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Countries around the world have begun the process of vaccinating people against COVID-19, but the rollout has been facing logistical challenges. Kim Parlee speaks with Tarik Aeta, Healthcare Analyst, TD Asset Management, about where Canada and the rest of the world stand in their vaccination efforts.
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[SYNTHESIZED ORGAN SOUND EFFECT]
- Tarik, thanks so much for joining us. I want to start, if I could, with a data-loaded question. Going through some of the numbers that we all watch right now, it looks as though as of January 4, Canada has administered-- I think it's 0.31 doses per 100 people. The United States has administered 1.38 doses per 100 people. And Israel, if you take a look, has blown everybody away-- 14 doses per 100 people.
So when you hear about how that vaccine is getting rolled out, or the vaccines, I should say, are getting rolled out-- what does it tell you? What do we know about what's happening right now?
- Yeah, so, Kim, you're absolutely correct. This is frustrating. And I completely empathize with fellow Canadians. The rollout has been slow here in Canada with only 150,000 Canadians having gotten their first dose. But this was to be expected, and for a couple of reasons.
First of all, supplies at this stage are extremely limited. At the end of December, Pfizer-BioNTech and Moderna combined had less than 70 million doses available for the entire world. And when you consider the fact that everyone needs two doses, that's less than enough to vaccinate half a percent of the world's population. And it largely explains why on a global basis generally vaccination has been slow.
And here in Canada, while it's true that most of the 420,000 doses that we've received so far are still sitting on the shelf, that's because the provinces have held back supplies to ensure that there's enough supply for a second dose. However, now that Pfizer has committed for regular shipments to Canada, 200,000 doses weekly in the upcoming weeks, the provinces can now worry a little bit less about stockpiling. And this will allow the pace of vaccination to accelerate.
That said, as I mentioned prior times, supplies will still remain very constrained, until we hit the summer, and reserved exclusively for high risk individuals. Here in Ontario, for instance, they expect that only 8% of the population will be vaccinated by the end of March.
But that number increases quite rapidly. So by the end of July, 60% of the population will be vaccinated. And as we close out 2021, all Canadians will have access to a vaccine.
- Hmm. That's interesting. I want to come back to that, to "end of 2020," in a moment. But in addition to the fact that you're hearing the current vaccines committing to-- or suppliers, I should say, to committing to bringing out more vaccines more quickly, there could be some new vaccines coming online, which could also I assume alleviate that supply bottleneck.
- Yeah. So beyond the Pfizer-BioNTech and Moderna vaccines, there are three vaccines I'm keeping a close eye on in 2021. So this includes the J&J, AstraZeneca, and Sanofi vaccines. And this is because these three vaccines, if approved, can bring an additional 5 billion doses to the world by the end of the year. And then when combined with the Pfizer-BioNTech and Moderna vaccines, we'll have enough supplies to vaccinate most of the world by December 2021.
So starting with J&J, we should be getting their clinical trial results by the end of January, if not earlier. And based on the phase one data and the animal studies that they've run, I'm fairly confident J&J will post good results for their viral vector vaccine.
The second vaccine I'd watch closely is the AstraZeneca vaccine. And the reason Astra is so important is because they're promising to deliver over 3 billion doses. So this is more than anyone else. The UK has already approved it. And I would expect other countries to also follow in the weeks and months ahead.
And last but not least, a third vaccine I'll be watching is the Sanofi GSK vaccine. Their vaccine is based on more established technology where they're simply delivering copies of the COVID spike protein, with shipments expected to begin in the fall.
- It sounds as though right now-- I mean, obviously, people are very much caught in the moment of what they're dealing with-- some tragic circumstances going on. But if you take the UK, for example, ordering a complete lockdown-- a lot of the inoculation pattern is changing. Instead of waiting to give two doses for one people, the talk about-- just get one out to everybody or more quickly. Does that change what's going to be happening, especially when you talk about all those new vaccines that are coming in?
- Yeah, exactly. Many countries have begun exploring whether it makes sense to lengthen the time between doses or just give a single dose so that we can vaccinate more people. The main problem with this strategy is we simply don't have enough data to know how effective a single dose is.
And this is because the phase three trials that have been run so far for Pfizer and Moderna have been testing two doses. So, for example, Moderna only tested a single dose on 1,000 volunteers out of 30,000. Pfizer tested a single dose on less than 100 volunteers out of over 40,000.
That said, though, the data from Moderna on a single dose was reasonable. So 51% effective following the first dose and that number rises to 92% effective after two weeks on that single dose. So it is marginally less effective than two doses at 94%.
But more importantly, we don't know if a single dose is as durable as having two doses. And that's really the main risk here. But for a place like the UK, where you're having hospital capacity being breached, it is sensible as a short term measure to try to vaccinate as many people as possible with a single dose.
And here in Canada, for instance, Quebec has announced that they will be delaying second doses. And other provinces are also looking into it as well, especially in the case of Moderna where there's reasonable data to support it.
- Tarik, I want to ask you a big question at the end. I've only got 30 seconds for you, though, so I do apologize for that. But we're hearing of mutations of the virus. And I'm curious as to how confident you're feeling that-- let's take Canada as an example-- that we are going to be all vaccinated by the end of the year. Given the mutations and the number of cases that are going up, how confident are you feeling about that timeline?
- Yeah. So I guess on the mutations quickly, based on the data we've gotten so far for the mutations out of the UK and the mutation out of South Africa, the spike protein is 99% the same. So the vaccines that are currently being developed look like they will continue to be effective if these strains keep spreading some more. And then in terms of the rollout, I'm still fairly confident that as we approach the end of 2021 we'll be able to vaccinate most of the world. And then COVID will hopefully be largely behind us as we enter 2022.
- Well, we so hope that is the case. Tarik, thanks so much for joining us.
- Thanks, Kim. Appreciate it.
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- Tarik, thanks so much for joining us. I want to start, if I could, with a data-loaded question. Going through some of the numbers that we all watch right now, it looks as though as of January 4, Canada has administered-- I think it's 0.31 doses per 100 people. The United States has administered 1.38 doses per 100 people. And Israel, if you take a look, has blown everybody away-- 14 doses per 100 people.
So when you hear about how that vaccine is getting rolled out, or the vaccines, I should say, are getting rolled out-- what does it tell you? What do we know about what's happening right now?
- Yeah, so, Kim, you're absolutely correct. This is frustrating. And I completely empathize with fellow Canadians. The rollout has been slow here in Canada with only 150,000 Canadians having gotten their first dose. But this was to be expected, and for a couple of reasons.
First of all, supplies at this stage are extremely limited. At the end of December, Pfizer-BioNTech and Moderna combined had less than 70 million doses available for the entire world. And when you consider the fact that everyone needs two doses, that's less than enough to vaccinate half a percent of the world's population. And it largely explains why on a global basis generally vaccination has been slow.
And here in Canada, while it's true that most of the 420,000 doses that we've received so far are still sitting on the shelf, that's because the provinces have held back supplies to ensure that there's enough supply for a second dose. However, now that Pfizer has committed for regular shipments to Canada, 200,000 doses weekly in the upcoming weeks, the provinces can now worry a little bit less about stockpiling. And this will allow the pace of vaccination to accelerate.
That said, as I mentioned prior times, supplies will still remain very constrained, until we hit the summer, and reserved exclusively for high risk individuals. Here in Ontario, for instance, they expect that only 8% of the population will be vaccinated by the end of March.
But that number increases quite rapidly. So by the end of July, 60% of the population will be vaccinated. And as we close out 2021, all Canadians will have access to a vaccine.
- Hmm. That's interesting. I want to come back to that, to "end of 2020," in a moment. But in addition to the fact that you're hearing the current vaccines committing to-- or suppliers, I should say, to committing to bringing out more vaccines more quickly, there could be some new vaccines coming online, which could also I assume alleviate that supply bottleneck.
- Yeah. So beyond the Pfizer-BioNTech and Moderna vaccines, there are three vaccines I'm keeping a close eye on in 2021. So this includes the J&J, AstraZeneca, and Sanofi vaccines. And this is because these three vaccines, if approved, can bring an additional 5 billion doses to the world by the end of the year. And then when combined with the Pfizer-BioNTech and Moderna vaccines, we'll have enough supplies to vaccinate most of the world by December 2021.
So starting with J&J, we should be getting their clinical trial results by the end of January, if not earlier. And based on the phase one data and the animal studies that they've run, I'm fairly confident J&J will post good results for their viral vector vaccine.
The second vaccine I'd watch closely is the AstraZeneca vaccine. And the reason Astra is so important is because they're promising to deliver over 3 billion doses. So this is more than anyone else. The UK has already approved it. And I would expect other countries to also follow in the weeks and months ahead.
And last but not least, a third vaccine I'll be watching is the Sanofi GSK vaccine. Their vaccine is based on more established technology where they're simply delivering copies of the COVID spike protein, with shipments expected to begin in the fall.
- It sounds as though right now-- I mean, obviously, people are very much caught in the moment of what they're dealing with-- some tragic circumstances going on. But if you take the UK, for example, ordering a complete lockdown-- a lot of the inoculation pattern is changing. Instead of waiting to give two doses for one people, the talk about-- just get one out to everybody or more quickly. Does that change what's going to be happening, especially when you talk about all those new vaccines that are coming in?
- Yeah, exactly. Many countries have begun exploring whether it makes sense to lengthen the time between doses or just give a single dose so that we can vaccinate more people. The main problem with this strategy is we simply don't have enough data to know how effective a single dose is.
And this is because the phase three trials that have been run so far for Pfizer and Moderna have been testing two doses. So, for example, Moderna only tested a single dose on 1,000 volunteers out of 30,000. Pfizer tested a single dose on less than 100 volunteers out of over 40,000.
That said, though, the data from Moderna on a single dose was reasonable. So 51% effective following the first dose and that number rises to 92% effective after two weeks on that single dose. So it is marginally less effective than two doses at 94%.
But more importantly, we don't know if a single dose is as durable as having two doses. And that's really the main risk here. But for a place like the UK, where you're having hospital capacity being breached, it is sensible as a short term measure to try to vaccinate as many people as possible with a single dose.
And here in Canada, for instance, Quebec has announced that they will be delaying second doses. And other provinces are also looking into it as well, especially in the case of Moderna where there's reasonable data to support it.
- Tarik, I want to ask you a big question at the end. I've only got 30 seconds for you, though, so I do apologize for that. But we're hearing of mutations of the virus. And I'm curious as to how confident you're feeling that-- let's take Canada as an example-- that we are going to be all vaccinated by the end of the year. Given the mutations and the number of cases that are going up, how confident are you feeling about that timeline?
- Yeah. So I guess on the mutations quickly, based on the data we've gotten so far for the mutations out of the UK and the mutation out of South Africa, the spike protein is 99% the same. So the vaccines that are currently being developed look like they will continue to be effective if these strains keep spreading some more. And then in terms of the rollout, I'm still fairly confident that as we approach the end of 2021 we'll be able to vaccinate most of the world. And then COVID will hopefully be largely behind us as we enter 2022.
- Well, we so hope that is the case. Tarik, thanks so much for joining us.
- Thanks, Kim. Appreciate it.
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