The frequency of viral outbreaks and pandemics in the last two decades, including the current COVID-19 pandemic, has focussed attention on Canada's lack of preparedness, vaccine supply shortages and production self-sufficiency. There have been calls for a new public agency to develop and produce vaccines for the next pandemic. However, this proposal is ill advised, according to a new report from the C.D. Howe Institute.
In Home Remedies: How Should Canada Acquire Vaccines for the Next Pandemic? authors Paul Grootendorst, Javad Moradpour, Michael Schunk and Robert Van Exan review Canada's prospects for such an agency. They find that it would be risky to rely on such an agency to rapidly develop, test and produce vaccines, noting, among other problems, the logistical challenges in mounting a large-scale international multi-centre clinical trial in short order.
Instead, the authors argue, Canada can achieve a more reliable supply of vaccines for a future pandemic, and at a lower cost, by contracting with existing commercial producers that are already engaged in full-scale production, and who thus have demonstrated they have technical competency and secure input supply chains.
"The government can purchase either reserve capacity in existing domestic production facilities or can cover the cost of a modular production facility adjacent to existing facilities and can thus tap into the ventilation, steam, gas and other utilities needed to run the facility," they write. Canada can also enter into agreements with other countries such as Australia and the UK to rationalize production and share pandemic vaccines.
In support of their position, Grootendorst, Moradpour, Schunk and Van Exan point to how the COVID-19 vaccines currently used in G7 member countries are provided by for-profit firms that have emerged as the leading pandemic vaccine suppliers, which speaks to their capacity to develop, test and produce vaccines in compressed timelines.
They also note that a public agency focused on producing vaccines licensed from domestic developers would also face challenges, with the primary issue being production readiness.
Practically, they say, production facilities need to be operating continuously at or near full-scale capacity to hone the processes needed to meet stringent and evolving regulatory standards and ensure personnel have sufficient experience, and would also need a reliable supply of key inputs. Therefore, the public agency would need to be engaged in full-scale vaccine production even in non-pandemic times to maintain both production expertise and stable input supply chains, and would need to do so in each of the three vaccine platforms that may be needed for the next pandemic virus.
"This raises the question of what vaccines the agency would routinely produce, in non-pandemic times, and where the vaccines would be distributed," write the authors. Additionally, if such an agency elected to compete with existing private-sector producers, it would not increase private investment in vaccine manufacturing capacity and perhaps even end up degrading it.
"Regardless of its approach, however, Canada needs to act soon if we are to be ready for the next pandemic," conclude Grootendorst, Moradpour, Schunk and Van Exan.
Paul Grootendorst is Associate Professor, Leslie Dan Faculty of Pharmacy, University of Toronto.
Javad Moradpour is a Post Doctoral Fellow, Leslie Dan Faculty of Pharmacy, University of Toronto.
Michael Schunk is President at MS Biologics. He is an independent consultant with more than 25 years of experience as a vaccine industry executive.
Robert Van Exan is President of Immunization Policy & Knowledge Translation Consulting. He is an independent consultant with over 40 years of experience as a vaccine industry executive.