Key Findings of the Auditor General of Canada

• Public Services and Procurement Canada (PSPC) secured a sufficient supply of vaccine doses for Canada.
• Health Canada expedited the authorization of vaccines.
• The Public Health Agency of Canada (PHAC or the agency) equitably allocated vaccine doses to provinces and territories and distributed requested doses in a timely way.
• PHAC was unsuccessful in its efforts to minimize vaccine wastage.
• Despite data sharing issues, PHAC and Health Canada responded to vaccine surveillance data.^[1]

Summary of the Committee’s Recommendations and Timelines

Table 1—Summary of Committee recommendations and timelines

Background

According to the Office of the Auditor General of Canada (OAG), the rapidly evolving nature of the COVID‑19 pandemic and the “high demand across the world for vaccines put pressure on the federal government to act quickly on COVID‑19 vaccine approval, procurement, distribution, and surveillance.”^[2] To that end, “Canada’s COVID‑19 Immunization Plan: Saving Lives and Livelihoods, established by the federal, provincial, and territorial governments in December 2020, has the goal of enabling as many Canadians as possible to be immunized against COVID‑19 as quickly as possible while ensuring that high-risk populations are prioritized.”^[3]

On 27 July 2021, the Government of Canada announced that it had received more than 66 million doses of COVID‑19 vaccines, enough to fully vaccinate every person in Canada who was eligible at that time (people aged 12 years and older). As such, the “federal government’s target to provide vaccines to those who wanted them by Fall 2021 was met.”^[4]

Additionally, according to the OAG’s assessment, “the Government of Canada had spent approximately $5 billion on vaccines for the 169 million doses paid for between December 2020 and May 2022.”^[5]

In Canada, COVID‑19 vaccine approval and immunization rollout began as follows:

• December 2020 for adults;
• May 2021 for adolescents;
• November 2021 for children aged 5 years to 11 years; and
• July 2022 for children aged 6 months to 5 years.^[6]

In Canada, public health is a shared responsibility between the federal government, the provinces, and the territories, with vaccine distribution logistics usually under provincial and territorial responsibility. However, Canada’s immunization response to COVID‑19 involved collaboration between all levels of government, “Indigenous organizations, municipal governments, public health and logistical experts, vaccine companies, and Canadians.”^[7] Table 2 outlines various roles and responsibilities pertaining to the approval, acquisition and distribution of COVID-19 vaccines.

Table 2—Roles and Responsibilities regarding COVID-19 Vaccines

Source:  Table prepared by the Library of Parliament with information from Office of the Auditor General of Canada, COVID-19 Vaccines, Report 9 of the 2022 Reports of the Auditor General of Canada, paras. 9.4–9.8.

In 2022, the OAG released a performance audit that determined whether PSPC provided adequate procurement support to secure COVID‑19 vaccines; whether PHAC and Health Canada efficiently provided access to COVID‑19 vaccines; and whether PHAC and Health Canada’s surveillance of COVID‑19 vaccines was effective and timely.^[8]

On 6 February 2023, the House of Commons Standing Committee on Public Accounts (the Committee) held a hearing on this audit, with the following in attendance:

• OAG—Karen Hogan, Auditor General of Canada; Susan Gomez, Principal; and Nadine Cormier, Director
• PHAC—Dr. Harpreet S. Kochhar, President; Luc Gagnon, Assistant Deputy Minister and Chief Digital Transformation Officer, Digital Transformation Branch; Stephen Bent, Vice-President, COVID-19 Vaccine Rollout Task Force
• Health Canada—Dr. Stephen Lucas, Deputy Minister; Celia Lourenco, Acting Associate Assistant Deputy Minister, Health Products and Food Branch; and Supriya Sharma, Chief Medical Advisor and Senior Medical Advisor, Health Products and Food Branch
• PSPC—Arianne Reza, Associate Deputy Minister; Michael Mills, Assistant Deputy Minister, Procurement Branch^[9]

Additionally, there were two other hearings for this study: a public hearing on 23 March 2023 with representatives of various vaccine manufacturers that had entered into Advance Purchase Agreements with the Government of Canada; and an in camera hearing on 1 May 2023 with officials from PSPC regarding these Advance Purchase Agreements (APAs). The discussions stemming from these two specific meetings will be presented later in this report.

Definitions

The following definitions are used in this report:

Table 3—Definitions

Source:  Table prepared by the Library of Parliament with information from Office of the Auditor General of Canada, COVID-19 Vaccines, Report 9 of the 2022 Reports of the Auditor General of Canada, Definitions.

Findings and Recommendations

PHAC Was Unsuccessful in Its Efforts to Minimize Vaccine Wastage

PHAC knew that the potential existed for advance purchase agreements to result in excess doses and identified this as a risk in the summer of 2020. To mitigate this risk, it expected to donate excess doses to other countries and to work with vaccine companies to manage the vaccine supply.^[10]

As at 31 May 2022, six out of seven potential vaccines had been authorized for use in Canada. And, with each authorized vaccine came an obligation to purchase a specific quantity of doses and, for all but one agreement, options to purchase additional doses. This resulted in an oversupply of vaccine doses.^[11]

The agency purchased optional doses from Pfizer and Moderna, further contributing to the oversupply, which led to vaccine wastage as some of the doses expired before they could be used or donated. Agency officials explained that, due to 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.”^[12]

From December 2020 to the end of May 2022, there were about 169 million vaccine doses paid for, about 124.9 million of which were delivered to Canada. (PHAC reported that the majority of these doses were administered to individuals in Canada.)^[13] Subsequently, there were close to 32.5 million doses in federal, provincial, and territorial inventories. By the end of the audit period, the majority of them still had a shelf life and could be used in booster campaigns or donated; however, most would expire by the end of 2022, if unused. The OAG estimated that the 32.5 million doses in inventory at the end of May 2022 were worth about $1 billion using the average cost-per-dose estimated using publicly available and unclassified information.^[14]

Lastly, the agency was not able to properly track vaccine surplus and wastage once vaccines were delivered to the provinces and territories, because of a lack of data-sharing agreements with provinces and territories. This meant that PHAC relied upon voluntary reporting by these other governments. Furthermore, this reduced the agency’s ability to predict supply needs and plan for donations.^[15]

Consequently, the OAG recommended that to “minimize further wastage, the Public Health Agency of Canada should draw on the lessons learned from its management of the COVID‑19 vaccine supply and work with other implicated federal organizations and stakeholders to adjust its management of COVID‑19 vaccine surpluses.”^[16]

In its Management Response and Action Plan, PHAC stated its agreement with the recommendation and added that it will review lessons learned and collaborate with other departments and stakeholders to optimize COVID-19 vaccine supply management and reduce COVID-19 vaccine surpluses, wastage throughout the duration of the contracts. This will also help inform vaccine supply planning for future pandemics.^[17]

The agency also committed to the following milestones:

• Work with provinces and territories on demand planning and forecasting for COVID-19 vaccine supply leveraging the various governance and advisory committees within the Pan-Canadian Public Health Network (ongoing);
• Instruct PSPC, as contracting authority, to work with vaccine suppliers to adjust contractual commitments and delivery schedules, where possible (ongoing);
• Work with Global Affairs Canada and COVAX to make surplus doses available for donation to support global health and vaccine equity objectives (ongoing);
• Continue to evaluate internal processes, identify lessons learned and make adjustments to the approach in order to optimize vaccine supply management (ongoing); and
• Draft a “lessons learned” document on PHAC public health response, including vaccine procurement (December 2024).^[18]

At the hearing of 6 February 2023, members expressed concern about the volume of expired doses that could not be donated and thus were wasted. Harpreet Kochhar, President, PHAC, provided the following explanation:

I'll attempt to clarify that wastage is inevitable in any immunization program. When we initially started the vaccination campaign, the unavoidable wastage was around 3%. Basically, when you open the vial, you have to use it within a 24-hour time period, or it cannot be stored, etc.

As we moved further into our vaccination campaign, demand decreased. There were some other factors that meant that, from a wastage perspective, there was increased waste. In reality, what happened was that there were times when we had vaccines that were very complex, early in the rollout. As I said, you have to thaw them and you have a limited time period in which to use them. Also, as we moved on to other vaccines, stability data became more…such that we were able to say, “This vaccine could be used in nine months.” For example, Health Canada authorized an increase in the shelf life based on what was presented to them, so we continued to plan according to the nine‑month….

There were multiple factors that happened: cold chain excursions, puncturing of the vial, or inability to store at a particular temperature. Those were multiple factors that contributed to wastage, which is unavoidable.^[19]

In response to a question about the specific example of why only 8 million of 21.7 million doses were donated, with regard to what became of the remaining 13 million, Stephen Bent, Vice-President, COVID-19 Vaccine Rollout Task Force, PHAC, responded as follows:

[It’s] fundamentally important to note—that these doses were put on offer. There were countries that were not interested in taking them. It's not the fact that they were not accessible to the countries, it was the fact that COVAX could not find suitable homes for them. That was a difference from the early part of the pandemic, when there was a lot of demand and a scarcity of supply.^[20]

Therefore, the Committee recommends:

Recommendation 1

That, by 30 September 2024, the Public Health Agency of Canada present the House of Commons Standing Committee on Public Accounts with a report outlining its progress regarding A) its overall management of the COVID‑19 vaccine supply; B) its efforts to minimize vaccine wastage; and C) the number of doses donated, to whom, and an explanation for why some were not. A final report should also be presented by 28 February 2025.

Delays in Implementing a Vaccine Management Information Technology System

The OAG’s 2021 audit of pandemic preparedness, surveillance, and border control measures identified long-standing shortcomings regarding the PHAC’s information technology (IT) infrastructure used for the storage, processing, and analysis of health surveillance data from provinces and territories. In fact, for over 10 years before the COVID‑19 pandemic, the agency had also identified gaps in its existing IT infrastructure but had not implemented solutions to improve it.^[21]

Given this deficiency, during the pandemic, PHAC needed to rapidly implement a system to support vaccine management. In January 2021, Deloitte was contracted to develop a national vaccine management IT system (now known as “VaccineConnect”). Using data from PHAC, the provinces, and territories, the system was expected to “provide timely information on vaccine distribution, coverage, and safety. Some capabilities were to be in place by February 2021 to support order processing, supply chain visibility, inventory tracking, and vaccine coverage tracking.”^[22]

Although VaccineConnect was partially functional by June 2021, PHAC delayed the development of key system capabilities that would have helped with decision-making on wastage (e.g., tracking of expiry dates). The contract’s total estimated cost was $59.1 million; $37.4 million had been spent on VaccineConnect by the end of the audit period.^[23]

Later, key capabilities of the new system were delayed by the agency and were not ready in February 2021 as planned. PHAC developed workaround procedures and manually tracked expiry dates, wastage, and all the data from the start of the vaccination rollout to June 2021 in spreadsheets. However, the OAG found that, although some components of the system were functional in June 2021, the agency, provinces, and territories were not using them all, and PHAC still tracking data using spreadsheets.^[24]

PHAC had limited procedures in place to verify data quality for both its manual tracking and for VaccineConnect. This resulted in gaps in the inventory management data provided and a risk of error. For example, the OAG found that 150,000 doses appeared to have been delivered after they had expired, when in fact, they had not yet expired.

Consequently, the OAG recommended that the Public Health Agency of Canada should complete implementing VaccineConnect. This should include data quality procedures.^[25]

In its action plan, the agency stated its agreement with the recommendation and added that it is actively working to advance the implementation and data quality procedures of the three modules of VaccineConnect: the Intelligent Supply Chain (ISC); the Immunization Information System (IIS); and the Immunization Program Management (IPM). PHAC will continue to actively engage jurisdictional partners on identification of service gaps and emerging needs in order to support future integration of the systems.^[26]

The agency also added the following milestones:

• The 2.0 iteration of the ISC module was released in the Fall of 2022. The release has provided a streamlined user experience while providing business owners with additional reporting capabilities. Additional prioritized enhancements including wastage and inventory data collection, analysis, and interpretation for management of current and future demand and supply will be completed by 31 March 2023.
• IIS is evolving to a renewed foundation for vaccine data transfers of vaccine surveillance data between provinces, territories and PHAC. The Canadian Adverse Events Following Immunization Surveillance System (CAEFISS) is scheduled to be replaced by Cloud CAEFISS (a component of the IIS), with a planned Minimum Viable Product (MVP) targeted for early 2023 (Q4 2022/2023). This release will include user-requested capabilities for automated inter-jurisdictional interoperability and new vaccine surveillance monitoring tools. Subsequent releases, MVP+2 and MVP+3, including additional functionality are planned for Q1 2023 and Q2 2023 respectively, depending on securing further funding.
• PHAC will complete parallel validation of the Cloud CAEFISS system and data quality procedures to inform the decision regarding timing of full transition from the existing CAEFISS to Cloud CAEFISS (Completion date: 30 November 2023).^[27]

At the hearing of 6 February 2023, in response to a question about the outstanding $21.7 million of the contract to develop VaccineConnect (i.e., the difference between the total cost of $59.1 million and $37.4 already paid), Harpreet Kochhar provided the following explanation:

The contract was with a contracting firm that was providing those services to us. The rest of the money was actually spent on making sure we had the infrastructure available for it to work.^[28]

Dr. Kochhar also confirmed that the agency is “actively working to fully implement VaccineConnect” and as of November 2022, “the system has a newer module for tracking orders and inventory at the central level to support supply chain management.”^[29]

Therefore, the Committee recommends:

Recommendation 2

That, by 30 September 2024, the Public Health Agency of Canada present the House of Commons Standing Committee on Public Accounts with a report about the status of VaccineConnect.

Data-Sharing Problems Remain

The OAG found that some of the problems regarding the sharing of surveillance data that had been raised in several previous audits remained; e.g., the 2021 audit of pandemic preparedness, surveillance, and border control measures. In the current audit, those long-standing issues affected the effectiveness of the agency’s sharing of detailed case-level safety surveillance data with Health Canada, the World Health Organization, and vaccine companies. These issues also affected PHAC’s ability to collect disaggregated vaccine coverage data on population characteristics (e.g., ethnicity).^[30]

According to PHAC, Canada is the only G7 country that does not follow World Health Organization guidance that countries provide detailed, case-level data on COVID‑19 adverse events following immunization. Instead, the agency shared summary-level data.^[31]

Therefore, the Committee recommends:

Recommendation 3—on following WHO guidance

That the Government of Canda follow World Health Organization guidance that countries provide detailed, case-level data on COVID‑19 adverse events following immunization.

Additionally, PHAC established the Canadian COVID‑19 Vaccination Coverage Surveillance System at the start of the pandemic. It initially manually compiled data submitted voluntarily by provinces and territories, but by June 2021, the agency was processing this data electronically. However, a review of the data showed that some population characteristics (e.g., ethnicity or Indigenous status) were not included, because provinces and territories do not always collect or share that information. According to the OAG, without this type of disaggregated data, PHAC could have less information to target programs or communications to groups that may be at higher risk.^[32]

Since October 2020, PHAC and Health Canada have led work with partners, such as provinces, territories, and Indigenous organizations, on the Pan-Canadian Health Data Strategy. Its aim is to advance efforts to improve health data collection, sharing, and usage. However, “in a 2021 report, the Chief Public Health Officer of Canada noted that the strategy was not expected to be implemented prior to 2030 and encouraged the acceleration of its implementation.”^[33]

Consequently, the OAG recommended that given “the urgency and importance of improving timely access to quality data among health partners, the Public Health Agency of Canada and Health Canada should expedite their work with provinces and territories to implement the Pan-Canadian Health Data Strategy.”^[34]

In its action plan, PHAC stated that the Agency and Health Canada have been working with provinces and territories to co-develop the Strategy since December 2020 and that the Strategy “will address the long-standing issues affecting Canada’s ability to collect, share, access and use health data.”^[35] It also provided the following:

Through the Strategy’s series of commitments and proposed actions for improving Canada’s health data foundation, it will enable better health outcomes and public health responses for individuals, communities, and Canadian society through learning health systems.

Implementation will take place over several years, guided by aligned policies and frameworks with an integrated workplan. A review is planned for every three years. The pace of implementation will respect individual jurisdictions’ capacity, readiness, and seek opportunities to accelerate implementation through collaboration and re-use of expertise.^[36]

Health Canada’s action plan also stated that it will continue to collaborate with PHAC, along with the provinces and territories, to advance the development and implementation of the Strategy, and committed to the following milestones (by the end of 2023):

• Ministers endorse the Pan-Canadian Health Data Strategy as a long-term vision for better health data management guided by the Health Data Charter.
• Ministers affirm support for interoperability standards to enable data access and exchange.
• Ministers agree to Common Aims for supporting jurisdictional approaches to health data access and exchange, including through policy or legislative approaches.
• Federal, Provincial, and Territorial officials confirm governance, priorities and implementation plans.^[37]

At the hearing of 6 February 2023, Karen Hogan, Auditor General of Canada, explained some of the challenges of managing vaccine supply with the provinces and territories:

That's one issue we were trying to raise. It's that the federal government actually loses some visibility in what happens to the doses once they've been delivered to the provinces and territories.

VaccineConnect was suppose[d] to help with creating some awareness of where those doses were used, administered or expired. The long-standing issue of not having data-sharing agreements is that it just doesn't allow the provinces and territories to let the federal government know where the information is, who has it and how to share it.

Those have been long-standing, where an agreement needs to be in place, back to 1999.^[38]

In response to a question about the current status of the development of the Strategy, Stephen Lucas, Deputy Minister, Health Canada, provided the following:

During the course of the pandemic, the Public Health Agency and Health Canada worked extensively with provinces and territories to support and facilitate data information sharing, including working with them towards common interoperability standards so that data systems can communicate with each other in the country.

We have been working with provinces, territories and other stakeholders, informed by advice from an expert advisory group chaired by Dr. Vivek Goel, on developing a pan-Canadian health data strategy to facilitate the collection, sharing, use and public reporting of health data.^[39]

Dr. Lucas further added that this work has continued with health officials, and elements of the strategy were to be discussed at the First Ministers meeting of 7 February 2023.^[40]

Therefore, the Committee recommends:

Recommendation 4—on the Pan-Canadian Health Data Strategy

That, by 30 September 2024, the Government of Canada present the House of Commons Standing Committee on Public Accounts with a comprehensive report about the status of the Pan-Canadian Health Data Strategy.

The OAG also recommended that the “Public Health Agency of Canada, in collaboration with Health Canada and the provinces and territories, should resolve barriers to

• better share vaccine surveillance information among themselves;
• provide access to the Canadian Adverse Events Following Immunization Surveillance System to Health Canada; and
• provide surveillance data, including case-level details as needed, to the World Health Organization and vaccine companies in a timely manner.”^[41]

In its action plan, PHAC acknowledged that information sharing is an important component of Canada’s vaccine safety surveillance system, which is a collaboration between provinces and territories, the Agency, Health Canada, and vaccine manufacturers, and will continue to advance better information-sharing with its partners.^[42] It also provided several milestones (refer to Annex A).

At the hearing of 6 February 2023, Stephen Lucas reiterated Health Canada’s agreement with the recommendation and added that it will continue to collaborate with PHAC, the provinces and territories on the pan-Canadian health data strategy, and supports ongoing work with them to provide greater access to the Canadian adverse events following immunization surveillance system.^[43]

Therefore, the Committee recommends:

Recommendation 5—on the Canadian Adverse Events Following Immunization Surveillance System

That, by 30 September 2024, the Government of Canada present the House of Commons Standing Committee on Public Accounts with a comprehensive report about the status of the updated, cloud-based Canadian Adverse Events Following Immunization Surveillance System.

Additional Matters Pertaining to CanSino, Medicago, and Pfizer

CanSino

At the hearing of 6 February 2023, members asked several questions pertaining to the government’s efforts to secure a vaccine with CanSino. However, witnesses from PSPC and Health Canada responded by stating that no APA was negotiated with them and that their organizations were unable to respond to those questions; however, both suggested that Innovation, Science and Economic Development Canada might be able to do so.^[44]

In response to a further question about an agreement between CanSino and the National Research Council of Canada, and possible reasons for which it was not included in the audit, Karen Hogan provided the following:

We did speak to it at the beginning of the audit, when we were scoping, but as I mentioned, it wasn't a contract that resulted in an advance purchase agreement for vaccines for the country, so it wasn't included in the scope of our audit.^[45]

Medicago

There were also questions pertaining to Canadian-based COVID-19 vaccine manufacturer Medicago (maker of Covifenz), and its current role, capacities, and obligations, given that its parent company, Mitsubishi Chemical Group recently announced plans to wind down its operations. For example, at the hearing of 6 February 2023, in response to a question about an order for 20 million doses of Covifenz, Arianne Reza, Associate Deputy Minister, PSPC, provided the following:

[With] the recent news from Mitsubishi and Medicago, coupled with the demand and our constant review of contracts, there are active negotiations going on right now looking at the 20 million doses and what can be done to adjust it.^[46]

Additionally, when asked about why the approval process was longer for Covifenz than for other vaccines, Celia Lourenco, Acting Associate Assistant Deputy Minister, Health Canada, provided the following:

For the Pfizer and Moderna vaccines, it took three months for us to evaluate all the data and approve the vaccines.

It took much longer for the Medicago vaccine because the company was very late in providing all the data. The evaluation began in April 2021. We did not receive the data for phase 3 until December 2021, and we approved the Medicago vaccine in February 2022.^[47]

Following the hearing of 6 February 2023, the Committee received supplemental information from federal organizations; selected specific information about Medicago can be found in Appendices B and C.

Lastly, during a hearing held with representatives of the pharmaceutical industry on 23 March 2023, when asked about their APA for 20 million doses that were never produced, Toshifumi Tada, President and Chief Executive Officer, Medicago Inc., provided the following:

Although we got an approval from Health Canada in February of last year and were preparing for the launch of the product, we faced unexpected quality problems. While we were fixing these, market needs for the vaccine evolved toward bivalent vaccines. Our vaccine is monovalent. Therefore, we just…. The approved vaccine was irrelevant, because of the market evolution.^[48]

Pfizer

When asked why Canada only signed an APA with Pfizer in October 2020 but the United States signed a contract in July of that year, Fabien Paquet, Vaccines Lead, mRNA Vaccines and Antiviral Portfolio, Pfizer Canada, provided the following:

The actual first agreement that was signed and communicated was in August of 2020. That was the first agreement that Pfizer signed. That was an early agreement to actually establish a basis for a more detailed agreement later on. That was basically a couple of weeks after the U.S. and among the first in the world after the U.S.^[49]

When asked why Pfizer’s vaccine rollout in Canada lagged behind that of the U.S., Mr. Paquet explained that “in 2021 in Canada, Pfizer alone delivered over 55 million doses, which is way above what was initially in the contract. In other words, Pfizer has been able to deliver more vaccines faster in Canada than what was initially planned in the contract.”[50]

Additional Considerations

On 1 May 2023, the Committee held an in camera hearing with officials from PSPC to review the unredacted COVID-19 vaccine contracts (i.e., the APAs). This section includes information about the COVAX program; it also includes other matters that were discussed at that hearing for which recommendations have been made.

The Committee wishes to emphasize that the extraordinary measure of including in camera testimony is due to the nature of the COVID-19 pandemic. Some members believe that relevant testimony heard in camera was deemed critically important to this study, and is within the Committee’s mandate.

The COVAX Program

According to the World Health Organization, COVAX “is the vaccines pillar of the Access to COVID-19 Tools (ACT) Accelerator. The ACT Accelerator is a ground-breaking global collaboration to accelerate the development, production, and equitable access to COVID‑19 tests, treatments, and vaccines.”[51]

In response to a question about Canada’s participation in the COVAX program, an official from PSPC, provided the following:

In September 2020, we signed an agreement with COVAX and provided an upfront payment of U.S. $53 million, which would allow us access of up to 15 million doses. We ended up drawing five million doses under that agreement. Of that, we received 900,000 doses in Canada and donated the rest.[52]

When asked if having separate negotiations with seven manufacturers (i.e., Moderna, Novavax, Medicago, Pfizer-BioNTech, Sanofi and GlaxoSmithKline, Johnson & Johnson (Janssen), and AstraZeneca) was contrary to the spirit of the COVAX program, that same official responded as follows:

I wouldn't characterize it as being signing side agreements. We had a strategy to acquire a portfolio vaccines of the most promising candidates should they be approved, and get early access for Canadians. We didn't see them as side agreements; we saw them as part and parcel of the strategy.[53]

Lastly, with regard to Canada’s participation the program’s donation process, that same official provided the following:

I believe throughout the pandemic we had been trying to support donations. It's been a challenging space. There's more supply globally and more production globally then there is uptake.[54]

Recommendations

In view of the many matters discussed during the in camera hearing of 1 May 2023, the Committee makes the following recommendations to help the Government of Canada better prepare for future pandemics with regard to the supply of vaccines:

A.  Improved Communication and Consultation Across the Government

Discussions were held on the necessity to have a clearer understanding of the role of each entity involved in the federal decision-making process of vaccine procurement. For example, the official from PSPC, provided the following:

I would submit that the task force would make recommendations. Those recommendations would go [PHAC]. The president of [PHAC] would have made a decision based on the advice of the task force, their own officials, and probably advice from Health Canada […]

I would agree that in terms of taking lessons learned it's important to look comprehensively at the role of the task force, their responsibility, their mandate, and their impact on the decisions. I would agree that's a key area to look at.^[55]

Therefore, the Committee recommends:

Recommendation 6—on improved co-ordination across government

That the Government of Canada ensure a system of improved communications and consultation between any advisory group (e.g., the COVID-19 Vaccine Task Force) and the Public Health Agency of Canada, Health Canada, Public Services and Procurement Canada and any other federal entity involved in the management of vaccines, with a clearer and publicly divulged role assigned to each entity.

B.  Procurement Challenge Function

That a large amount of purchased vaccines expired before they could be used or donated raised points about how even with large quantities of doses on hand, more doses were being ordered. Some members felt that if the contracting agent, in this case, PSPC, had more of a say in the process, there may be a chance to better communicate about what has been procured thus far, what has been used, and what the provinces are saying with regard to their supply; this may help reduce excess supply of vaccines that may go unused.[56]

Therefore, the Committee recommends:

Recommendation 7—on the procurement challenge function

That the Government of Canada ensure that Public Services and Procurement Canada is more diligent in its challenge function role with regard to how the amounts and delivery of approved vaccines are managed.

C.   Contract Flexibility

Points were raised regarding the structure of the APAs and to what extent Canada was obliged to purchase vaccines. These agreements specify the purchase of certain amounts at certain prices, at different stages of the pandemic—for example, re-supplying an existing vaccine or trying to obtain a newer version that targets variants, etc. Notwithstanding the challenging circumstances under which the government was procuring vaccines, some members felt that the pharmaceutical companies could have had the potential to take advantage of the situation.[57]

Although the witnesses from PSPC stated that the contracts and the companies did offer some degree of flexibility, the Committee nevertheless recommends the following:

Recommendation 8—on contract flexibility during a pandemic

That the Government of Canada ensure that all contracts procured during a pandemic or other public health crisis allow for flexibility, while ensuring accountability and value for money.

D.  International Vaccine Marketplace

Some members voiced concerns about how Canada had to negotiate with vaccine producers in a global marketplace. In response to a question about why some companies were reluctant to enter into negotiations with Canada (e.g., AstraZeneca), the official from PSPC provided the following:

[They] were reluctant because they were certainly focused on the United Kingdom where they were actually developing. Again, in the context of global competition, they were negotiating agreements with other countries, and looking also to participate in a global co-operative agreement for vaccines.

Looking at those two things, we were competing not just in a negotiation with a company, but also in the context of their negotiations and commercial interests with other countries.^[58]

In light of what was learned during this pandemic, especially regarding the challenges Canada faced in negotiating with vaccine manufacturers in a global context, the Committee recommends the following:

Recommendation 9—on knowing the international vaccine marketplace

That the Government of Canada ensure that responsible federal entities maintain a comprehensive understanding of the international marketplace for vaccines.

E.   Pandemic Preparedness

The Committee heard that other countries had looked at what was learned from the pandemic and how they could be more prepared for the next one. For example, another official from PSPC provided the following:

I know in the United States there was a major “Lessons Learned” report. It was not done officially by Congress, but by a number of think tanks. Those are the kinds of resources we like to make sure we’re aware of and benefit from lessons learned elsewhere… and we’re going to move ahead with our collective learning, including advancing the bio-manufacturing strategy and enhancing our readiness for the next time.^[59]

Therefore, the Committee recommends:

Recommendation 10—on pandemic preparedness

That the Government of Canada require all responsible federal entities to undertake a comprehensive review of their preparedness for future pandemics, including a comparative analysis of OECD countries and report its findings to the House of Commons Standing Committee on Public Accounts by 31 January 2025.

F.   Domestic Manufacturing and Research Funding

There were several points raised about how Canada did not have suitable domestic vaccine manufacturing capabilities to meet the COVID-19 pandemic. For example, in response to a question about federal investments in Medicago, the first official from PSPC provided the following:

The investment in the manufacturing facility was for the future. We were hoping that some of the doses would get manufactured there. One of the lessons learned in the early parts of the pandemic was the need to have Canadian capacity. That investment was really driven by having capacity for the future, a bonus if it could actually produce some of the COVID doses.^[60]

The second official later added that “the absence of a strong domestic manufacturing capacity in Canada influenced our bargaining position. It would have been a different playing field had we had major domestic manufacturing capacity.”^[61]

Therefore, the Committee recommends:

Recommendation 11—on domestic vaccine capacity and research funding

That the Government of Canada 1) undertake a review of Canada’s domestic vaccine manufacturing capacity; 2) examine how it can improve upon its current suite of policies and programs to boost domestic capacity; and 3) provide a report to the House of Commons Standing Committee on Public Accounts by 31 January 2025.

Conclusion

The Committee concludes that although the Government of Canada procured sufficient quantities of COVID-19 vaccines, it was deficient in several areas of managing its supply. Much work needs to be done in order to facilitate the secure and efficient transfer of key health-related data between the federal government and the governments of the provinces and territories.

In this report, the Committee makes 11 recommendations to help the federal government better manage its administration of vaccines for the COVID-19 and future pandemics.