173 million to help Quebec City-based Medicago develop a COVID-19 vaccine and build a large plant to produce it.
The vaccine is now in the third and final stage of clinical trial testing. A relatively new player — the company has been privately held since 2013 — Medicago has partnered with GSK to help launch the product.
Unlike the other COVID-19 vaccines that have been authorized for use, Medicago's vaccine uses virus-like particles which mimic the structure of the coronavirus.
"Before launching a vaccine, it is essential to test its safety and efficacy during clinical trials," a spokesperson for the company said.
"While standard vaccine development timelines can take five to 20 years, we plan to submit a COVID-19 vaccine to health authorities for regulatory reviews in 2021."
ABOUT THE AUTHOR
John Paul (J.P.) Tasker is a reporter in the CBC's Parliamentary bureau in Ottawa. He can be reached at firstname.lastname@example.org.
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