Justin Trudeau COVID-19 Press Conference March 30: AstraZeneca Vaccine, Vaccine Deliveries

Justin Trudeau: (00:01) [French 00:00:01]. Hello, everyone. [French 00:00:03]. We have a lot of ground to cover this morning, so let's get right into it. I'll begin with vaccines. This morning, I visited the vaccination clinic at the Nepean Sportsplex here in Ottawa. It was great to see more and more people getting vaccinated. People were in a good mood. A lot of folks were there with their elderly parents. Everyone was chatty and focused, but quite frankly, it was the amazing volunteers, who were working so hard, who really encouraged us all, and we saw smiles on everyone's faces. Justin Trudeau: (00:41) I also had the chance to chat with a few of the many healthcare workers who are part of this vaccination effort, who're all doing an incredible job during this really tough time. My job as a politician is usually go around shaking hands, so that wasn't the challenge that we got to do. There was a number of older folks who I needed to remind that an elbow bump is the way we do it, but we're all figuring out how to navigate through this, and the fact that so many people are getting vaccinated is a really good thing. Justin Trudeau: (01:12) Our frontline workers have given up a lot to stay safe. Last week, I spoke to nurses from the Victoria General Hospital in Winnipeg. They shared what this past year has been like caring for isolated patients in serious situations, sometimes being their only point of contact, and holding an iPad or holding their hands while family members watch through a window, was incredibly difficult, incredibly challenging for healthcare workers across the country, even more so when it comes to the fears that on returning home, they might be bringing home this disease to their families. It's been incredibly stressful, but they continue to step up every single day, and all of us need to make sure we're doing the best we can to keep them from getting overwhelmed and overloaded with new cases, but everything they do makes them the heroes of this pandemic. Justin Trudeau: (02:08) [French 00:02:08]. As we've been saying for months, and as we've been planning with the provinces and territories since last year, the end of March will be followed by an increase in vaccine supply. We now have handily exceeded our promise target of six million doses delivered before April, and this week we begin our ramp-up phase. Throughout April and May, a million doses a week are scheduled to arrive from Pfizer alone, plus Moderna, plus AstraZeneca. For June, we have good news to share this morning. Pfizer has now confirmed that they will be moving up five million doses from later in the summer into June. That'll bring our total from 4.6 million to 9.6 million doses for that month alone. Of course, that's in addition to the other doses of the Moderna and AstraZeneca vaccines that we'll also get. Justin Trudeau: (03:48) A lot of doses being delivered means a lot of people who are able to get their shot. If you haven't had your vaccine already, it might be your turn or a family member's turn soon. If you want to learn more about vaccine safety and effectiveness, there'll be a Facebook live event tomorrow, where Dr. Tam, Dr. Njoo, and other experts will answer Canadian's questions directly. To attend or get more information, go to the Healthy Canadians Facebook page. Justin Trudeau: (04:18) Today, I also want to talk about where we are with the virus, and what that means going forward. In some places, cases of COVID-19 are holding steady, or even going down, and especially in longterm care homes, vaccination seems to be making a real difference in protecting people from outbreaks. That said, hospitalizations from COVID-19 remain high, and case numbers are going up in many regions here in Canada and around the world. Variants of concern, which can spread more easily and make people even sicker are increasing quickly. In BC, where the number of cases had been under control, they're now having to put in place new restrictions for the next three weeks. I want to extend my full support to Premier Horgan, and to all premiers across the country as they make tough decisions to keep people safe. Justin Trudeau: (05:11) As we have since day one, the federal government will have their backs and do whatever it takes to save lives, to protect our frontline workers, and to support jobs and businesses until we get through this. [French 00:05:25]. As we rebuild from this pandemic, we have to make sure no one gets left behind. Yesterday, Ministers McKenna and Monsef announced $250 million for transit in rural and remote communities. This fund is part of the unprecedented public transit investment we announced last month, and it is the first federal fund dedicated to rural transit. This is part of our job to create jobs and fight climate change. It's also about building more inclusive communities where seniors can get to their doctor's appointments and where people of every age can get the services they need. Justin Trudeau: (08:18) Before I end today, I want to say a few words about Easter and Passover. Again this year, we won't have the kinds of celebrations we were all hoping for, because we just can't afford to let our guard down. I know I've said the same thing before every major holiday over the past year, but this time, what's different is that even if the end of the pandemic is in sight, the variants mean the situation is even more serious. We're entering the final stretch of this crisis. We just need to stay strong a little longer. More and more vaccine doses are coming every week, so there's reason to be hopeful, so please keep yourself and your loved ones safe. Now is not the time to travel. Avoid gatherings and parties, and continue to keep your distance. I know it's not easy, but together we will get through this. [French 00:09:15]. Anita. Anita: (09:25) Good morning, and thank you for joining us today. By the end of this week, Canada will have received approximately 9.5 million doses of approved vaccines from three manufacturers, Pfizer, Moderna, and AstraZeneca. This is well ahead of the six million doses that we had originally projected for the first quarter of this year, with 3.2 million doses arriving this week. The work to accelerate the delivery of doses continues every day. [French 00:10:01]. As the prime minister just announced, Pfizer-BioNTech is again accelerating deliveries to Canada, with an additional five million doses arriving in June. Canada will receive at least one million doses of the Pfizer-BioNTech vaccine every week from now until the end of May, and in June, that will be two million doses a week every week. Anita: (10:56) Canada was among the very first countries in the world to sign a deal with Pfizer, and we have worked constructively with the company and all suppliers in order to ensure a stable supply of vaccines for our country. Originally, we had contemplated approximately eight million Pfizer doses in the second quarter alone, and now, due to successive negotiations with the company, we are set to receive close to 18 million doses of Pfizer by the end of June. This means millions more additional doses available to be administered to Canadians by the first days of summer. We said that when vaccines were ready, Canada would be ready, and we are with a diversified portfolio of vaccines. This is why, in addition to the accelerated Pfizer doses, 1.5 million doses of AstraZeneca's vaccine were loaded onto trucks this morning in the United States and are en route to Canada as we speak. Anita: (12:05) We also expect 4.4 million additional doses of AstraZeneca before the end of June. Combined across the currently approved vaccines, Canada is now on track to receive at least 44 million doses of vaccine by the end of June, and very well on the way to having more than enough to ensure that every Canadian who wishes to be vaccinated can be fully vaccinated by the end of the summer. [French 00:13:07]. The government of Canada will continue to bring vaccines into this country, while managing the inherent volatility in global supply chains for this product. We will see through this challenge together. [French 00:13:23]. Thank you. Speaker 1: (13:25) And we'll turn it over to Dr. Tam. Dr. Tam: (13:36) [French 00:13:36]. Today, we'll touch on the recent safety signal associated with the use of the AstraZeneca vaccine in adults under 55 years of age. But first, we'll begin with an update on the current numbers and trends. Dr. Tam: (13:53) COVID-19 activity has been steadily increasing for several weeks, with a rising number and proportion of more contagious variants driving epidemic growth in many areas. To date, over 970,000 cases of COVID-19, including 22,900 deaths, have been reported across Canada. Over the past week, there have been an average of over 4,600 new cases and 26 deaths reported daily. The ongoing increase in infection rates is now playing out in our hospitals, with rising trends and severe and critical illnesses placing renewed strain on the health system. Over the past week, an average of over 2,200 people with COVID-19 were being treated in our hospitals each day, representing a 6% increase over last week. Over 660 of these people were being treated in intensive care units, which is 14% higher than last week. Most concerning is the continued increase in number and proportion of variants of concern that spread more easily and increase the risk of severe illness outcomes. Dr. Tam: (15:13) Over the past week, there has been a 64% increase in new variant cases. To date, over 9,000 variants of concern cases have been reported across Canada, with the B117 variant accounting for over 90%. New variant case numbers represent the tip of the iceberg, as there are thousands more cases that have screened positive for problematic mutations. Yesterday, Health Canada issued a statement in relation to new data on additional cases of a rare type of blood clot known as vaccine-induced prothrombotic immune thrombocytopenia, or VIPIT, which occurred following the administration of the AstraZeneca vaccine in several European countries. To date, no cases of VIPIT has been reported in Canada. Nevertheless, as the data on these additional cases could change the risk/benefit assessment, Health Canada, as regulator, has put in place additional terms and conditions on the authorization of AstraZeneca vaccine in Canada. In the interim, Canada's National Advisory Committee on Immunization has recommended to pause the use of AstraZeneca vaccine for people age under 55 years, pending a full risk assessment by Health Canada. Chief medical officers of health have considered NACI's recommendations and have issued a statement outlining a unified decision to take this precautionary measure. I know that this is another difficult development in the seemingly never-ending twists and turns of this pandemic, but there is a point of grace. I couldn't have said it better, so I would just like to quote Dr. Menaka Pai, Associate Professor of Hematology and Thromboembolism at McMaster University, who notes, "Strong global vaccine safety surveillance rapidly picked up this rare and serious adverse event. Collegiality, academic rigor, transparency, and medical science will help us manage it." Dr. Tam: (17:37) As spring begins, warmer weather and important religious observations such as Passover, Easter, Vaisakhi, and Ramadan are upon us. We too must do our best, and remember our duty to protect one another. COVID 19 activity levels are different depending on where you are in Canada, but there is a risk of introduction and rapid acceleration of cases everywhere. Please continue to follow local public health recommendations, stick to safer ways we've learned to celebrate during COVID-19, and save gatherings for a better time in the future. Despite the hurdles, we are getting closer every day, and we're stronger and more united for it. Thank you. Speaker 2: (18:28) [French 00:18:28]. Dr. Newt: (21:00) [French 00:21:00]. Speaker 3: (23:41) Thank you, Dr. [inaudible 00:23:43]. Now we'll turn to questions from media. We'll start on the phone. And after we're done, the ministers and doctors will be available once the Prime Minister leaves after a few questions as well. Operator, over to you. Operator: (23:53) Thank you. [French 00:23:56]. Speaker 4: (23:58) [French 00:23:58]. Justin Trudeau: (24:13) [French 00:24:13]. Speaker 5: (24:51) [French 00:24:51]. Justin Trudeau: (25:03) [French 00:25:03]. Speaker 5: (25:54) [French 00:25:54]. Operator: (25:55) Thank you. [French 00:25:56] Next question, Ryan Tumilty, National Post. Line is open. Ryan Tumilty: (26:02) Yeah. Good morning, sir. I'm wondering, with the system that we have now in which Health Canada approves vaccines, and then NACI makes recommendations. In this case of the AstraZeneca vaccine, it seems to be sewing some confusion and some hesitancy having Health Canada say a vaccine is safe for all groups, but then having NACI saying that it should only be used for people over the age of 55. I'm wondering if you think fundamentally this structure maybe isn't fit for a pandemic, even if it works during normal times. Justin Trudeau: (26:33) I think what we saw yesterday, Ryan, was all the different levels of organizations of experts coming together, whether it was public health officials across the country coming out with a coordinated statement or a Health Canada and NACI working together to ensure that there is coordination in the messages. Look, I understand how challenging this be for Canadians. The science is evolving as we get more and more data. Experts are refining and shifting their recommendations. Justin Trudeau: (27:06) Canadians need to know that every step of the way there is one thing driving all these experts, and that is keeping Canadians safe and getting through this pandemic as quickly as possible. That is the underlying element to every recommendation, to every decision that is put out there. And I can tell you that the work that is being done is extraordinary, not just here in Canada, but coordinating with people around the world. Justin Trudeau: (27:38) The bottom line for Canadians is the right vaccine for you to take is the very first vaccine that you are offered. The more we get Canadians vaccinated quickly and safely, the quicker we'll be able to get back to a semblance of normality with the variants that are more severe and more transmissible increasing around the population, we need to make sure we're doing everything we can to get through this. Speaker 3: (28:10) Follow up, Ryan? Ryan Tumilty: (28:13) Yeah. So just as a followup, on the issue of vaccine hesitancy overall, we've seen reports that in some longterm care facilities only 60% or 70% of the staff are taking the vaccine. Toronto actually had to put a big push to get people into vaccine appointments last week. Now that we have this flood of vaccines coming, are you concerned about hesitancy about not getting people to take them quickly enough to end the pandemic? Justin Trudeau: (28:42) I think it's certainly something that is on our mind. We know that the way to get through this is to get as many people as possible vaccinated. And that's certainly our focus, but we're seeing, as I saw this morning at the vaccine clinic here in Nepean, people are positive and enthusiastic about getting vaccinated. And I think people understand that the way to protect us all is for people to get vaccinated. But maybe I'll turn to Dr. Tam for further thoughts on your first question and on the hesitancy question, Theresa. Dr. Tam: (29:16) Yes. On the first question, there are different roles for the different groups, but as the Prime Minister said, we work lock step, each playing its role. So Health Canada being the regulator triggered a signal to the manufacturer to say, "We need more data. We need it to be broken down by age and sex to look for this more serious and rare side effect that is being seen following immunization, even though we haven't seen it yet in Canada." Dr. Tam: (29:54) With that, while the data is being gathered we amass experts from Canada, but also had experts from Germany providing with their firsthand interpretation of what this clotting with low platelets entity is like. And some of the underlying scientific explanations. With that, the National Advisory Committee on Immunization looked into that and said, "While we're waiting for this information, for more information to come, we've seen enough of the science, but also what we've seen already coming out of the European countries to say, take the precautionary approach." And given the data that we've seen, where most of these rare cases occur in the under 55s, that's the recommendation they have provided, to pause offering the AstraZeneca vaccine for this age group for now. Dr. Tam: (31:01) And then all the chief medical officers got together, having heard all of this as well and made a unified position to take this precautionary approach. So that's how that all worked together, but all of it had to be done really quickly. And so I think you've seen that at play yesterday to take the precautionary approach, to keep Canadians as safe as possible while offering a safe and effective vaccine. Operator: (31:30) Thank you. Next question. Operator? Speaker 6: (31:38) [French 00:31:38] Speaker 7: (31:46) [French 00:31:46] Justin Trudeau: (32:25) [French 00:32:25] Speaker 6: (34:22) [French 00:34:22] Speaker 7: (34:25) [French 00:34:25] Justin Trudeau: (34:59) [French 00:34:59] Anita Anand: (36:24) [French 00:36:24] Speaker 8: (36:38) [inaudible 00:36:38] Is it possible to say at this point what impact these new restrictions on AstraZeneca are going to have on the overall vaccine rollout? And I guess the longer these restrictions stay in place, is that going to compound whatever impact there is? Operator: (36:50) I'll turn to Minister Anand, but I can say that our portfolio of vaccines was from the very beginning, as we've seen extremely heavily weighted towards Moderna and Pfizer. The fact that we are getting 1 million Pfizer doses every single week over the coming weeks, rising to 2 million a week for the month of June, the fact that the target of six million doses for Canadians by the end of March, by right now was based on Pfizer and Moderna alone means that we are still in very good situation. But of course, we want to get more doses of more varied vaccines, and ensuring the continued delivery of those doses rapidly, including the AstraZeneca doses to as many Canadians as possible in the coming months continues to be our priority. Anita, to follow up on that? Anita Anand: (37:45) Thanks, Prime Minister. Just to build on that, the advice of the vaccine task force of course was to procure vaccines from seven leading vaccine manufacturers. And the minimum amount of doses was 20 million for every two shot vaccine and 10 million for J&J. But in addition to that, we exercised options to purchase additional Moderna and Pfizer doses. So as the Prime Minister said, we are heavily weighted on Madonna and Pfizer as a result of exercising those options. Anita Anand: (38:22) We have 44 million doses of Moderna coming to Canada overall and 40 million doses of Pfizer coming to Canada overall. And as you're aware, 22 million doses of AstraZeneca. So we are continuing to exercise and see the benefits of a diversified portfolio of vaccines. Yes, we are heavily weighted on Moderna and Pfizer at the current time, but what we use as our baseline is the approval of Health Canada. Once a vaccine is approved by Health Canada, if it's safe and effective, and from a procurement standpoint, that means all systems are go to bring those vaccines into the country, which is exactly what PSPC does every single day. Thank you. Glen McGregor: (39:11) Glen McGregor, CTV News. Prime Minister, two weeks ago we had heard reports about blood clotting issues with the AstraZeneca vaccine, yet you came out and assured Canadians that it was safe and you encouraged them to go get it if it was offered to them. Now we know that there are concerns about this in younger people. Was it a mistake for you to do that? And do you think, will that change the way you give advice about vaccines in future? And finally, what would you say to the Canadians who, based on your advice two weeks ago, went out and had that AstraZeneca shot. Operator: (39:43) The advice given by health professionals, the advice that I gave was that the right vaccine for you is the very first vaccine that is offered, and Health Canada continues to ensure the safety and effectiveness of any vaccine administered in Canada. As we've seen over the past number of weeks, there are different recommendations and limitations given in as the science evolves, but every step of the way the recommendations that Health Canada makes and that I and other politicians pass along, because none of us are vaccine efforts, but we are there to help amplify the messages by Health Canada, that vaccines are safe and effective and that everyone needs to get vaccinated with whatever vaccine is offered to them as quickly as possible. But I will turn to Theresa for follow-up on that. Okay. [French 00:40:42] Theresa? Dr. Tam: (41:32) Yeah. So the advice on any medication or vaccine can evolve over time, and I think Canadians should be reassured that we have systems in place to detect safety signals and then analyze them. As I've said in my opening remarks, it's actually been quite a remarkable feat of international collaboration and science to try and sort out the initial ... Dr. Tam: (42:03) To try and sort out the initial reports. And I think the change in advice has been because there is now more information that was made available. And still, even if the events were rare, while things are being worked out, that's the balance of risk and benefit was examined. And that was the position and the advice that Health Canada and the National Advisory Committee on immunization had provided. Every medication or vaccine can come with rare side effects, which will not be picked up until many millions of people receive the vaccine. The initial clinical trial with tens of thousands will not pick up rare events. So I think the important thing, I think, to emphasize to everyone is that we have systems and checks and balances in place. But please do remember that over the course of the administration of the vaccine to many millions of people in the world, if there should be any new signals, we will be communicating that after a thorough examination, but science will continue to evolve in this space. Dr. Tam: (43:22) On those over 55 years of age and over, the balance of risk and benefit is such that the impact of COVID is much more serious in the older age groups. And that's the concern. We have a rising third resurgence and with an acceleration of cases and with serious outcomes in older populations, when compared to a relatively rare event, that's how Nassi made his recommendations as well. And a Minister Anand and the Prime Minister stressed, we do also have a fundamental base of MRNA vaccine. Speaker 9: (44:13) [foreign language 00:44:13]. Justin Troudeau: (44:41) [foreign language 00:44:41]. Theresa Wright: (46:20) Good morning Prime Minister. Theresa Wright from the Canadian Press. Obviously we're very preoccupied with vaccines today. What are you telling your children and other young people when they ask you, "When will I get the vaccine?" Justin Troudeau: (46:34) Obviously, we know how important it is to protect the most vulnerable, and that's why our vaccine rollout has been focused on elderly Canadians, on people in remote or indigenous communities, and of course, on frontline health workers, but we're getting closer and closer to the point where we will start to vaccinate more and more Canadians. But the imperative is always keeping Canadians safe. Part of keeping everyone safe is making sure there are increasing percentages of the population vaccinated, because that's part of what allows us to be safer as a society. But in terms of vaccination of younger people, we know there is much data being collected right now. There are studies ongoing. And for the latest on that, I'm happy to turn it to the expert and ask Dr. Tam about what the latest is on when we might know about how and when kids might start getting vaccinated. Theresa. You're on mute, Theresa. Dr. Tam: (47:46) Okay. Sorry. The clinical trials, as the Prime Minister said, is on a number of vaccines are ongoing. So I think first of all, some of the trials started in the older kids, at the youth, and then some of the younger population under the age of 12, some of the trials have only just started. So it's likely that we won't hear about the youth, the teenagers, until later on in the year, and then the younger kids beyond that. So sometimes clinical trials can go faster, particularly if the enrollment is fast and if there's actual disease activity in wherever those clinical trials are done. So the timeline is a bit variable. But that's all I know at the moment. Merica Walsh: (48:48) Good afternoon, Prime Minister, Merica Walsh with the Globe and Mail. For well over a month now, you've been asked what you personally knew about the allegations against General Vance in 2018. But instead of answering that question, you've pivoted to say what your office knew. I'm wondering if today, you can clarify for Canadians what you personally knew about the allegations against General Vance, whether you knew about them in 2018. Justin Troudeau: (49:13) No, we did not. My office knew there was allegations that were brought forward. We did not know the substance of those allegations until the Global News reporting. Mercedes Stevenson: (49:28) Hey, Prime Minister. Mercedes Stevenson with Global News. I want to follow up on Merica's question about what you specifically knew. I understand that nobody knew the substance of the allegations in 2018, but your office was aware that there were allegations made. We've asked your office what you knew about that, and the last two weeks, they just keep telling us that you have nothing to add. So I want to ask you very specifically today. Prime Minister, did you know about any allegations of any concerns of sexual misconduct regardless of the content in 2018 or before, and when you extended General Vance's term? Justin Troudeau: (50:03) No. Speaker 10: (50:08) Thank you. That concludes Prime Minister's time. We'll now turn to questions for doctors and ministers. Thank you, Prime Minister. We'll start on the phone with questions just in one moment, Operator. Operator: (50:37) Thank you, [foreign language 00:50:39]. Should I go ahead? Speaker 10: (50:47) Yes, please. Operator: (50:47) Okay. Next question. [foreign language 00:50:49]. Speaker 11: (50:56) [foreign language 00:50:56]. Speaker 10: (50:56) Minister? Anita Anand: (51:35) [foreign language 00:51:35]. Speaker 12: (52:24) [foreign language 00:52:24]. Speaker 13: (53:18) [foreign language 00:53:18]. Dr. New: (54:54) Okay. [foreign language 00:53:44]. Speaker 10: (55:01) Thank you. We'll now go to the next question from the next journalist. Operator? Operator: (55:05) Thank you. [foreign language 00:55:07]. Next question, Tonda Charles, Toronto Star. Line open. Tonda Charles: (55:12) Hi there. Thanks. I wonder if Dr. Tam or Dr. New or Minister Anand might be able to clarify a couple of things on the AstraZeneca piece for me. How many in that age group aged 18 to 55 have already received the AstraZeneca, given that Canada had already, as I understand it from the website, distributed about half a million to provinces? and I wonder Minister Anand, do you have a cancellation [inaudible 00:55:42] and get a refund on any portion of the AstraZeneca, if it turns out that there's such a hesitancy about receiving it, or if it's narrowed so much now only between the... Recommended between the 55 and 65 year old age group, as I understand it, because you prefer Pfizer, Madrona for the older group. Dr. New: (56:04) It's Dr. New. Maybe it can start to follow up on what I think I said yesterday. Based on the data that was provided, and I'm aware of, I think somewhat a bit over 300,000 doses have actually been administered of the AstraZeneca vaccine, or in this case, the one from the Serum Institute of India. I'm not sure, maybe Dr. Tam has additional comments, but that's my understanding. That's somewhere in the neighborhood of slightly over 300,000 doses administered. Thank you. Dr. Tam: (56:34) Yes. I'll just add, I think it's around 370 to 309,000 doses, but many of the provinces have been using them in over 55. So Ontario, for example, have not been using this vaccine. They continue to address the priority populations with the AstraZeneca vaccine. There was a couple of jurisdictions who may have used the AstraZeneca vaccine in the under 55s. But I think actually, the vast majority of provinces were still targeting the older age groups. And so I can't tell you exactly, but just to emphasize that we have not received any reports of those rare [inaudible 00:57:28] event with low platelets to date. Speaker 10: (57:35) Minister Anand? Anita Anand: (57:41) We are receiving 1.5 million AstraZeneca doses from the United States today as part of our contract with AstraZeneca for 20 million doses. And this is an approved vaccine in this country. As the Prime Minister has repeatedly said, any vaccine that has been approved is safe and effective and is the one that Canadians should take. And as a result, we will continue to bring in vaccines to this country following on from the approval of Health Canada for those vaccines, whether it's AstraZeneca, Pfizer, Moderna, or Johnson & Johnson. Thank you. Speaker 10: (58:25) Follow question, Tonda? Tonda Charles: (58:27) Yeah. Thanks. So I take that as a no to the cancellation refund business. 31 million Canadians is the estimate of the population over 18 that are supposed to be vaccinated with all the approved vaccines. So let's assume that most of those will be two dose vaccines because we don't have a schedule on Johnson & Johnson yet. So that's 62 million doses. Can you give us an update? When do you expect 62 million doses to have been delivered on Canadian soil? What is the schedule also for Johnson & Johnson? Anita Anand: (59:03) Well, just to refer to your comment before you asked the question, I wouldn't assume that, Tonda. I have said that the terms of our contracts are covered by confidentiality clauses, and I won't be breaching our contracts while we're trying to procure vaccines. Now, onto the question regarding the number of doses, my team can provide the precise breakdown in the numbers of doses. But as I mentioned, we expect 44 million doses of approved vaccine coming into this country, at least, prior to the end of June. And we are still finalizing the delivery schedule with J&J, but we have had discussions with them, including some correspondence that I was engaged in last evening, and our deliveries of J&J will be beginning at the end of April. Speaker 10: (01:00:19) Thank you. Next question, Operator? Operator: (01:00:23) Thank you. [foreign language 01:00:25]. Next question, Mike Likiter, Global News. Line open. Mike Likiter: (01:00:30) Thanks for taking our questions. I just wanted to address this to Dr. Tam and Minister Hide, you as well. And Dr. New can weigh in if you'd like. But like it or not, you've got a bit of a PR nightmare on your hands now with vaccine hesitancy because of AstraZeneca. At one point, the recommendation was not for over 65, then it was, now it's for not people under 55. Besides just saying, "Just trust us," what are you going to try and do now to, or what do you have to say to Canadians who might try and avoid AstraZeneca at all costs? Dr. Tam: (01:01:13) I don't know if Minister Hide is on the phone, but I could start. [inaudible 01:01:20]. And I think just to reassure Canadians that, oh, along the way, the recommendations were informed by the data at hand. So for those who are over 65, it was just that there wasn't enough data, as soon as the data came in, that the AstraZeneca vaccine was very effective in the prevention of illness and serious outcomes in that group. That didn't really come out through clinical trials. Those clinical trials didn't have enough people, but pointed towards that it would be effective. When the UK information and from other countries came in, the recommendation was rapidly shifted so that the vaccine was then recommended for the older age group. Dr. Tam: (01:02:06) So that's based on data that showed good effectiveness. So that's, I think, what everybody needs to remember. This, again, is new data and it's a precautionary approach for a rare event, but serious. So that is what the recommendation was based on. So I think fundamentally, the important thing is that, especially with safety signals, we want to be transparent and rest assure to all Canadians that the systems in place and that the vaccines that will be going out for whom they're indicated will be safe and the factor for those populations. So I think that's really, really key. I think, as the Prime Minister said, the provinces have come down to a consensus position. So when they offer the- Dr. Tam: (01:03:03) ... come down to a consensus position. So, when they offer the vaccine locally to you as an individual, those policies have already been put in place so that you take whatever you have given to you when you make that clinic appointment. That's the important thing. But it's because we have a rigorous system to essentially analyze that data and put out the recommendations. Dr. Tam: (01:03:26) Yes, this is a rapidly moving pandemic and the vaccines are put in place after very good clinical trials, but we will obviously continue to see data evolve. But it's only to make sure that we have the best and most safe and effective vaccines for Canadians. That's why the recommendations are changing. Dr. Tam: (01:03:54) So, I think vaccine confidence is important, so of course there needs to be more targeted approaches to different population groups. I know that seniors and those who at a very high risk of severe outcomes have been rolling up their sleeves. We've seen them keep coming to get the vaccine. Dr. Tam: (01:04:16) Certainly, up until now, the provinces have been using up the AstraZeneca vaccine that they were planning anyways, in terms of implementation. They're just going to start changing their operational stance so that they can deliver the vaccine to the target populations. I think, again, for Canadians, when the provinces offer you the vaccine, take the vaccine that you're provided. Dr. Njoo: (01:04:46) It's Doctor Njoo. I could maybe add to what Dr. Tam said. I think I understand the question, and certainly we understand that for the average Canadian there are obviously I think a lot of questions and concerns. I think when the chief medical officers of health met, on obviously a bit of an emergency basis on the weekend as we discuss this issue, it was top of mind as well, in terms of how would this affect the vaccine coffin, the flip side of vaccine hesitancy. Dr. Njoo: (01:05:19) I think, at the end of the day, what's really important and key is that it's good communication and being transparent and open. That's what I think is a very important moving forward. The chief medical officers of health agreed that they, as the spokespersons, as well in their individual provinces and territories, have a key role to play and they're certainly giving credible information on a daily basis to the residents of the province. I think it's very important so that their residents can feel comfortable and confident that the information they're getting from their public health leaders is good and they should be following, hopefully, the recommendations from their public health officials. Dr. Njoo: (01:05:59) Another key group that also needs to be engaged are the healthcare providers, because we know that the average Canadian actually trusts their health care provider, in terms of getting credible information. So, one of the things that we're doing is working very closely with the frontline healthcare providers, making sure that they're empowered, they have the tools, they have the credible information that they can then use to have informed discussions with their patients so that, at the end of the day, all Canadians can make an informed decision, in terms of the best choice of what they should be doing. Which obviously we want to keep encouraging Canadians take the first vaccine that's offered to you. Obviously, all of the approved vaccines in Canada have been approved by Health Canada as being safe and effective. Thank you. Moderator: (01:06:44) Thank you. I'll now turn to the room for questions. Just as a note that we've got about 10 minutes left. So, we'll aim for brief answers with equal questions. Thank you. Speaker 14: (01:08:25) [foreign language 01:06:57]. Dr. Njoo: (01:08:25) [foreign language 01:07:22]. Minister Patty Hyduke: (01:08:32) Hi. It's Patty Hyduke. Can you hear me now? Moderator: (01:08:35) Yes, minister. Minister Patty Hyduke: (01:08:36) Okay. Well, I just wanted to go back to the last question actually, and let people know on the issue of vaccine hesitancy, one of the analysis we made in February was the $64 million fund called the Immunization Partnership Fund, which is to support partnerships with organizations that work with a variety of different populations across Canada to help Canadians understand their choices around vaccination, to get better access to information in language that they understand best in their own first languages. I think this is a really important part around working with folks that are worried or anxious about what vaccination might mean for them, is to make sure that they have access to people that can communicate in ways that make them feel safe to ask those hard questions. Minister Patty Hyduke: (01:09:27) So, I just wanted to go back to that because I think this is an important piece. Not everybody will be able to get information in the same way. At the federal government level, we know that there are many wonderful partners across the country, working in a variety of different settings, with a variety of different people that need to get information in different ways. This partnership bond actually supports their work and allows them to hire people at work in communities in a way that gets information to the folks that need it the most, in perhaps different ways that we traditionally think people are getting information. Thank you. Moderator: (01:10:09) [foreign language 01:10:09]. Anita Anand: (01:10:32) [foreign language 01:10:32]. Speaker 15: (01:11:19) Did the government of Canada indemnify AstraZeneca and/or Serum Institute of India for any potential litigation over adverse effects caused by their vaccine? And if so, has there been any discussion in recent weeks about potential liability to the government if... and we've seen cases of deaths in Europe that may or may not be related to the vaccine. I'm just wondering if that's something on your radar right now, a possible liability on this? Anita Anand: (01:11:51) Okay. Well, thank you for the question. I think you and I have discussed this issue in the past and I have indicated that indemnification clauses are standard in vaccine contracts around the world, including in Canada's. In addition, we have been in the process of establishing a compensation regime that perhaps Minister Hyduke could speak to. But as it concerns the particular vaccine that you have mentioned, we are continuing to procure that vaccine as it continues to have the approval of Health Canada. Thank you. Minister Patty Hyduke: (01:12:32) All I can add to that is, yes, Canada is working on a vaccine injury program to support people that may become injured as a result of vaccinations. We are one of the last remaining G-7 countries to have this in place and, in fact, it was a requirement by some of the manufacturers and it is long overdue, so we'll have more details as that work unfolds. Tom Perry: (01:13:04) Hi. It's Tom Perry from CBC. Just a question for Dr. Tam. Doctor, I'm just wondering, the changing advice we're seeing on AstraZeneca, is this normal for a vaccine or are we seeing this because of the fact that these vaccines were rolled out so quickly, that the advice is changing as the real world information is coming in? Dr. Tam: (01:13:27) Yeah, I think with other routine vaccines things evolve in a slower track, for sure. As you've seen, as what I've just said is when the clinical trial data did not have enough people over the age of 65 and then you get new information in real life that is actually effective, that's the evolving science. Dr. Tam: (01:13:55) So, I think I would say partly yes, because this is a fast moving pandemic, but we are actually getting the real world data faster than usual as well. Having the information from the United Kingdom, for example, on the AstraZeneca vaccine, that probably wouldn't have happened that fast in routine vaccinations, but it did occur pretty quickly and therefore the recommendation was changed. Dr. Tam: (01:14:25) Rare adverse events, even for routine vaccines, will come up once many more millions of people go get vaccinated. And partly maybe because the vaccines have been ramping up really fast, as the numbers of people who have actually needs builds up quickly, you will then get these signals fast as well. So, I think it's just a matter of the amount of vaccines being rolled out across the world quite quickly, but the process itself isn't different. I think the speed of which these signals or data is emerging is fast. Marieke Walsh: (01:15:06) Hi there. Marieke Walsh with The Globe Mail. I have a second follow-up but I'll make sure that my colleague Teresa... so, I'll alternate. Minister Anand, I'm wondering if you can clarify specifically the timelines for vaccines now in Canada. Because while you're announcing the speed up of deliveries of Pfizer, we have not yet, for example, received any information about the delivery of the core 20 million shots from AstraZeneca through that bilateral contract. Marieke Walsh: (01:15:36) You're saying more than 40 million now by the end of June. Can you please just clarify what are included in that and what is happening with that main AstraZeneca contract for 20 million doses? Anita Anand: (01:15:50) Sure. I would love to clarify it and I'll give you some numbers broken down and my team can reiterate them if you miss any of them. Okay? You know that we have 9.5 million doses coming into the country prior to the end of the week. Of that 9.5 million, we're going to be receiving 1.5 million from the United States. That 1.5 million is actually part of the 20 million AstraZeneca doses, which Canada has purchased. So, you have to consider that as the beginning of our deliveries of the 20 million. Okay? Anita Anand: (01:16:32) I was talking with AstraZeneca yesterday, in fact, about this and pressed them for the deliveries going forward, in addition to the 1.5 million doses coming from the United States today. They confirmed that we will be receiving at least one million AstraZeneca doses in June, under the APA. That's in addition to the 1.5 million doses coming from Serum and the 1.9 million AstraZeneca doses coming from COVAX. Anita Anand: (01:17:12) If you put those AstraZeneca doses together with our Pfizer deliveries of 17.8 million and Moderna of 12.3 million prior to the end of June, you arrive at 44 million. Thank you. Teresa Wright: (01:17:33) This is Teresa Wright from The Canadian Press. My question is for the Dr. Tam or Dr Njoo. Most drugs and vaccines come with side effects and some, like birth control pills, have a much higher risk of blood clots than the AstraZeneca vaccine. So, why do you think that vaccine, in particular, is so easily swayed by any reports of side effects when there are other vaccines and other medications that have greater side effects? Dr. Tam: (01:18:05) Yes. As you said, medications have side effects and they are listed in the product monographs and some of them, again, will change as more data comes in. That's actually quite common for any treatment and medications. I think partly it's because vaccines are provided to people who are well, whereas treatments are generally provided to people who have a medical condition or who's sick. Dr. Tam: (01:18:35) The birth control pill is actually quite an interesting analogy because that's also generally in people who are well, but who have particular need. I think that there's partly is because it's a preventive measure, so the bar is pretty high for the risk and benefits. But you're in the middle of a pandemic with people who look at the death, hospitalizations, and ICU admissions every day. I think, then, it's important to point out in very real terms to everyone what that risk actually is and then explain that to the individuals as they're coming to get the vaccine. Dr. Tam: (01:19:25) But yes, there's many different underlying drivers of vaccine hesitancy. Some of which of course is related to misinformation, but I do think that the bar is set a bit differently for risk and benefit just because you're giving a preventive measure to a well person. Marieke Walsh: (01:19:47) It's Marieke Walsh again. I have another question for, I believe, Minister Anand. The shots coming from the United States this week, 1.5 million from AstraZeneca, have those gone through all of the Health Canada approvals? Will they be shipped out right away or what do they still need to go through at Health Canada? When will they actually be delivered to the provinces? Minister Patty Hyduke: (01:20:12) Maybe I can take that question. The doses from the Americans are under review right now by Health Canada. Each, as I've explained before in this forum, each vaccine is assessed on the data of the vaccine itself, but also data is assessed from manufacturing sites and indeed batch numbers. Those doses will be carefully scrutinized by Health Canada before they're released to provinces and territories for use. Marieke Walsh: (01:20:42) When will they be delivered, then, to provinces? What's the timeline? Minister Patty Hyduke: (01:20:51) It will depend on the data review done by Health Canada. Maybe, Dr. Tam, you have more up to date information as I do. But my understanding is that they're still awaiting some of the information from the manufacturing site in particular, but that information may be a couple of days old. I know Health Canada is working very closely with the corporation to make sure they have the appropriate information so that they can provide the regulatory approval for those doses. Anita Anand: (01:21:23) [crosstalk 01:21:23] I might just have something from the procurement standpoint after Theresa. Go ahead, Theresa. Dr. Tam: (01:21:28) I was just going to say we will have to check in with a regulator. I don't have any more information. Anita Anand: (01:21:39) From a procurement standpoint, the regulatory review of the additional manufacturing sites is to be completed in the coming days. That's what I was made aware of from the supplier late last week. But the procurement part of this is that the doses are being pre-positioned so that they're ready for distribution once the Health Canada approval has been obtained of all the necessary elements. Moderator: (01:22:17) Thank you. That concludes today's press conference.