Millions of surplus doses of COVID-19 vaccines worth an estimated $1 billion are set to expire by the end of the year due to problems with the technology used to track the distribution and use of doses, Canada’s auditor general has found.
Karen Hogan also flagged ongoing problems with data-sharing between the federal and provincial governments, which she says caused the Public Health Agency of Canada (PHAC) to struggle with sharing detailed case‑level information on vaccine safety with Health Canada, vaccine companies and the World Health Organization (WHO).
“While the organizations involved were successful in securing vaccines and quickly distributing them to the provinces and territories, the Public Health Agency of Canada’s efforts to minimize wastage were unsuccessful,” Horgan said during a news conference in Ottawa Tuesday.
Overall, the auditor general said two federal agencies tasked with procuring vaccines – PHAC and Procurement Canada – did a good job of quickly and efficiently securing purchase agreements with vaccine manufacturers to ensure enough doses would be available to vaccinate every person in Canada.
Procurement Canada established advance purchase agreements in 2020 with seven companies that showed potential to develop viable vaccines.
However, because of requirements in these purchase agreements to buy minimum numbers of doses, the PHAC ended up with a large surplus of doses – a situation the agency knew would be a likely outcome, Hogan says in her report.
This led to vaccine wastage because some of the doses that Canada procured expired before they could be used or donated.
In addition, PHAC later purchased more doses from Pfizer and Moderna, further contributing to oversupply and waste of vaccines, Hogan found.
“Officials explained that, because of the evolving nature of the pandemic, there was a need to keep buying optional doses, to expand coverage, to accelerate deliveries and to address waning immunity and changes in vaccine administration guidelines, such as shortened booster intervals and the National Advisory Committee on Immunization advice recommending the use of a certain vaccine type,” the report states.
In total, Ottawa purchased about 169 million vaccine doses between December 2020 and May of this year, at an estimated cost of $5 billion.
About 84.1 million doses have been administered to Canadians. But as of May 2022, there were still 32.5 million remaining doses in federal, provincial and territorial inventories, estimated to be worth about $1 billion.
Most will expire by the end of 2022 if unused, Hogan says.
In 2021, the federal government committed to donating the equivalent of 200 million COVID‑19 vaccine doses internationally by the end of 2022 to “help vaccinate the world.”
Hogan’s audit says this number includes 50.6 million doses that PHAC deemed surplus.
However, she found that as of the end of May of this year, only 15.3 million of those 50.6 million surplus vaccines have actually been donated. This, despite a claim by Ottawa it is “on track” to meet this commitment by the end of this year, according to a statement on the federal government’s website detailing Canada’s vaccine supply and donation strategy.
Hogan also found that, despite a federal commitment to donate doses with as much shelf life left as possible, which ideally would be 14 to 16 weeks, countries receiving these donations have been given doses that had only four to eight weeks left before they expired.
“Officials told us that there are challenges with donations that are outside of Canada’s control, including the willingness of other countries to accept donations offered,” Horgan says in her report.
“Furthermore, many countries are now trying to donate their surplus doses, resulting in a slowdown in demand for donations.”
PHAC’s efforts to minimize wasted doses of vaccine were unsuccessful in part because of delays in developing and implementing a technology platform called VaccineConnect that was purchased from Deloitte Inc. for just under $60 million to track vaccine distribution in Canada, coverage and safety, the audit found.
VaccineConnect was partially functional by June 2021, but key system capabilities that would have helped with tracking things like vaccine expiration dates were delayed, leading to “workarounds” that had to be developed, including staff tracking vaccines using spreadsheets.
One of the main reasons PHAC has not been able to properly track vaccine surplus and wastage once doses are delivered to the provinces is due to significant gaps in data-sharing between federal agencies and the provinces and territories, Hogan found.
This is despite numerous previous audits in which concerns have been raised about a long-standing lack of data-sharing agreements with the provinces and territories, Hogan said.
“We raised concerns about the sharing of health data between the federal and provincial or territorial health authorities in 1999, 2002, 2008, and again in our 2021 audit of pandemic preparedness,” Hogan said Tuesday.
“These long-standing issues, including implementing a pan-Canadian framework for sharing information, must be urgently addressed because the sharing of health data is a cornerstone of effective surveillance to keep Canadians safe.”
Health Minister Jean-Yves Duclos says he welcomes the findings of the auditor general, particularly those that point to successful and swift procurement and distribution of vaccines to the provinces and territories, even if this did result in an oversupply.
“At the beginning of the pandemic, no one could have predicted which vaccine candidate would be most effective. With heightened global demand, our government clearly established that we would invest in multiple vaccine candidates to ensure rapid access to the safest and most effective vaccine against COVID-19,” Duclos told reporters in French.
“This strategy, while producing a surplus, proved very successful. Canada was among the first three countries in the world to administer doses in December of 2020.”
Duclos also heartily endorsed Hogan’s call for more urgent action on health data-sharing with the provinces and territories.
The federal government has been trying to move forward with efforts to co-develop a pan-Canadian health data strategy, including recently making it one of the conditions placed on provinces and territories as part of a promise for more health-care funding.
Better information-sharing is not only needed at the government level to track things like vaccine safety and to identify key populations that may need more outreach or support, as identified by the auditor general, Duclos said.
Health workers and patients also need better access to their health information and for health systems to move away from paper-based records to ensure quality and safe health care, he said.
For example, in Ontario there is no system that allows hospitals to determine whether a child in their emergency department has been vaccinated, Duclos noted in French.
“We don’t have the technology in 2022 to allow both patients and health workers to access this information.”