How Canada rose to the top for 1st doses of COVID-19 vaccine

For months now, noted American cardiologist and researcher Eric Topol has been keenly following the rollout of COVID-19 vaccines around the world. And he can't say enough good things about his northern neighbour's fast and sudden rise to the top.

His frequent praise for Canada can be found on Twitter, including a recent tweet lauding the country for "pulling away, setting a new pace and ceiling for 1st dose vaccinations of major countries."

It's a rise to the top that he says is mostly due to "the culture" of Canada.

In an interview with CBC News, Topol said Canadians are more science-based, less vaccine-hesitant and certainly less likely to be "anti-vaxx" than those in his own country.

But other experts note it's actually a confluence of factors that has put Canada on track to become the world leader when it comes to the share of its population inoculated with at least one dose of the COVID-19 vaccine. 

According to online research publication Our World in Data, Canada has just nudged out Israel to top the global pack, having doled out at least one dose to more than 64 per cent of its citizens. Israel, now trailing Canada, has given first doses to 63 per cent of its citizens.

'Really no magic to this'

"There's really no magic to this, there's no pivot," said Dr. Isaac Bogoch, an infectious disease specialist and member of Ontario's COVID-19 vaccine task force.

"It really is a team effort from a federal, provincial and local level. And we have a pretty impressive capacity to administer vaccines very quickly in the country," he said.

"So when vaccines are actually coming into the country, we can get them into the arms of citizens very, very quickly — and that's what you're watching right now."

There are some significant caveats, however, according to Edouard Mathieu, who is Our World in Data's head of data.

Canada's rise has mostly happened due to its strategy of betting on vaccinating as many people as possible with a first dose and delaying the second dose, he said in an email to CBC News.

"This means that Canada now has one of the lowest ratio of first to second doses in the world," he said.

Still, some experts say giving more Canadians partial protection with one dose helped to drive our surging third wave down across much of the country at a critical time.

At the start of the global vaccination campaign, Canada lagged behind other countries. Mere months ago, at the beginning of March, Canada had vaccinated just under four per cent of its population with one dose — slightly behind France (4.7%), and Germany and Italy (5.1% each), but a fair distance back from the U.S. (15.2%), the U.K. (30.5%) and Israel (55%).

'Pace significantly quickened'

According to Mathieu, this lasted up until April 1, when "Canada's pace of vaccinations significantly quickened."

By that date, an average of 188,000 people were receiving a dose every day in Canada: a figure that is now at 375,000, or one per cent of the country's population, he said. This makes Canada the country with the highest pace in the G7 — on par with the U.S. at its peak in mid-April — and without "showing any sign of slowing down."

Bogoch credited that in part to the federal government's access to vaccines, saying "thankfully, we have truly millions and millions and millions of vaccines coming into the country now."

For example, Canada will be receiving at least 55 million COVID-19 vaccine doses by the end of July, Public Services and Procurement Minister Anita Anand announced earlier this week.

But only months ago, Canada's inability to secure a large and steady supply of shots at the start of the vaccination campaign had a significant impact on the country's vaccination rates.

"The major factor is really that we've been reliant on other people supplying us vaccines for a long period of time," said Jason Kindrachuk, an assistant professor and Canada Research Chair in emerging viruses at the University of Manitoba.

"We didn't have that ability to pull any doses within Canada to start doing any dispensing."

Canada reliant on other countries

Instead, Canada had to rely on countries like the U.S. and the U.K., which were busy supplying their own populations with vaccines made in their own plants. 

"They were taking care of themselves before while they were ramping up their production capacity," said Dr. Ross Upshur, with the University of Toronto's Dalla Lana School of Public Health.

Kindrachuk said it was always known that based on the purchasing agreements provided by the federal government, there would be an increasing number of doses available moving into early spring and summer.

"I think for Canada, the long game — we've done quite well, with all things considered," he said. "Would it have been better for us to get this earlier? Absolutely."

Vaccination rates also got a boost by the provinces, Kindrachuk said, which were able to adjust to some of the logistical hurdles involved with the rollout, including distance between communities. 

"We've had to adjust to that in real time, for something that we didn't necessarily appreciate," he said. "The provinces, I think, did play a big part in being amenable and being somewhat flexible with the situation ... presented to them." 

Upshur believes the key to Canada's ramped-up vaccinations was what he described as a "really impressive levée en masse."

"Everybody pulled together and said, 'Let's just get as many people vaccinated as fast as we can,'" he said, noting that included the rise of pop-up and mass vaccination clinics.

"[There was] better collaboration between all sectors — in the health sector, public health, clinical care, pharmacies, primary care. Everybody. Everybody's doing their bit. We found a way to get it done."