Trudeau says he wants an AstraZeneca shot, but a supply crunch could be coming

Prime Minister Justin Trudeau said today his office was busy working the phones to secure him an appointment to get the AstraZeneca shot at a pharmacy, now that age restrictions for the vaccine have been adjusted in Ontario.

Speaking in French, Trudeau said he was eager to get the AstraZeneca shot in particular "to convey the message to all Canadians that they should be vaccinated with the first one that is offered to them as quickly as possible."

While the vaccine is safe and effective, it has been the subject of much debate in recent weeks — with competing recommendations about who should get the vaccine and when.

Here's a look at the current state of Canada's AstraZeneca supply and some answers to common questions about vaccine deployment in the months ahead:

How many AstraZeneca doses are there in Canada right now?

Trudeau, 49, may not have much time to secure that vaccine appointment. The country's limited AstraZeneca stockpile is quickly running low as some provinces open up eligibility to younger people. And no one seems to know for certain when the next shipment of this COVID-19 vaccine will arrive.

The federal government had distributed 2,316,000 AstraZeneca doses to the provinces and territories as of Monday. Many of them have been administered already.

As of last Thursday, 709,000 doses had been used nationwide — but much has changed since Maj.-Gen. Dany Fortin, the military commander leading federal vaccine logistics, delivered that update.

Some jurisdictions were reporting an abundance of the AstraZeneca product when Fortin made his statement — 543,000 doses were sitting unused in Ontario pharmacies, for example — because older Canadians were either reluctant to take this shot or had other options at public health-run clinics.

Frustrated with the number of shots it had on hand, Quebec gave up on scheduling appointments and launched a series of walk-in clinics.

The largest provinces have now adjusted their age criteria. Based on Statistics Canada data, some 6.3 million more Canadians between the ages of 40 and 54 are now eligible to book appointments to get the AstraZeneca vaccine.

Now that this larger age cohort is cleared to get the vaccine, demand almost certainly will outstrip supply. Less than 48 hours after the policy shift, some major retailers, including Costco and Walmart, were reporting zero availability in Ontario.

After Ontario went first in expanding eligibility on Sunday, Alberta, B.C., Manitoba and Quebec have all followed suit — jurisdictions that together account for roughly 86 per cent of the Canadian population. (Quebec said today it would restrict the shot to people age 45 and older.)

So when is the next AstraZeneca shipment coming?

Nobody knows for sure. Supplies could be relatively limited over the next month or more.

Officially, 4.1 million more AstraZeneca doses are expected by Canada Day, but dates for the next set of deliveries have not yet been finalized.

Of the 2.3 million AstraZeneca shots that have been delivered so far, 500,000 were produced by the Serum Institute of India.

That private company, which produces a biologically identical version of the AstraZeneca product, was poised to deliver one million more shots in April and an additional 500,000 in early May. Those shipments have been punted for now.

"We are expecting a delay in the shipment," Joelle Paquette, the director general responsible for vaccine procurement at Public Services and Procurement Canada, said earlier this month.

As India grapples with a deadly surge in its COVID-19 caseload — the country is posting more than 200,000 new cases a day — the government there has restricted virtually all exports of Serum Institute-made shots, diverting most of the 2.4 million doses the institute churns out each day to the domestic vaccination campaign.

Canada is also expecting 1.6 million AstraZeneca doses by the end of June from Covax, the global vaccine-sharing initiative. The timing of that shipment is also in doubt.

The Serum Institute produces millions of shots for Covax — again, Indian restrictions have delayed those deliveries — but SK Bioscience in South Korea is also a designated manufacturer for the worldwide vaccine alliance.

Canada has received 316,000 Korean-made doses from Covax but details about another shipment are scant.

"Delivery schedules are not yet finalized, therefore precise delivery dates are to be determined, but doses are expected this quarter," a government official, speaking on background, told CBC News.

Canada is also poised to receive one million AstraZeneca-made shots in the April-through-June period.

Those shots likely will come from U.S. plants but, again, a delivery schedule has not yet been confirmed by procurement officials. Those doses are "expected in June," an official said, but issues at a U.S. plant could still derail those projections.

Could the U.S. help us out and send more doses?

Possibly. The Biden administration sent 1.5 million doses of AstraZeneca to Canada last month.

U.S. regulators haven't even approved that product for use yet in the American marketplace — but the company is still manufacturing it in the United States. More than 20 million doses have been stockpiled already, according to Bloomberg News.

Trudeau has said his government will work with the U.S. to secure more supply.

"We have continued to engage with partners around the world, including the United States, about getting more doses quickly," Trudeau said on April 9.

There's another snag in the U.S. supply chain. A major U.S. supplier of the AstraZeneca product, Maryland-based Emergent Biosolutions, was forced to make adjustments at its plant this week after workers there inadvertently ruined 15 million doses of the Johnson & Johnson vaccine.

Until now, the Maryland plant had been making supplies for both vaccines — but the Biden administration has demanded that Emergent retool to ensure a steady supply of uncontaminated J&J shots and nothing else.

AstraZeneca will have to find another U.S. partner in short order, which could disrupt manufacturing and deliveries.

I've already had a dose of AstraZeneca. What does all this mean for me?

The National Advisory Committee on Immunization (NACI) has said the provinces (and territories, although they're much further ahead in the vaccination effort) can wait up to four months between first and second doses.

In most provinces, if you receive a shot today you likely won't be scheduled for a second dose until August. The government has 16 weeks to procure more AstraZeneca doses — or land the ones they've already contracted to receive — to get recipients their second doses.

There's also the possibility that someone who received an AstraZeneca shot could receive a dose of another product at a later date.

A U.K. trial is looking into whether COVID-19 vaccines can be mixed. Researchers are probing whether an AstraZeneca-recipient can get the Pfizer product for the second dose.

"We're seeing some experience and trials going on around the world in terms of a mixed schedule," Dr. Howard Njoo, Canada's deputy chief public health officer, said on April 8, citing the U.K. study.

"We're looking very carefully at that to see what the outcomes are in terms of overall effectiveness and ... certainly that'll be taken into account of what might be put forward here in Canada."

Is the shot safe?

Following reports of rare blood clotting events among some who received the AstraZeneca vaccine, Health Canada officials reaffirmed last week they still believe the product is safe — and Canadians should have no qualms about rolling up their sleeves for it when the time comes.

NACI was expected to provide an update on its AstraZeneca-related guidance today but that press conference was cancelled at the last minute.

In a statement, Health Canada said the immunization advisory committee "postponed the planned release of its guidance ... in order to further validate its data analysis. NACI expects to be able to release its finalized guidance later this week."

Health Canada has said that if regulators conclude at any time that the risks of the AstraZeneca shot outweigh its benefits, the department won't hesitate to pull the vaccine's authorization.