Mr. Speaker, Health Canada’s mandate is to help Canadians maintain and improve their health. The health and safety of Canadians is Health Canada’s top priority, and the department exercises stringent regulatory oversight over health products, including vaccines. Health Canada received Pfizer’s submission seeking authorization to its Pfizer-BioNTech COVID-19 Vaccine on October 9, 2020, available at https://www.canada.ca/en/health-canada/news/2020/12/health-canada-authorizes-first-covid-19-vaccine0.html. The department is not a signing authority of purchasing contracts for health products, including COVID-19 vaccines.
Before a vaccine is approved in Canada, the Department conducts a rigorous scientific review of its safety, efficacy and quality. Submissions typically contain extensive data regarding the vaccine's safety, efficacy and quality, including results of pre-clinical and clinical studies, details on manufacturing processes, and information on adverse events following immunization, or AEFI. An authorization is only issued when benefits of the vaccine outweigh the risks of its use.
Following authorization, Canada has a robust and well-established vaccine safety surveillance system involving Health Canada, Public Health Agency of Canada, or PHAC, provinces and territories, and vaccine manufacturers. Health Canada continues to monitor the safety profile of health products once they are on the Canadian market, to help ensure that the benefits of the product continue to outweigh the risks. The safety profile of these products is monitored by reviewing safety information submitted by manufacturers as well as considering safety information from international regulators. When new safety issues are confirmed by the Department, Health Canada takes action, which may include communicating new risks to Canadians and healthcare professionals or changing the recommended use of the product.
In response to (a) to (e), Health Canada is aware of the referred presentation regarding FDA “Plans for Monitoring COVID-19 Vaccine Safety and Effectiveness”, which occurred at the Vaccines and Related Biologic Products Advisory Committee, or VRBPAC, held on October 22, 2020, including the slide #16 of the 22 “possible adverse event outcomes.” Since the authorization of the first COVID-19 vaccines in Canada on December 9, 2020, Health Canada has been monitoring possible adverse events including these 22 “possible adverse event outcomes.”
In addition, Health Canada and the PHAC have been actively monitoring and reviewing AEFI reports. All AEFI reports submitted by provincial and territorial public health authorities and federal departments are captured in the Canadian Adverse Events Following Immunization Surveillance System, or CAEFISS, which is managed by PHAC. In addition, the Canada Vigilance Program, or CVP, managed by Health Canada, receives AEFI reports from manufacturers, Canadian hospitals, healthcare professionals and consumers. Information about AEFIs reported in Canada, including some of the 22 “possible adverse event outcomes” is published on the Government of Canada’s website. It is important to note that these reports do not necessarily imply that a relationship between the adverse event and the vaccine has been established. However, they are an important information source supporting ongoing safety monitoring. Additional information is also available on the following public websites: COVID-19 Vaccine safety and side effects, at https://www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-19/vaccines/safety-side-effects.html#a5; Vaccine safety and possible side effects, at https://www.canada.ca/en/public-health/services/vaccination-children/safety-concerns-side-effects.html; Health Product InfoWatch, at https://www.canada.ca/en/health-canada/services/drugs-health-products/medeffect-canada/health-product-infowatch/published-newsletters.html#a1; Pfizer-BioNTech Comirnaty COVID-19 Vaccine, at https://www.canada.ca/en/health-canada/services/drugs-health-products/covid19-industry/drugs-vaccines-treatments/vaccines/pfizer-biontech.html; and Regulatory Decision Summary of Pfizer-BioNTech Comirnaty COVID-19 Vaccine, at https://covid-vaccine.canada.ca/info/regulatory-decision-summary-detailTwo.html?linkID=RDS00730.
In response to (f) to (i), as part of the regulatory requirements, a product monograph is publicly released at the time of a vaccine’s authorization. The product monograph is developed and managed by the manufacturer. The content, wordings, and format are carefully reviewed by Health Canada to ensure that it is prepared in accordance with the Product monograph guidance documents and notices, found at Canada.ca. Updates of the product monograph are summarized in the Post-Authorization Activity Table (PAAT) at https://covid-vaccine.canada.ca/info/paat-SBD00510-comirnaty-en.html for Comirnaty.
A product monograph is a factual, scientific document on the drug product that, devoid of promotional material, describes the properties, claims, indications, and conditions of use for the drug, and that contains any other information that may be required for optimal, safe, and effective use of the drug. It is used to inform physicians, pharmacists, dentists, nurses, other healthcare professionals, and patients about the appropriate use of the product.
A package insert is also required at the time of a vaccine’s authorization. As noted above for the Canadian Product Monograph, at the time of authorization, the safety information included in package inserts was based on the available safety data from clinical trials. Furthermore, Health Canada is responsible for ensuring that the product monograph and package inserts are updated over time to adequately reflect the risks associated with the vaccines that are authorized in Canada. Health Canada-approved information is used by the appropriate bodies (e.g., provincial and local public health authorities, etc.) to guide recommendations, vaccine use, as well as information provided to vaccine recipients.
In response to (j) to (k), the referred report of 1,291 "serious adverse events (SAEs) of special interest" which were contained in Pfizer's report of April 30, 2021, entitled "5.3.6 CUMULATIVE ANALYSIS OF POST-AUTHORIZATION ADVERSE EVENT REPORTS OF PF-07302048 (BNT162B2) RECEIVED THROUGH 28-FEB-2021", was prepared by the manufacturer, Pfizer, for the US FDA. Health Canada reviewed safety reports submitted by the manufacturer including data from the referred report. The information reviewed did not identify new safety concerns and was consistent with the known safety profile of COMIRNATY. Outcomes of Health Canada’s safety reviews for COMIRNATY, as well as subsequent reviews, are available online at the Post Authorization Activity Table for COMIRNATY at https://covid-vaccine.canada.ca/info/post-authorization-activity-table.html?linkID=SBD00510.
To date, the benefits of these vaccines continue to outweigh their known risks.