Evidence of meeting #44 for Health in the 43rd Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was doses.
A recording is available from Parliament.
Bloc
Sébastien Lemire Bloc Abitibi—Témiscamingue, QC
I will end with this question. Are you afraid of the danger of the “covidization” of scientific research? By this I mean that all investments are devoted to the same issue, to the detriment of funding in other areas.
Professor, Canadian Association for Neuroscience
Absolutely. COVID is not a thing of the past. It is still here, and it's going to be here with us for many years. However, we do not know what the next thing is going to be, what the next crisis is going to be. It might be a virus. It might not be a virus. We have no idea where it's going to come from.
The fact is that every single thing that we have been able to do—we've been able to catch the viruses, etc., all the different global issues—is because of fundamental research. We have no idea where breakthroughs are going to come from.
The biggest breakthrough, I believe, is CRISPR technology, which started off studying bacteria. With CRISPR technology, we now possibly have the ability to treat many genetic diseases, and it will be coming up fairly soon, I hope.
Liberal
The Chair Liberal Ron McKinnon
We go now to Mr. Davies.
Mr. Davies, go ahead, please, for six minutes.
Don Davies NDP Vancouver Kingsway, BC
Thank you.
Dr. Kalyan, having watched the last year and a half, Canada rolling out our vaccine production and procurement and delivery strategy, what are your main take-aways for us?
Adjunct Professor of Medicine, University of British Columbia and Vice-President, Scientific Innovation, Qu Biologics, As an Individual
The COVID-19 pandemic has provided an important opportunity to identify and rectify our deficiencies in having a cogent plan to deal with emerging infectious threats that takes into account not only the short immunological health of Canadians but also the long-term health. This is a nice segue from what Dr. Shernaz Bamji was speaking about.
My first wish for the immediate response would be to immediately diversify our portfolio of the types of vaccines we have in Canada, specifically procuring or acquiring in some way whole inactivated vaccines. As I mentioned, one was just authorized by the World Health Organization for emergency use.
Another, which I particularly favour due to its formulation, is in development by Valneva and the U.K. National Institute for Health, for example. They're in phase three development. They've been looking at Canada for a potential phase three trial site, and I'm hoping we would take advantage of that. [Technical difficulty—Editor] inactivated vaccines would be better booster shots for people who have already had COVID-19 and recovered, because they would be able to retain that more fulsome memory.
Secondly, we need to ensure we have capabilities to develop a vaccine of our own preferred design in Canada. We have no GMP facility here at this moment, and this is not new. We've heard a lot about this. India, China and Kazakhstan have their own facilities, and they've all developed inactivated vaccines for their populations. Not having this capacity and expertise has left us vulnerable and potentially at the whim of external interests, which are I think what we're beholden to at this time.
Thirdly, we need to ensure we have a more diverse expertise to advise on vaccine development and/or procurement, which includes a deeper understanding of the immune system and what constitutes immune competency to a given pathogen.
Lastly, I would say we need to make it a policy for drugs, particularly vaccines and immunotherapy that are approved in Canada, to include sex-based dosing analysis for both safety and efficacy.
NDP
Don Davies NDP Vancouver Kingsway, BC
What specifically are these unknown concerns with the new gene delivery platform vaccines that we are using?
Adjunct Professor of Medicine, University of British Columbia and Vice-President, Scientific Innovation, Qu Biologics, As an Individual
What we don't know is what we don't know. For me, one of the biggest black holes is that we have no clear biodistribution or in-situ expression data for these gene delivery vectors, meaning we don't know where these go and where they're being expressed.
As an immunologist, it's still unclear to me how these expressed proteins are presented to the immune system. Typically our immune system relies on a danger signal, or what we call pathogen-associated molecular patterns or PAMPs. This helps us to differentiate cell from non-cell and what's dangerous from not dangerous, to launch an appropriate type of immune response. Antiviral immunity is different from antifungal immunity, which is different from antiparasitic. These strategies are different.
In respect, for example, to the lead mRNA vaccine candidates we have, I don't see where that instructive information is contained for the immune system to know what exactly it's supposed to be fighting. It's like eliciting an answer without knowing what the question is. The long-term consequences of this immune ambivalence I think are yet to be determined.
Lastly, in terms of the DNA vector vaccines, we have not evaluated and we should—so I would add that to my wish list—the antibody and the immune response to the adenovirus vector itself, the thing carrying the message. Presumably we'd be generating a pretty strong response to the vector, which theoretically means that each subsequent booster shot would elicit a lower immune response to the message, because the messenger is being wiped before it delivers it.
We have not asked for any of this more detailed nuance. We could be giving booster shots eventually, by the third time, and they're just blanks for our immune system. We're not launching sufficient immune response to the spike protein that is being encoded in the message there.
NDP
Don Davies NDP Vancouver Kingsway, BC
I'm going to throw two questions in here.
First, why do you prefer the live attenuated vaccines for children, and second, I mentioned women.
I think women are generally not considered in our male-dominated health care system. We know that women bear the brunt of experiencing more severe adverse events related to vaccination. You commented on that. We know that women have twice as many antibodies as men and we know that they have increased susceptibility to autoimmune diseases, yet we're giving the exact same medication, the exact same dose, to children and women.
What's your position on that?
Adjunct Professor of Medicine, University of British Columbia and Vice-President, Scientific Innovation, Qu Biologics, As an Individual
I'll take the easier question first.
For the live attenuated vaccines, they engage and train all parts of the immune system so it acts as one. That includes training the innate immune system, which also has that type of memory that's contained at the epigenetic level, and mobilizing the awareness of the adaptive immune system to respond appropriately to a given type of pathogen. Multiple studies have shown that this type of training provided by live attenuated vaccines protects kids not only against specific pathogens that are a target of the vaccine, but they also provide a more broad range of protection against immune pathologies.
For example, the BCG vaccine, which is a really old-school live attenuated vaccine, is now being tested for the treatment of type 1 diabetes. Young immune systems require this education and exercise, if you will, to function properly, just like other complex systems such as muscles, bones and language acquisition.
In respect to women, this is not new. It has been forever. I think a large part is that drug development doesn't want to make anything more complicated than necessary, and looking at sex-based differences has been ignored across the board. However, I think when it comes to the immune system, given the profound difference, it is unfortunate that we continue to just have a regression to the mean, essentially. That is what we do, and women tend to bear the brunt for things like vaccination. We really should be looking for more sex-based analysis in terms of dosing and safety.
Liberal
The Chair Liberal Ron McKinnon
Thank you, Dr. Kalyan.
Thank you, Mr. Davies.
That wraps up our round of questions. I think we can try to squeeze in another quick round with maybe two minutes per party, if we're all very disciplined.
We'll go, I believe, to Ms. Rempel Garner or Mr. Barlow.
Conservative
John Barlow Conservative Foothills, AB
Thank you very much, Mr. Chair.
Quickly, this question is to Ms. Paish.
You were talking about inconsistency between land and air borders.
Did the panel take a look at the Alberta pilot project, which was on initially during COVID, where they were using rapid testing at the airports and the land border? There were very strong results from that, very positive results. Did the panel look at that as an option, comparing that to the hotel quarantine?
Panel Co-Chair and Chief Executive Officer of the Digital Supercluster, COVID-19 Testing and Screening Expert Advisory Panel
Thank you, Mr. Barlow.
Yes, we did. We looked at a number of the pilots. We looked at the Alberta pilot, and Verna Yiu actually sits on our panel. We also looked at the pilots that had taken place in other provinces as well. Those were all incorporated into our recommendation.
Conservative
John Barlow Conservative Foothills, AB
Ms. Paish, was there any evidence in terms of the effectiveness of a hotel quarantine over quarantining at home?
You talked about a comprehensive at-home quarantine program. Through the panel's review, was there any evidence that showed that the hotel quarantine was more effective than a comprehensive at-home quarantine program?
Panel Co-Chair and Chief Executive Officer of the Digital Supercluster, COVID-19 Testing and Screening Expert Advisory Panel
No. We didn't have any evidence that established the efficacy of that three-day quarantine hotel program.
In fact, as you know, our recommendation includes more stringent observation and support of people in their place of quarantine at home. That, combined with a seven-day PCR test, was seen as being the most effective way of both supporting the quarantine and making sure that if the virus had in fact developed during that period of time it would be caught.
Conservative
John Barlow Conservative Foothills, AB
Thank you.
I have one last question to Dr. Kalyan.
Can you say if an attenuated vaccine is more effective? Some of your testimony was quite interesting there.
Adjunct Professor of Medicine, University of British Columbia and Vice-President, Scientific Innovation, Qu Biologics, As an Individual
Historically, given that it's the only one that has succeeded in wiping out infectious diseases, I would say yes, but it takes longer to develop these live attenuated vaccines.
I was looking at the types of vaccines being developed on the spreadsheet of the World Health Organization. There are a couple that are in development. That kind of training that engages the entire immune system and puts everything on the same page, as opposed to giving a piece of information to only one arm, is going to be by far, in my opinion, more effective. Also, it provides the right exercise for your immune system to operate more functionally overall.
For children, definitely there has been quite a large body of evidence showing that live attenuated vaccines are better.
Liberal
The Chair Liberal Ron McKinnon
Thank you, Mr. Barlow.
We will go now to Ms. O'Connell.
Ms. O'Connell, please go ahead for two minutes.
Liberal
Jennifer O'Connell Liberal Pickering—Uxbridge, ON
Thank you, Mr. Chair.
Ms. Paish, following up from where we left off, at that meeting on May 10, I believe I wrote down that you were consulting with provinces and territories on the findings and on the panel's recommendations. If I heard correctly, you didn't get much push-back in that there was agreement around the table for that.
At that time, in my home province, for example, there were ads being run showing “blood maps” of closing the border and how the third wave was completely to blame on the border. At the time of these blood maps, of the virus spreading, in the political realm you're saying that provinces and territories were actually supportive of lifting restrictions. This would be in your conversations. I'm not asking you to comment on the political side of things, but in those conversations, they were supportive of lifting border measures.
Panel Co-Chair and Chief Executive Officer of the Digital Supercluster, COVID-19 Testing and Screening Expert Advisory Panel
In the discussions we had both with the medical health officers and with the federal, provincial and territorial ministers—so at two different meetings—the health officers had suggestions and comments, but I'd say those were supportive and things like the Alberta pilot were discussed. With the ministers, there was no criticism or concern raised about elements of the report.
