In Canada, after any vaccine—not only the Merck vaccine, but any vaccine—has been approved and has passed the tests of safety and efficacy, there's a national body called the National Advisory Committee on Immunization, composed of specialists and representatives from every single province in Canada, which recommends that the vaccine be utilized for public programs.
After that, it is up to each of the provinces to decide for themselves. However, as I was explaining earlier, the federal government must show some leadership when it comes to public health, given that the programs are not being implemented soon enough or in a timely manner.