Mr. Speaker, the number one issue for all Canadians is control over the COVID pandemic. A large part of this comes down to getting vaccines out as soon as we can.
This is not the first time that vaccines have been involved in changing the world. A lot of people forget that polio recently was occurring in epidemics. I, in almost 35 years of practising medicine, have never seen an acute case of polio. I have, however, seen cases of tetanus and measles. I have seen quite a few children die of that in developing countries. In Canada, however, we practically have no cases, again, because the vaccines.
Early on in this pandemic, vaccines, rightfully, were seen as the cure to this. There is reason for caution because of the various variants, but so far things are looking really well. It seems that pretty much all the vaccines with respect to all the variants work to some extent, and particularly they work in preventing severe disease, hospitalization and death. Vaccines really are what is going to get us out of this and get us back on the road to being normal again.
How are we doing in terms of vaccinating our population? I think we are doing really well. I know the opposition is going to look at me and say that because I am a Liberal, I am going to say the Liberals are doing really well. If people have watched the health committee over the last year, they know I have not shied away from asking my government hard questions about managing the pandemic.
Having said that, does any Canadian really watch health committee? My mother does not even watch health committee. However, if people were to watch it, I think they would realize I am someone who is prone to speaking my mind and somebody who is not going to say something I do not believe in. Our federal government has done very well in procuring vaccines and the provinces, for the most part, have done really well in getting those vaccines into arms of people.
Right now, about 31% of eligible Canadians have had at least their first dose of the vaccine. We are third among the G7 in getting the vaccines out. In May, we are apparently getting over 10 million vaccines. Health Canada is anticipating that by June 30, we will have 36.5 million doses of vaccine. NACI thinks that 75% of eligible Canadians can get at least their first dose of the vaccine by mid-June.
We would like to do it faster and so would everyone else in the world, but obviously there is a limited supply and tremendous demand all across the world. Unfortunately we just cannot buy COVID vaccines in Canadian Tire. We, as the government, are whipping the vaccine horse as hard as we can. I have never whipped a horse, but I think the meaning of that saying is that if we keep whipping a horse, eventually we cannot get it to do anymore work. Similarly, with the vaccines, we are whipping this as hard as we can.
We would like to give all Canadians their first dose of the vaccine by the Victoria Day weekend, but I do not think it is possible. It will take a bit longer, but I do not think that much longer. We thought this was going to be a marathon. A year ago, a lot of people were predicting it was going to take two or three years to get a vaccine; it has taken a lot less. As it happens, this has turned out to be more like a 1,500-metre race than a marathon.
Let me talk about the spacing between the two doses of the vaccine as mentioned in the motion. This is not the government's policy. This is a recommendation of NACI, the National Advisory Committee on Immunization. It is an external advisory body that advises PHAC, but it is ultimately up to the provinces to decide whether they accept that advice.
It is important to note that with respect to this advice, although it recommends up to a four-month interval between the first and second dose, it also states, “ as soon as all eligible groups have been offered their first dose of vaccine, second doses should be offered. The interval between first and second dose should not be extended any longer than needed to offer first doses of vaccine to all eligible individuals.” Why a longer interval? Because if there is a longer interval, we can basically vaccinate twice as many people.
What is the evidence that this is a safe strategy?
Let us look at the efficacy first from the original trials, and these are the original trials with Moderna and Pfizer, which calculated vaccine efficacy starting two weeks after the first dose. For the first two weeks, no vaccine is going to work as it takes a while to get the immune response. An efficacy of about 92% was found. With AstraZeneca, it was about a 76% efficacy between the 22nd and 90th day after administration.
What does the real world data show? It is a bit complicated because different jurisdictions have taken different approaches with the intervals between the first and the second dose. For example, Israel and the United States have basically gone according to the manufacturer's recommendation. B.C. was delaying the second dose to about five or six weeks.
The best evidence really comes from Quebec and the United Kingdom. In both those jurisdictions, pretty well from the beginning, they decided to have about a three-month interval between the first and the second dose. In addition, when we look at the data about effectiveness, there is a difference between different jurisdictions in terms of the intervals but also different groups looked at different end points in the data. We can look at total mortality rate, rates of hospitalizations, incidence of symptomatic disease, asymptomatic disease and incidence of positive tests.
With respect to incidence of symptomatic disease, asymptomatic disease and positive results, the effectiveness after one dose of the vaccine shows as somewhere in the 60% to 80% range. The more important number I think we will all agree is not how often one gets asymptomatic disease, it is the incidence of where people get more severely sick and end up hospitalized or die from it. The numbers with respect to that, after one dose, is actually pretty good. In fact, it is also pretty good with respect to the elderly, because it is known the elderly cannot mount the same kind of immune response as quickly as younger people.
The NACI site shows some of the actual evidence on the effectiveness of one dose in preventing COVID. One study from Bristol in the United Kingdom showed an effectiveness of 71% to 79% in preventing hospitalization for frail, elderly patients who had one dose of Pfizer. With AstraZeneca, it was about 80%. A study of health care workers from Scotland showed a vaccine effectiveness against hospitalization of 84% with one dose.
The largest and best study of real world data was from Public Health England, which showed that one dose of the Pfizer and AstraZeneca vaccines were approximately 80% effective in preventing hospitalization in those over the age of 80.
How long does immunity last after the first dose? Data from AstraZeneca clinical trials show immunity does not wane for at least 90 days. Data on the RNA vaccines from the U.K. and Quebec show that immunity does not wane for about two months.
Also, the experience with other vaccines requiring two doses like the hepatitis A vaccine or the HPV vaccine is that immunity can last up to six months. Furthermore, scientists know immunity does not just drop off a cliff but slowly decreases.
What about immunity from about nine weeks to 16 weeks after the first shot of the RNA vaccines Pfizer and Moderna? We have to recognize the data is still coming in. We only started mass vaccination of people basically in January. NACI recognizes the numbers are still coming in, continues to monitor the data and evidence and is prepared to change its recommendations if the evidence suggests we ought to.
Increasing the interval between the two doses is certainly the right policy. This is what helped the United Kingdom's number of cases, at least in part, to drop precipitously, so I think we are on the right course. I know this cannot happen fast enough. Patience is the golden virtue. However, I know it is hard to be patient with all the things that are happening around COVID. Really, this is a 1,500 metre race. We are at about 1,400 metres. The end is in sight. We have to keep going and following public health advice. It will soon be over.