As It Happens·Q&A

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

Canada has struck deals with four drug companies to procure a potential COVID-19 vaccine, but an infectious diseases specialist says it's still too early to know what bet will be worth taking.

Dr. Michael Gardam says the government's strategy of striking deals with multiple drug companies is wise

Dr. Michael Gardam, an infectious disease physician, is medical director of infection prevention and control at Women's College Hospital. (Craig Chivers/CBC)


Canada has struck deals with four different drug companies to procure a potential COVID-19 vaccine, but an infectious diseases specialist says it's still too early to know what bet will be worth taking.

U.S. biotech firm Novavax announced Monday it has negotiated an agreement with the federal government to produce 76 million doses of its potential coronavirus vaccine, should it get Health Canada approval. Later in the day, the government said it struck a separate deal with Johnson & Johnson for 38 million doses of its potential vaccine.

This comes on top of existing deals with Pfizer and Moderna — and there could more in the works. 

"We have multiple contracts in place with multiple suppliers because at this stage, no one knows which vaccine is going to be successful," Public Services and Procurement Minister Anita Anand told reporters on Monday.

Dr. Michael Gardam, an infectious disease specialist at Women's College Hospital in Toronto, spoke to As It Happens guest host Helen Mann about what we do and don't know about the possible vaccines. Here is part of their conversation.

How hopeful 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 there will be a vaccine available within the next year. And, you know, the early evidence suggests that vaccines are likely to be effective.

What we don't know, of course, is which vaccines are going to be effective. So we don't know which company ultimately is going to have the best vaccine and also the safest vaccine.

And of course, we also don't know: is this something you get once? Do you get a booster every year? Those are all questions that will be answered.

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

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Novavax is a Maryland-based biotech company which has never brought a vaccine to market. It's still in Phase 2 of vaccine trials with a pretty small sample size. What's encouraging about that particular vaccine?

They do have some encouraging early results. It is a slightly more traditional vaccine. And I think that, you know, as 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 field in terms of the companies to make sure that they've got a reasonable chance that at least one of these is going to be successful.

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

Some of these vaccines that we're talking about are actually using genetic material from the virus. So basically, you're injecting genetic material. It could be directly. It could be through a virus vector. And then your body is actually producing the proteins that your body is then going to react to, versus more traditional vaccines, which are actually giving you the protein that your body is going to react to.

So these are all different strategies for vaccines, and the ones giving the genetic material are relatively new strategies.

Canada had been collaborating with a Chinese company. It was called CanSino, the co-operation. There were promising reports about that vaccine with the clinical trials supposed to be happening here in Canada. That was abandoned last week. Did we lose out on a big player there?

It's hard to know. I don't know the inner workings as to why they made that particular decision.

There were reports the Chinese government refused to ship that vaccine to Canada. I'm just wondering if there's concerns about political tension between China and Canada playing a role in this?

Honestly, I think there should be concerns about political tensions between Canada and multiple other countries. I mean, we've seen this previously in pandemics. And we even have, in our Canadian pandemic plan, the idea that we should have local domestic manufacturers, we should have local stockpiles for that exact reason.

When you get a global emergency, collaboration between countries can often fall by the wayside, and it's kind of every man for themselves. And we've certainly seen that in the United States, for example, where they've tried to corner the market on various antiviral drugs and, you know, presumably possibly with U.S.-manufactured vaccines as well.


Right now, we see [U.S.] President [Donald] Trump has launched this thing called Operation Warp Speed some time ago. And we've seen how protectionist he has been, putting Americans first being his motto. Should Canada be taking a similar approach, a more aggressive internal response?

I just think you have to make sure that your Canadian supply — be it personal protective equipment, be it a vaccine, whatever — that your supply is secure.

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

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

What we're looking for is a very clear benefit to being vaccinated in terms of your risk of infection, [and] your risk of serious disease is dramatically reduced with the vaccine versus placebo.

And then what we want to see, of course, is that it's safe. You want to know that after that Phase 3 trial, that you've given it to tens of thousands of people and there are no significant side-effects beyond a sore arm and that sort of thing.

We don't have that information yet. And still, it's why I sort of say that I'm cautiously optimistic. We still have a ways to go until we actually have a vaccine that's proven safe, manufactured and then given out to Canadians.

The other thing, of course, is the concern that we might be betting on the wrong horse or the wrong horses and be left with no COVID-19 vaccine. Is that a legitimate concern?

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

It's hard to know ahead of time whether four is enough. There's reasonable expectation that at least, you know, one or more of these vaccines is going to be successful. So I think it's a reasonable hedge.

If it turns out a year from now, none of these work, then Canada will have completely dropped the ball. If it turns out that all four of them work, then we'll look like geniuses, right?

Then there's the whole rollout and making sure that all of us get that vaccine, or the people who need it first get it. Do you have concerns or advice about how that could be done in the most efficient way possible?

That's one of the challenges with vaccination strategies and emergencies like this, is that it's not enough to just have the vaccine. You actually have to get it to people. And we certainly saw in 2009 with the H1N1 pandemic that, you know, there were long lineups, there was confusion where people could get 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 produced by Jeanne Armstrong. Q&A has been edited for length and clarity.

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