Light at the end of the tunnel

This week's news that early results from Pfizer's coronavirus vaccine trial show that it may be upwards of 90 per cent effective offered a faint glimmer of hope that an end to this dreadful pandemic may finally be in sight. While we are cautiously optimistic, we must not ignore the enormous challenges that lie ahead. And whether our federal and provincial governments are up to the task is very much an open question.

First, it must be noted that Pfizer's results are still preliminary and the company has yet to make its data public. It may end up being less effective than the initial trial suggests, and we don't know how long immunity will last. But given that over 50 vaccine candidates are currently being tested, with a dozen in Phase 3 trials, it's safe to assume that some of them will prove safe and effective.

If the Pfizer vaccine does pan out, it's possible that it could hit the market as early as next spring. But even then, it will be a massive challenge to produce enough doses to meet global demand.

Canada has signed an agreement to purchase 20 million doses from the pharmaceutical giant, with an option to acquire 56 million more. How long it will take for those supplies to start arriving at our borders, and for Health Canada to approve it, is anyone's guess. Given that we were late to the game to sign contracts and Dr. Anthony Fauci, America's top infectious disease expert, is saying that the average American should have access to the vaccine by April, it's safe to assume we won't be at the front of the line.

Given that Canada has signed agreements with numerous companies currently developing vaccines, the best- case scenario would see more than one of them receiving approval around the same time so all our eggs won't be in one basket (there is much hope that AstraZeneca will also be able to bring its vaccine to market in fairly short order).

Procurement Minister Anita Anand said on Tuesday that the federal government is expecting the first shipments to arrive “in the first part of 2021.” Yet even then, getting the vaccine into the arms of Canadians is going to be a challenge.

The first question will be who is first in line to receive it. While the obvious answer is “front-line health-care workers and at-risk populations such as seniors,” much depends on how many doses we have access to (supplies will be extremely limited at first) and who the vaccine proves to be most effective for. Despite the National Advisory Committee on Immunization publishing its recommendations for which groups should be prioritized, there are still no clear answers.

The next challenge will be delivering the vaccine to Canadians, which will be a logistical nightmare. The Pfizer vaccine must be stored at extremely cold temperatures, around -70 C, while commercial freezers generally go down to only -15 C.

This means that specialized equipment is going to be needed along every step of the distribution chain — from cargo planes, to trucks, to vaccination clinics — which will limit the number of locations where the drug can be administered. This is going to be especially challenging in remote communities, which lack the necessary medical, transportation and storage infrastructure.

The federal government is well aware of these issues and is currently soliciting bids from shippers, couriers and companies that specialize in moving temperature-controlled goods. But it is concerning that the government does not have an official plan for rolling out a vaccine, or at least has not made one public, as the U.S. Centers for Disease Control and the World Health Organization did months ago.

It also has a lot of work to do if it hopes to convince Canadians that a vaccine will ultimately be safe — according to the federal government's own survey, only 61 per cent of Canadians say they will take a vaccine once it becomes available.

To see how badly governments can screw these things up even with substantial lead time, look no further than Ontario's bungled flu vaccination campaign.

The government knew for months that there would be higher demand this flu season. In September, it said it was implementing “the largest flu immunization campaign in Ontario's history.” Yet pharmacies ran out within weeks. Rexall was forced to temporarily pause its vaccination program, just as it was supposed to get underway.

Unfortunately, this pattern of governments playing catch-up in order to respond to events that were entirely predictable months in advance, or dragging their feet on implementing measures that have proven successful in the past, has become all too familiar. Just look at how long it took the federal government to admit that masks are an effective infection-control measure, or that closing our borders can slow the spread of the virus.

The vaccination program will be the final test of how well our governments, and the Canadian people, can come together to stage a final offensive against this virus. If our governments don't come up with a rock-solid plan for acquiring, distributing and administering vaccines, and Canadians don't accept that mass adoption of a vaccine is our best hope of beating this thing, then we could be dealing with COVID-19 for years to come.

In other words, if we don't stick the landing on this one, we will have no one to blame but ourselves.

GETTING THE VACCINE INTO THE ARMS OF CANADIANS IS GOING TO BE A CHALLENGE.