Federal officials shut down single-dose Moderna vaccine proposal

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Federal health officials have ended speculation as to whether the Moderna vaccine could be used as a one-shot option, as opposed to needing two doses.

In response to Gen. Rick Hillier, chair of Ontario’s COVID-19 vaccine distribution task force, who called on Health Canada to look into the option in order to more quickly vaccinate the population, federal Minister of Health Patty Hajdu said that would not be possible.

“That is not the what the pharmaceutical company has indicated as appropriate use, nor is it what the regulators have approved, based on the pharmaceutical requirements,” Hajdu said.

Dr. Howard Njoo, Canada's deputy chief public health officer, added to Hajdu’s comments saying the usage of the Moderna vaccine is “pretty straight forward,” based on the data from clinical trials and information provided to Health Canada for approval.

“From a scientific, public heath, medical perspective, it’s all with a two-dose regime,” Dr. Njoo said. “That’s what Health Canada has approved.”

“There’s no data there to look at in terms of if there was a one-dose regime, what that would have in terms of an impact on [the] duration of the immunity or the efficacy over the long term.”

On Tuesday, Hillier said he has not seen any evidence of a single dose of the Moderna vaccine being an effective method of protecting individuals from COVID-19, but indicated he wanted the federal government to look into it.

“It’s late to ask for a Christmas gift but if I could ask for one I would ask Health Canada to re-look at the Moderna vaccine, and see if we could make that a one-shot vaccine and give us that...greater capacity to go out and vaccinate people even faster than we plan on doing now,” Hillier said at a press conference.

“I don’t have evidence, what I have is a discussion amongst medical colleagues who come together and then talk to us and advise us and say...the one shot of Moderna vaccine offers an incredible amount of protection and why wouldn’t we at least consider making it a one-shot vaccine. Getting that vaccine into people’s arms therefore much more quickly and offering that heightened level of protection in a way that we simply won’t be able to do by making it a two-shot vaccination program.”

Ontario unveils ethical framework for vaccine distribution

On Wednesday, Ontario released its ethical framework for vaccine distribution in the province.

Dr. Maxwell Smith, bioethicist and assistant professor at Western University, explained that this frameworks is not intended to provide a direct answer to exactly when certain groups of people should be able to receive a COVID-19 vaccine, but lays out considerations that should be made in the distribution process.

“They articulate a set of ethical considerations and ethical commitments that will guide our recommendations and decisions in the coming weeks and months,” Dr. Smith said.

The six guiding principles, as outlined in the framework, are as follows:

• Minimize harms and maximize benefits: Reduce overall illness and death related to COVID-19, protect those at greatest risk of serious illness and death due to biological, social, geographical and occupational factors, protect critical infrastructure, and promote social and economic well-being.

• Equity: Distribute vaccines without stigma, bias or discrimination, while actively working to reduce disparities in illness and death related to COVID-19 (including social determinants of health), and ensure benefits for groups experiencing greater burdens from the pandemic.

• Fairness: Ensure that every individual within equally prioritized groups has the same opportunity to be vaccinated, with an inclusive and consistent processes tailored to unique needs of Ontario's communities.

• Transparency: Underlying principles, rationale, decision-making processes and plans for COVID-19 vaccine prioritization are clear, understandable and communicated publicly.

• Legitimacy: Make decision based on the best available scientific evidence, shared values and input from affected parties including those historically underrepresented, to ensure decisions have the intended impact.

• Public trust: Ensure decisions and decision-making processes are informed by these principles to advance confidence and trust in Ontario's COVID-19 immunization program.

When asked about the ethical considerations that need to be made if Ontarians are given a vaccination card, or some sort of proof of COVID-19 vaccination that would allow the to access certain services, Dr. Smith said this “certainly raises a lot of different ethical considerations.”

“We want to make sure that we’re identifying those that have been vaccinated,” he said. “But [the extent] to which that information would be used to limit services or other things I think is an important question where you need to think about potential stigma and inequities that may emerge from that.”

Dr. Dirk Huyer, the coordinator of Ontario’s outbreak response, added that to his knowledge, there haven’t been any specific interest groups that have reached out to indicate they want to see this proof of vaccination for their operations, but stressed that it is important for the province to have a record of vaccine uptake.

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