Much of the country is in the grips of an alarming third wave. While more vaccines are coming, Johnson & Johnson’s (J&J) will offer unique benefits in a time of crisis, said Dr. Isaac Bogoch, an infectious disease specialist based out of Toronto General Hospital.
“This is a great opportunity to vaccinate people with a one-and-done vaccine,” he told Global News.
“But we do have a ton of Pfizer coming into the country. So the question is. how do we best use this particular vaccine?”
When will Canada receive them?
A total of 300,000 doses of J&J’s vaccine will arrive “around the end” of this week, according to Federal Procurement Minister Anita Anand. Distribution to provinces and territories will begin the first week of May.
But the clarity stops there.
Procurement Canada officials have said further shipments aren’t expected until June. The ministry previously said more deliveries could be coming later in the spring and summer.
A government source told Global News a delivery schedule following this week’s shipment has not yet been confirmed. The source provided no reason for the potential month-long gap in deliveries except to say work continues on finalizing those details.
Canada approved the vaccine in early March and had pre-ordered 10 million doses, with options to order up to 28 million more, but manufacturing problems from the company led to shipment delays to Canada and elsewhere. Officials have maintained the initial 10 million doses are still expected by September.
They’ve also been quick to point out that a significant increase in COVID-19 vaccine doses from Pfizer alone in May and onwards will keep Canada on track.
“While we don’t have huge numbers of Johnson & Johnson at this time, we don’t have clarity or line of sight on AstraZeneca in the short term. … The total amount of vaccine doses this quarter alone is well above 40 million,” said Maj-Gen. Dany Fortin, who is overseeing logistical planning for Canada’s vaccine distribution efforts, on April 22.
“We will feel a significant increase.”
Will adding 4th shot speed up vaccination efforts?
Experts have long emphasized the J&J shot could play a big role in improving vaccination coverage.
The shot only requires a single dose and can be stored at standard refrigerator temperatures, which should make it much more accessible and promise greater flexibility for jurisdictions to vaccinate as many Canadians as quickly as possible.
Those benefits make Johnson & Johnson’s product a powerful tool — especially as Canada faces setbacks with its AstraZeneca shipments, Bogoch said.
Though Canada has purchased 20 million doses from a U.S. plant, so far none have been shipped. Canada also has a contract for two million doses from the Serum Institute in India, of which 500,000 have been delivered. The rest have been delayed as that country grapples with a deadly surge in cases. A significant portion of the doses being made in India is being diverted to its own domestic vaccination campaign.
Without a clear timeline, Bogoch said J&J’s vaccine could easily be subbed into pharmacies, which have predominately administered AstraZeneca thus far.
Like all other vaccines, it will be up to provinces and territories to decide eligibility for the new vaccine, but Bogoch suggested jurisdictions could keep guidelines for AstraZeneca the same for J&J.
“We’ll be running short on AstraZeneca soon, and we don’t yet have a date for another arrival of an AstraZeneca shipment from the United States, so Johnson & Johnson is an easy fit for pharmacies,” he said.
So far, Canada’s vaccine campaign is being held up by significant — and consistent — deliveries from Pfizer. While less so, Moderna also makes up a significant portion of doses received so far as well.
A similar scenario has played out in the United States, despite it rolling out J&J in early March.
While about 42.5 per cent of Americans have received at least one shot of a COVID-19 vaccine, and about 28.9 per cent are fully vaccinated, only about five per cent of those have been the J&J vaccine.
When the U.S. paused the shot for 11 days as health officials looked into six cases of rare blood clots, White House officials said it wouldn’t have a “significant impact” on the vaccination plan due to the ample supply of Pfizer and Moderna.
There may be hesitancy from some Canadians about the shot as a result of concerns about very rare blood clots, but the fact it has already been in use in the U.S. may boost confidence, Bogoch said.
“Of course, you can’t ignore the very rare, but not zero per cent, risk of these blood clotting events, but on the other hand, we’d never had this much COVID-19 in Canada,” he said.
“There’s a lot of appealing attributes. … It’s a really good vaccine.”
How should it be rolled out?
Experts say its easy storage could make it a perfect candidate for hard-to-reach areas of the population, or people who might not be able to commit to an appointment for a second shot, like vulnerable populations or those with mobility issues.
“That is so huge in terms of taking this vaccine and bringing it to targeted populations,” Dr. Sumon Chakrabarti, an infectious disease expert in Mississauga, Ont., told the Canadian Press earlier this month.
“I wish it was (arriving before) the end of April, but I’ll take it.”
Chakrabarti said the vaccine is conducive to large, mobile vaccine clinics that can be set up quickly to target populations in hard-hit communities, including essential workers.
“You can transport the vaccine there and just boom, boom, boom, get it into people’s arms,” he said. “The timing doesn’t help — we really wanted to start (vaccinating) essential workers as quickly as possible. … But it’s something you can do (easily) with J&J.”
With J&J being one-dose, Bogoch said it also “eliminates barriers that might prevent people from coming back for a second vaccination.”
“We know there are some populations that will have more challenges — through no fault of their own — for coming back for a second dose, like populations in prison, populations in shelters, migrant farmworkers. They would all be ideal candidates,” he said.
“For a migrant farmworker, it’s sometimes challenging to know where these individuals are going to be in three, four months’ time. They may not be here for their second dose, but at least we can help protect them while they’re here.”
The shot also opens the door to at-home vaccinations, Dr. Amira Roess, a professor of Global Health and Epidemiology at George Mason University, told Global News previously. She said vaccinators could technically “go out and reach people, instead of requiring them to come to where the vaccine is being held.”
“Elderly people who can’t leave their home — they’re really going to benefit,” she added.
The National Advisory Committee on Immunizations (NACI) has yet to issue any guidance around the use of Johnson & Johnson’s COVID-19 vaccine. However, NACI officials said Friday the recommendation has been “ready for a while” and that the U.S. investigation, which is now completed, had delayed them releasing that information.
Health Canada has approved the shot for use in anyone 18 years of age or older.
At the end of the day, it has to be applied in an equitable manner, Bogoch said.
“We really need to vaccinate people that might otherwise not get a vaccine or might be less likely to come back for a second dose,” he said.
“We have to use it wisely in those populations.”
— with files from the Canadian PressView link »