Health Committee on March 11th, 2021

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

Sure. I have very limited time. I have only a minute and a half left.

[Dr. Marc Berthiaume]

Okay. Sorry.

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

You can table that with committee if you'd like, although none of your colleagues tend to do that on a regular basis.

With the minute that I have left, you and other officials from the federal government have said that it's a province's decision what advice it takes, essentially. Are you not concerned that a balkanization of vaccine recommendations across Canada would potentially lead to vaccine hesitancy or to people age 65 and older holding off getting vaccinated given the lack of clarity and advice from the government?

[Dr. Marc Berthiaume]

I think that's a question for my PHAC colleagues.

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

Go ahead.

[Kimberly Elmslie]

Thank you very much. Maybe I'll start on that one.

In the context of the vaccine strategy and the need to ensure there is a diverse strategy and availability of vaccines across the country, what's important is that we're getting vaccines to the provinces and territories and they're getting effective vaccines into the arms of Canadians.

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

Are you concerned at all about vaccine hesitancy due to the confusion in advice?

[Kimberly Elmslie]

We have been providing clear advice to Canadians through the work with the provinces and the territories. We'll continue to do that.

[Michelle Rempel, Conservative, Calgary Nose Hill, AB]

I would say you are not. By what stretch does conflicting advice mean clarity?

[Kimberly Elmslie]

There will be advice that changes over time. That is exactly what is happening as science becomes clearer and as more studies are reading out their results. We can expect to see changes in advice.

It's really important to continue to provide as much information as clearly as we can, recognize that it will change, and inform the public that things will change as evidence changes.

[The Chair, Liberal, Ron McKinnon]

Thank you, Ms. Rempel Garner.

We'll go now to Ms. Sidhu for six minutes.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you to all the witnesses for joining us today. I know that all of you have been working very hard for all Canadians. Thank you very much for that.

Mr. Chair, by the end of the month we'll have 8.5 million doses of COVID vaccines. By July we will have 36.5 million vaccine doses. This does not even include the one from Johnson & Johnson.

My first question is for Dr. Quach. A lot of Canadians are listening, and some data presented by the experts may be complex to understand. In simple terms, based on all the data you have considered, how effective is AstraZeneca?

[Dr. Caroline Quach-Thanh]

In terms of efficacy, it is 60% efficacious for 18 to 64 and approximately 40% efficacious for the older population. However, when you look at effectiveness, it seems to have a 70% to 80% effectiveness in preventing hospitalizations and death, which is comparable to the other vaccines.

These are real-world data, which are not of the same high-standard quality as what we usually see in randomized control trials, but they are the data that we will have moving forward with the rollout of the vaccines. That's what we are also looking at.

In terms of preventing complications, it's good.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you.

Dr. Quach, for the sake of clarity, do you think that Canadians should choose to wait for a specific vaccine, or should they take the first one that is offered to them?

[Dr. Caroline Quach-Thanh]

At this point in time, I think that you take whatever is offered to you, because the risk of catching the infection is now, while the transmission in the community is high. If you wait until June or July, when your turn comes for the mRNA vaccine for instance, you're still at risk of infection until then.

Our hope is that the Canadians who are most vulnerable to infections and complications will be able to get vaccinated as quickly as possible.

[Sonia Sidhu, Liberal, Brampton South, ON]

Dr. Berthiaume, can you tell us about the data that Health Canada considers when it makes recommendations for who is eligible for a vaccine? Obviously, you examined the clinical data that came in on a rolling basis. Do you take information from any other sources?

[Dr. Marc Berthiaume]

When we examine a submission, like for the AstraZeneca vaccine, we evaluate based on the data provided by the sponsor. For this specific submission, the sponsor provided the data from four clinical trials, two of which were more important in terms of the analysis. They also provided the real-world data from Scotland as part of the evidence to consider for the approval of their vaccine.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you.

As we know, NACI recently advised that the second dose could be effectively administered with longer gaps. For any of the witnesses, does extending the COVID-19 vaccination have particular concerns for any particular population or group?

[Dr. Caroline Quach-Thanh]

In terms of the extended interval, the most vulnerable in long-term care facilities, for example, are probably the group we wouldn't be extending. The reason NACI didn't put that out explicitly was that when we spoke to our counterparts, the provinces and territories all said that most of their population was already vaccinated.

However, when we look at data provided by Quebec, B.C. and the U.K., we see that even in those very fragile populations we still have a vaccine effectiveness above 80% up to eight weeks, which does not seem to be declining over time. That was one of the bases on which that recommendation was made.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you.

With all that being said, do you think the recommendations that we have discussed will put any Canadians at risk?

[Dr. Caroline Quach-Thanh]

I think what you really have to look at is the risk-benefit, as we were saying. What we are aiming for is to get as many Canadians vaccinated with the first dose, with an overall effectiveness of approximately 80%, which then can help control the pandemic and decrease the impact of variants on that transmission.

Of course, if we had plenty of vaccines and we were able to give the vaccine quickly, we would not be trying to extend that interval. I think this interval is also of limited duration. It doesn't mean that all Canadians are going to have their two doses at a four-month interval. It means that now, to be able to use up the vaccines we're getting, which are still in limited supply, we are hoping that the first dose is given to as many people as possible, and when the bulk of the rest of the vaccines come in, at that point we can shorten the interval closer to six weeks or so.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you.

Mr. Chair, do I have more time?

[The Chair, Liberal, Ron McKinnon]

You have 40 seconds.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

Can I make a point of clarification? Isn't that a procedural thing you can do? There's something the witness said...or am I totally wrong? Dr. Quach-Thanh, I think it's really important—

[An hon. member]

Mr. Chair, point of order. He can't come in here—