Leading the vaccination campaign

Halifax’s Dr. Joanne Langley is at the vanguard of the effort to inoculate Canadians against COVID-19

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r. Joanne Langley says Nova Scotia and the rest of the country have built-in immunity against vaccine supply hiccups: a roster of five other vaccine makers to choose from if Pfizer or Moderna fail to deliver.

The Dalhousie University professor and infectious diseases expert has been at the forefront of Canada’s COVID-19 battle since May, when Ottawa picked her to co-lead a vaccine taskforce.

After hundreds of hours of meetings, she and her colleagues came up with a portfolio of seven companies, with which the federal government signed $1-billion worth of advance purchase agreements for millions of vaccine doses to treat SARS-CoV-2, as the disease is known in the medical and vaccine world.

So far, only Pfizer (working German biotech firm BioNTech) and Moderna have approval. But vaccines from AstraZeneca, Medicago, Johnson & Johnson, Novavax, and Sanofi are likely not far off.

The eventual supply from the other providers means this province should be able to deliver on a plan to have 75% of Nova Scotians fully vaccinated by the end of September (learn more in this recent Halifax Magazine story).

Langley, a specialist in pediatrics and head of infectious diseases at the IWK Health Centre in Halifax, says Pfizer’s current supply glitches are unsurprising.

For those of us working in vaccines, these kinds of things are completely expected,” she says. “It’s not like you’re pouring a glass of water. It’s a biological process you’re dealing with. Things can go wrong. They will eventually go right… But you have to make sure you’re meeting every standard.”

It’s much too soon to predict how effective the vaccines will be in the long run or what path COVID-19 might take. “Some pathogens come and just burn out,” Langley says “SARS-1 is an example of that. And some just persist, for example, H1N1, which came in 2009 and is routinely included in flu vaccines each year.”

Experts are modelling COVID’s potential. “At one extreme, it could continue to evolve each season. On the other hand, it might not,” says Langley. “We don’t know what the story will be for [the coronavirus].”

Dr. Joanne Langley. Photo: Submitted

Some projections show the virus could continue circulating into 2024. With widespread immunity, the only people susceptible to catching it would be newborns and children.

The Pfizer and Moderna vaccines are on par with some of the most effective vaccines in medicine, each with close to the 97% success rate of the measles vaccine.

But the test period has been too short to know how long that effectiveness will last. With some vaccines like the flu, for instance, annual doses are needed, while a tetanus shot is only recommended every 10 years.

“Until we have widespread use of the COVID vaccine and we understand the presence of the virus in vaccinated people, we should continue to be very careful of protecting grandparents and our older friends,” says Langley.

Without a vaccine, there would be ongoing outbreaks and higher rates of death until the population reached its own herd immunity, she says.

No vaccine would also mean an extended need for health measures to try and thwart the spread of the virus, such as mandates for physical distancing, limited gatherings and mask wearing, in a further test to the limits of a functioning society.

“Even during the influenza pandemic of the early 1900s, we didn’t have these widespread societal mesasures,” says Langley.

Developing effective vaccines so quickly was a remarkable scientific achievement. The previous record was four years for the mumps in the 1960s. Initially, experts weren’t expecting a vaccine for COVID-19 for 1.5 to two years. “It shows what can happen when we focus on a threat,” she says.

Two things that helped speed things along this time around were hundreds of millions of dollars in backing for expedited COVID vaccine development from the U.S. under its “Operation Warp Speed” program, and work that already had been done on messenger RNA vaccines, also known as mRNA vaccines, and other advances in research.

With the mRNA vaccines created by Pfizer and Moderna, instead of injecting a weakened or inactivated germ, they teach cells how to make a “spike protein” that triggers an immune response that creates antibodies to protect people from getting infected from the virus. The process is quicker than creating inactivated or weakened germs.

Longer term, Canadian companies such as Halifax vaccine-maker IMV Inc. might have a role to play in treatment efforts.

Finding such companies was on Langley’s to-do list at the taskforce.

IMV, formerly known as Immunovaccine Inc., was among the handful to get funding, landing $10 million from Ottawa to-date. The company, which started out of Dalhousie in 2000 with cash from the government to create a vaccine to prevent seals from getting pregnant, has taken its patented “rocket-booster” vaccine technology to develop immunotherapies for cancer treatments and, now, a possible COVID-19 vaccine.

Langley says companies such as IMV that didn’t make the list of seven contracted by Ottawa to provide vaccines could sell their product in deals down the road with the provinces, which are the typical buyers of vaccines.

Langley is on the advisory committee for the deployment of the vaccine in Nova Scotia.

“The rollout to an entire population is not a small effort, especially when you’re dealing with a vaccine that needs to be held at very special storage conditions at [- 70 C],” she says. “It all takes time. We’d all like it to be faster. I think we will see things speed up as people get more familiar with it.”

Halifax Magazine