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A Global Vaccine Timeline

Opinion by Chanel Best. This piece is part of The Global Vaccine Challenge, a series by Chanel Best on the inequalities in access and distribution of COVID-19 vaccines.


A dark map of the world. Red circles of different sizes cover the map, representing the varying severity of COVID-19 outbreaks in different parts of the world.

My vaccine appointment is booked for June 9, 2021, and, by then, more than 50% of Canadians will have received the first dose of a COVID-19 vaccine. While the rollout has certainly been flawed, the rapid development of this vaccine is worthy of recognition. The fact that I will get a needle in my arm on Wednesday is the result of the largest global project between private corporations, international organizations, university researchers, and state actors outside of wartime. Procurement, testing, manufacturing, and distribution processes were expedited by international collaboration across sectors. The crucial impacts of this collaborative effort are best demonstrated through a timeline I created of the vaccine’s development and rollout, from the first case of COVID-19 to my own vaccine appointment. The timeline has been divided into broad stages, but it should be noted that stages often overlapped . The stages are simply a tool to simplify and provide additional clarity to help organize the long process of vaccine development.


November 17, 2019: First known case of SARS-CoV-2, the illness that causes COVID-19

contracted, in Wuhan, China [1].


January 11, 2020: The SARS-CoV-2 genome is shared publicly through GISAID in early January, providing the global scientific community and pharmaceutical companies with the sequencing data needed to kickstart their rapid development response [2].


January 25, 2020: Toronto man travelling from Wuhan becomes the first Canadian case of COVID-19 [3]. Political action in Canada against coronavirus begins to take place.


January 27, 2020: COVID-19 mRNA Vaccine Program Initiation [4]. The Moderna and Pfizer-BioNTech vaccines are developed using mRNA biomedical technology which creates a natural response in human immune systems to protect against COVID-19 (a much faster process than past vaccines).


February 7, 2020: Moderna Inc. completes the first clinical batch of a vaccine funded by the Coalition for Epidemic Preparedness Innovations (CEPI), a foundation launched at the World Economic Forum [5].


February 11, 2020: The World Health Organization (WHO) announces that they expect it to take 18 months to create, test, and manufacture a successful COVID-19 vaccine [6].


March 16, 2020: The NIH begins phase 1 clinical trials of Moderna Inc’s vaccine at the Kaiser Permanente Washington Health Research Institute in Seattle, WA. The first human COVID-19 trial occurs over approximately 6 weeks [7].



An infographic titled 'Testing Information,' detailing the 3 stages of vaccine development


March 23, 2020: Canada announces $192 million in funding for the development, testing, and manufacturing of vaccines through partnerships with Vancouver-based company AbCellera and Quebec-based Medicago [8].



May 4, 2020: European commission holds a fundraiser and raises €7.4 billion for the global development and deployment of vaccines against COVID-19. The government of Canada pledges $850 million [9].


May 21, 2020: The U.S. and a U.K.-based pharmaceutical company, AstraZeneca, announces a collaboration to accelerate the development of a vaccine called AZD1222. The Biomedical Advanced Research and Development Authority (BARDA) donates over one billion dollars to AstraZeneca, hoping to make the first doses available in October 2020 [10].


July 2020: Data indicates promising results from phase 1/2 trials of Moderna Inc’s COVID-19 vaccine. As phase 3 trials begin for Moderna, investment into the vaccine by BARDA totals $955 million. Vaccines produced by AstraZeneca and CanSino Biologics also show promising results [12].

August 5, 2020: The government of Canada signs a multi-million vaccine dose agreement with Moderna Inc. and Pfizer-BioNTech. Pfizer will supply its BNT162 mRNA-based vaccine candidate, while Moderna will provide its mRNA-1273 vaccine candidate [13]. The first vaccine agreements between the Canadian government and private pharmaceutical companies occurred seven months before the first vaccine was administered in Canada.


August 11, 2020: While still undergoing phase 3 trials, the Sputnik V vaccine developed by Gamaleya Research Institute receives early approval in Russia for emergency use amidst skepticism in the West [14].





September 3, 2020: COVID-19 vaccine research landscape includes 321 candidates. Of these, 33 clinical trials will take place in at least 470 different sites across 34 countries [15].


September 6, 2020: Oxford-AstraZeneca halts phase 3 vaccine trial for a safety review following an adverse reaction. Trials eventually restart in October [16].



October 1-12, 2020: Oxford-AstraZeneca BioNtech-Pfizer and Moderna submit applications to Health Canada for review of their vaccines, which end up being approved in December and January [17].


November 16, 2020: The CAF announces Operation VECTOR, a plan to support to the Federal, Provincial, and Territorial governments in the distribution of COVID-19 vaccines [18].


November 19, 2020: Canada has more vaccines per capita secured than any other country [19].


December 9-13, 2020: Health Canada authorizes the Pfizer-BioNTech COVID-19 vaccine for use in people 16 years of age or older. First vaccine shipment arrives (30,000 doses) [20] [21].



December 14, 2020: V-Day – Canada’s first Pfizer-BioNTech COVID-19 vaccine is administered at 11:25 am to 89-year-old Gisele Levesque, a resident of a long-term care home in Quebec City [22].


December 18, 2020: COVAX announces access to two billion doses of several COVID-19 vaccine candidates, which should enable all 172 participating countries, including Canada, to have access to doses in the first half of 2021 [23].


The goal of COVAX is to ensure equal access to vaccines across all countries. Wealthier countries gain access to all potential vaccines, avoiding risks of backing any one candidate, while lower income countries get financial support and equal access to a vaccine once available. COVAX is led by Gavi, CEPI, and WHO. To learn more about COVAX, click here.


December 19, 2020: New Brunswick is the final province to administer their first dose of the COVID-19 vaccine [24]. No vaccine has yet been administered in northern Canada.


December 23-24, 2020: Health Canada authorizes the second COVID-19 vaccine in Canada, manufactured by Moderna [25]. Canada receives first shipment of Moderna vaccines, with priority given to the Yukon and Northwest Territories [26].


December 31, 2020: WHO makes announcement regarding vaccines and new emerging strains of COVID-19. This requires global coordination to assess strains and vaccine effectiveness [27].


February 24, 2021: Moderna completes manufacturing for its variant-specific vaccine candidate, mRNA-1273.351, against the SARS-CoV-2 variant B.1.351. It is shipped to the NIH for a phase 1 clinical trial led and funded by NIAID [29].


February 26, 2021: Health Canada authorizes the use of the third COVID-19 vaccine manufactured by AstraZeneca in adults aged 18-55, after an additional four-month review [30]. A week later, Canada receives their first shipment of 500,000 doses of the AstraZeneca vaccine from the Serum Institute of India [31].


March 5, 2021: Health Canada authorizes the use of the COVID-19 vaccine manufactured by Johnson & Johnson for ages 30 and up [32].


As of July 3, 2021, the Johnson & Johnson vaccine has not been administered in Canada. Shipments of the vaccine were delayed due to manufacturing issues. Despite receiving more than 300,000, they have not been distributed to the provinces and territories. There are four vaccine candidates approved by Health Canada and two awaiting approvals. To learn more about this process, click here.


March 11–16, 2021: Moderna begins clinical trials of its COVID-19 variant vaccine and phase 2 clinical testing on humans aged 6 months to 12 years old [33]. Ensuring COVID-19 vaccines are safe and effective for children is considered critical in the next phase of the global vaccination campaign.


March 29, 2021: NACI recommends pausing the use of the AstraZeneca COVID-19 vaccine on those under the age of 55 after reports of rare but serious blood clots [34]. That day, most provinces respond by halting use of the vaccine for those under the age of 55 while Nova Scotia stops use of the vaccine altogether [35]. Questions grow about how restrictions for the AstraZeneca vaccine will affect vaccination supply.


April 7, 2021: NACI recommends extended dose intervals for COVID-19 vaccines to optimize early vaccine rollout in Canada. In the context of limited vaccine supply, extending interval from 6 weeks to four months speeds up the process for every Canadian to receive a first dose of the vaccine [36].


April 8, 2021: Canada receives first shipments from COVAX including 317,000 doses of the AstraZeneca vaccine [37].


April 30, 2021: The United States announces Pfizer will start supplying Canada with COVID-19 vaccines from its manufacturing site in Kalamazoo after allowing shipments outside the country for the first time. Canada is the second country to receive doses from the United States, [38] signaling loosening restrictions for cross border shipments of vaccines.


May 5, 2021: Canada is the first country to approve Pfizer-BioNTech vaccine for those 12 and over [39].


May 15, 2021: In Canada, there are 20,384,000 doses delivered and 50.58% of the population receives their first dose, compared to 9.43% of the global population [40].


May 18, 2021: Ontarians aged 18+ eligible to book vaccines.


For a vaccine to reach my arm in Canada, it took a tremendous global effort—from several months of scientific development and negotiations, driven by billion-dollar investments to ensure breakthroughs and collaboration across sectors, to a coordinated effort by the Canadian government to import vaccines and provinces to create a distribution plan. The cost efficiency and accelerated development of the COVID-19 vaccine is a historic accomplishment. And while efforts have been made for equal vaccine distribution, they frequently fall short. Canada’s vaccination rollout reflects the dominance of wealthy nations in the vaccine development process. Unevenness also presented itself in Canada by different regions of the country being able to begin administering the vaccine before others. The vaccination rollout revealed hierarchies in the processes created by globality and existing inequalities.


Acronyms

BARDA - United States Biomedical Advanced Research and Development Authority

CAF - Canadian Armed Forces

CEPI - Coalition for Epidemic Preparedness Innovations

NACI - Canada's Naitonal Advisory Committee on Immunization

NAID - National Institute of Allergy and Infectious Diseases

NIH - National Institute of Health

WHO - World Health Organization

 

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  2. Le, T.T., et al. The COVID-19 vaccine development landscape, 9 April 2020, Nature Reviews Drug Discovery. https://www.nature.com/articles/d41573-020-00073-5

  3. Bronca, T. COVID-19 A Canadian timeline, 08 April 2020. Canadian Healthcare Network. https://www.canadianhealthcarenetwork.ca/covid-19-a-canadian-timeline

  4. BioNtech & Pfizer. Update on our COVID-19 vaccine development program with BNT162b2, 02 December 2020. https://investors.biontech.de/static-files/53f0968a-279b-4f82-a2fc-d67dcb6e4e91

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  7. National Institute of Health. NIH clinical trial of investigational vaccine for COVID-19 begins, 16 March 2020. NIH. https://www.nih.gov/news-events/news-releases/nih-clinical-trial-investigational-vaccine-covid-19-begins

  8. Abedi, M. Canada to spend $192M on developing COVID-19 vaccine, 23 March 2020. Global News. https://globalnews.ca/news/6717883/coronavirus-canada-vaccine-spending/

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  10. McKeever, V. AstraZeneca receives $1 billion in U.S. funding for Oxford University coronavirus vaccine, 21 May 2020. CNBC. https://www.cnbc.com/2020/05/21/coronavirus-us-gives-astrazenena-1-billion-for-oxford-vaccine.html

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  20. Government of Canada. 2021.

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  22. Forani, J. 'V-Day': First COVID-19 vaccines administered in Canada, 14 December 2020. CTV News. https://www.ctvnews.ca/health/coronavirus/v-day-first-covid-19-vaccines-administered-in-canada-1.5230184

  23. World Health Organization. COVAX Announces additional deals to access promising COVID-19 vaccine candidates, 18 December 2020. WHO. https://www.who.int/news/item/18-12-2020-covax-announces-additional-deals-to-access-promising-covid-19-vaccine-candidates-plans-global-rollout-starting-q1-2021

  24. Renic, K. First COVID-19 vaccines given in New Brunswick, 19 December 2020. Global News. https://globalnews.ca/news/7532787/first-covid-19-vaccine-new-brunswick/

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  27. World Health Organization. Coronavirus disease: Vaccines, 2021. https://www.who.int/news-room/q-a-detail/coronavirus-disease-(covid-19)-vaccines?adgroupsurvey={adgroupsurvey}&gclid=CjwKCAjw-qeFBhAsEiwA2G7NlwXpj5L8Dx0U0rv4obuMc2AuAnR43_bXf8PbFdpPrxSgwHc0DNsX-RoC_FwQAvD_BwE

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