Health Committee on Feb. 19th, 2021

[Dr. Guillaume Poliquin]

With respect to the protection afforded by these vaccines, it's important to put the effect of neutralization antibodies into the broader context. With respect to the degree of neutralization that's elicited, it is one of the proxy measures for efficacy, but a particular threshold has not yet been determined on a global level of what is considered to be truly protective.

At this point, we note that the reduction in neutralization titers is notable, but it remains high and therefore we will need to continue to monitor the impact of this through ongoing clinical evaluation.

[Don Davies, NDP, Vancouver Kingsway, BC]

AstraZeneca has said it expects to have a new version of its COVID-19 vaccine ready for use for mid or late 2021 to respond to concerns about emerging variants that may be more transmissible or resistant to existing vaccines.

Will Canada have access to this updated vaccine under the terms of our existing bilateral supply agreement with AstraZeneca?

[Dr. Roman Szumski]

Mr. Chair, that would not be covered under the current agreements and would be covered by new negotiations.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

We know that about 130 countries have not received a single dose of vaccine to date. Do we have any concern that that lack of vaccination will make the emergence of vaccine-resistant variants more likely?

[Dr. Guillaume Poliquin]

The interplay of vaccines and the emergence of variants is a complex question that we are monitoring. We will note that the emergence of variants of concern began before vaccine rollout programs occurred with the first notable one being in August 2020 with D614G. Therefore, as we continue to move forward, we must be ready and continue to invest in our ability to rapidly detect and understand the variants of concern, which is why we are investing $53 million in the integrated variants of concern strategy.

[Don Davies, NDP, Vancouver Kingsway, BC]

I'm not sure that I have a—

[The Chair, Liberal, Ron McKinnon]

Thank you, Mr. Davies. You've had three minutes already.

We'll start round three now. We'll start with Mr. Brassard for five minutes, please.

[John Brassard, Conservative, Barrie—Innisfil, ON]

Mr. Chair, I'm going to be splitting my time with Mr. Maguire.

I have quick questions here. For months now, Canadians have been hearing about two doses, so I want an answer to this question. On the one-dose decision, did that come from PHAC or NACI, or was that a political direction?

[Kimberly Elmslie]

If I may, Mr. Chair, there has not been a one-dose decision in the sense that NACI has provided its advice on the dose schedule for Pfizer and Moderna, and its current advice says that the dose interval should be no more than 42 days.

As Dr. Quach said, NACI is now receiving evidence and research findings from Quebec, from the U.K. and other countries—

[John Brassard, Conservative, Barrie—Innisfil, ON]

We've actually heard, Ms. Elmslie, that one dose could work. In fact, Dr. Njoo said it could work as well. Where's this direction coming from? Is PHAC giving this direction?

[Kimberly Elmslie]

In the context of one dose could work, that's different from saying it would work.

We do have preliminary evidence to say that there is high efficacy following one dose, but we need more data to understand the durability of that effectiveness and whether or not it wanes. So that's why the discussion around the dose interval remains very alive in the scientific community, and that's why NACI will be looking at that again next week at their meeting.

[John Brassard, Conservative, Barrie—Innisfil, ON]

Okay. How does one dose affect the variant, then, in the data that you've received so far? Have you received any data at all?

[Kimberly Elmslie]

I'm just trying to think about whether we've received data on the effect of the variant from the one dose. I'd have to check on that and get back to you. I don't want to misspeak.

[John Brassard, Conservative, Barrie—Innisfil, ON]

You're not misspeaking. This is evidence that's been provided publicly. There have been lots of discussions about one dose being effective in this case. Either PHAC is pushing this narrative, or it's coming from somebody else. I'm surprised actually that you don't know where it's coming from.

I'm going to pass this over to Mr. Maguire right now.

Thank you.

[Larry Maguire, Conservative, Brandon—Souris, MB]

Yes, I'm just wondering. We need to know more, I guess, about the one dose, as 82% of the deaths have been coming out of long-term care homes. Will people in those homes be getting a booster in this area this fall before the first dose of vaccines has even been delivered to the general public?

Will someone answer that?

[Kimberly Elmslie]

I would say that these remain open questions. As public health professionals, we are looking carefully at the science and trying to understand what the impact of variants will be. We need more data from countries that are doing research in this area. Those data are starting to come to us, and we're analyzing those carefully. That's the way, of course, that we consistently provide our advice, based on those data. At this point we're waiting for more data on the—

[Larry Maguire, Conservative, Brandon—Souris, MB]

Is that data on seniors alone or is it on all age groups? I believe the briefing was talking about all age groups.

How soon would Johnson & Johnson and AstraZeneca be okayed here in Canada?

[Kimberly Elmslie]

The latter question is a regulatory question, which belongs to our colleagues at Health Canada.

As for the former question, on age groups, it depends on the population being studied, but we do have data from older age groups.

[Larry Maguire, Conservative, Brandon—Souris, MB]

You don't have any from younger groups, from middle-aged people?

[Kimberly Elmslie]

It crosses the spectrum of ages, and that's what we'll see and what NACI will see next week as it receives further follow-up data on these populations.

[Larry Maguire, Conservative, Brandon—Souris, MB]

Pardon me, because of time, can someone answer the other part of the question, on Johnson & Johnson or AstraZeneca?

[Kimberly Elmslie]

Was that a question on timing?

[Larry Maguire, Conservative, Brandon—Souris, MB]

Yes. It came up that they weren't going to be even authorized in the United States until mid-March. Is that true? If that's the case, where are we at in Canada with them? That's only three weeks away.

[Kimberly Elmslie]

Yes, and so that is a question for the regulatory authority at Health Canada.

[Larry Maguire, Conservative, Brandon—Souris, MB]

Is there anyone who can tackle that?