OTTAWA – Canada seemed to be off to a quick start. Regulators had approved a coronavirus vaccine jointly developed by Pfizer just before the US, and national news broadcasts were soon filled with pictures of people receiving their first injections.
But hopes raised by the vaccination launch in December – including news that Canada had ordered doses ten times its population – have worsened. Manufacturing issues at Pfizer and Moderna, makers of the two vaccines currently approved in Canada, have resulted in reduced shipments – including several weeks in which no vaccine has arrived at all.
While the disruption has become a talking point for the nation, more fundamental factors affecting Canada's strategic choices and its manufacturing realities have always resulted in the launch of vaccinations being a test run rather than a full rollout.
Even if Canada is back on schedule, this nation of 37.5 million is expected to receive just six million doses by the end of next month. So far, only about 1.5 million people have been injected.
Updates to a global vaccination ranking now get almost as much media coverage as hockey results. With the UK and even the United States continuing to climb the rankings despite their troubles, Canada has fallen significantly on the list that sits between Bangladesh and Romania this week.
The country's vaccination fears have caused a drop in approval ratings for Prime Minister Justin Trudeau's performance during the pandemic, according to polls. Almost 60 percent of Canadians believe the country should do better or at least as well as other developed nations, according to a survey.
This has also led to fierce criticism from the conservative opposition in parliament and from several prime ministers whose governments are responsible for putting needles in weapons.
"While the world is vaccinating millions of times, the government can only deliver a few thousand," said Erin O’Toole, the Conservative leader, in parliament on Tuesday. "Where's the plan to get vaccines into the arms of Canadians?"
Mr. Trudeau acknowledged the impatience but tried to give assurances.
"People are worried, people are fed up with this pandemic," he said at a press conference last week. "There is a lot of fear and there is a lot of noise right now. So I want to assure the Canadians that we are on the right track."
Canada wasn't alone. Short deliveries of vaccines have also created tension in Europe and other parts of the world
The pressure on Mr. Trudeau could ease. After Pfizer slowed and temporarily suspended shipments to Canada while a factory in Belgium was rebuilt to increase production, Pfizer sent its largest vaccine shipment to Canada this week. However, part of this broadcast was delayed by storms en route across the United States.
While the prime minister said the Pfizer resupplies will allow Canada to hit its six million can target by the end of March, it still means the vast majority of Canadians will likely wait for their shots well into the summer becomes.
Vaccine and infection control specialists say Canada's start has always been sluggish due to several key factors, most notably its decision last year to split its 414 million orders across seven different companies to reduce risk rather than upfront for a single vaccine put suppliers. To date, only two of these companies have approved vaccines for use in Canada.
Feb. 18, 2021, 2:29 p.m. ET
Canada also has inherent drawbacks: Most notably, its lack of an established vaccine manufacturer headquartered in the country and its relatively limited manufacturing capacity for making the vaccines developed by overseas companies.
Experts said the short or late deliveries shouldn't have surprised anyone so far.
"There has never been a vaccine rollout that did not go into bottlenecks due to problems fixing manufacturing errors," said Dr. Scott Halperin, Professor of Medicine at Dalhousie University in Halifax and Medical Director of the Canadian Center for Vaccination Science. "Anyone who didn't anticipate hiccups in the manufacturing process was simply unaware of the past."
Dr. David N. Fisman, professor of epidemiology at the University of Toronto's Dalla Lana School of Public Health, attributed the national hand pressing to another factor.
"It looks more like we got what we expected with the occasional hiccup," he said. “I think most of the sound and anger is really just related to the political scoring. Is there anything the federal government could realistically have done to get more vaccines earlier and magically stop those hiccups? "
Doug Ford, Ontario's Conservative Prime Minister, suggested a response despite his political viability. During a press conference last month, he called on President Biden to send Canada a million doses of vaccine from a Pfizer Michigan facility located within driving distance of the international border.
"Our American friends, help us," said Mr Ford, who has avoided criticizing Mr Trudeau. "You have a new president, no more excuses."
Under the Canadian system, the provinces are responsible for the running of health systems, including administering vaccinations, while the federal government regulates vaccines and drugs and negotiates prices. With the pandemic, Mr. Trudeau also took responsibility for purchasing the country's vaccine supply.
Brian Pallister, the Prime Minister of Manitoba, broke with that program last week, announcing that his province will be spending $ 36 million Canadian dollars to buy vaccines from a small business in Calgary, Alberta that is based on the development of a vaccine for cancer has switched to the coronavirus.
"I just want a Canadian home advantage," Pallister said when urging other prime ministers to work with him to "develop a Canadian-made solution, not just for today but for tomorrow."
However, the vaccine from Calgary Company, Providence Therapeutics, isn't going to speed up vaccination rates anytime soon. The company, which has asked Mr Trudeau's government for financial support, did not begin the first phase of human trials of his vaccine until late January.
Assuming the vaccine is approved, Providence expects production to begin late this year or early next year – long after Mr Trudeau's September goal of vaccinating all Canadians.
With Canada releasing little information about its vaccination contracts, Mahesh Nagarajan, a professor at the University of British Columbia's Sauder School of Business in Vancouver, said it was impossible to determine if anything could be done to expedite supplies.
Dr. However, Nagarajan said the country's relatively small population and lack of membership in a trading bloc like the European Union put it in a comparatively weak negotiating position.
"When production is elsewhere and resources are scarce, you can't just assume that people will ship things," said Dr. Nagarajan, adding that the province's effectiveness in administering vaccines is likely to determine whether Mr Trudeau's September target can be met.
Dr. Fisman said he was optimistic that Canada "will be inundated with vaccine supplies by summer". By then, he had some advice for Canadians.
"People need to take a few deep breaths and get through March and April," he said. "I think we're actually fine."