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The week in COVID-19 vaccine news: Kids to the back of the line and cooling attitudes on mandatory shots

Considered one of the few ways to finally bring the pandemic under control, the search for a vaccine is moving fast.

Teams around the world are at work on dozens of candidates in the hopes that one of them — and possibly more — will crack the code in the coming months; passing clinical testing and gaining regulatory approval.

Thousands of people are already rolling up their sleeves for clinical testing, while debates over major issues are underway about issues such as who will get the vaccine first? How will it be distributed? How do we make sure the rest of the world isn’t left out?

From major developments to high-profile misses, here’s what Canadians need to know this week.

Kids may not get first round of vaccines

Once a vaccine is approved, the question remains: who gets it first?

While Canada’s guidelines to vaccine priorities are expected in coming weeks, other jurisdictions are already making their plans known. Many authorities, including the World Health Organization, have said that front-line health workers, the elderly and those who are immunocompromised should be at the front of the line.

The U.S. Centers for Disease Control and Prevention (CDC) made headlines this week when they noted who shouldn’t go first: kids. This is a departure from say, flu shots, which experts almost always recommend for children.

But CDC officials noted that kids rarely have severe COVID-19 symptoms and none of the leading vaccine candidates are yet testing on underage subjects so the vaccine may not be recommended for them at first.

However, , Pfizer Inc. plans to enrol children as young as 12 in their late stage tests, while AstraZeneca plans to trial a small group of children between five and 12.

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Two more vaccines apply for Canadian regulatory approval

And then there were three: three experimental vaccines seeking the green light for use in Canada.

Two more vaccine candidates have begun the regulatory process here: Pfizer Canada, working with German biotechnology company BioNTech, and Massachusetts-based Moderna Therapeutics Inc. both submitted applications this week.

was the first company to take this step in early October.

It’s ultimately Health Canada’s call which vaccines are approved for use here, and it’s important to note that approval isn’t guaranteed and even in a best-case scenario is still a way off.

A major reason why? None of these vaccines have even finished clinical trials yet. In normal times researchers would have to wait until they had those final results before hauling their paperwork over to the scientists at Health Canada.

But thanks to the Minister of Health’s interim order, rolled out last month and designed to speed up the approval process for all things related to COVID, all three companies are able to do what’s called a rolling submission, where they’ll just hand results to Health Canada scientists as they go, who can, in turn, make suggestions or ask questions.

The hope is that this’ll make it much faster to get final regulatory approval, which usually takes almost a year after clinical trials wrap up.

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Vaccine before the U.S. election increasingly unlikely

Pfizer said Friday it could file as early as late November for authorization of its vaccine in the United States, in what’s called an emergency use application, which is when an unapproved drug is allowed because it’s a public health emergency.

In an posted online, chairman and CEO Albert Bourla outlined the timelines and safety milestones the company is aiming for. While this timeline could put Pfizer ahead of competitors, the announcement casts further doubt upon U.S. President Donald Trump’s promise to have a vaccine ready to go before the Nov 3. election.

Last month, the heads of nine biopharmaceutical companies — including Pfizer — banded together in a pledge to uphold “the integrity of the scientific process” and insist that their vaccines would not be rushed, in an bid to assure the public of an eventual vaccine’s safety.

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Testing halted on a major vaccine candidate

Johnson & Johnson has had to pause late-stage clinical testing of its vaccine candidate after a study participant came down with an “unexplained illness.” They’re now trying to figure out if that illness is related to the vaccine or not.

The company, which has signed an advance purchase agreement with Canada, said in a statement that some adverse reactions are an “” of a clinical trial, and experts generally agree that these situations — where a study is immediately shut down and an investigation begun — show the safeguards built into the vaccine development process.

Janssen, the company’s pharmaceutical arm, isn’t the first major player forced to take this step, either.

Last month, testing on the vaccine candidate being developed by AstraZeneca and Oxford University was also halted after a woman developed a rare inflammation of the spinal cord called transverse myelitis.

Testing has now restarted at many of their testing sites but remains on hold in the United States, where officials continue to examine whether there’s a safety risk.

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COVAX gets major boost

The international effort to get countries around the world to work together on a COVID-19 vaccine (and make sure poorer countries aren’t left out in the process) got a major boost this week, with the news that China was signing on.

China had initially missed the September deadline to sign onto what is known as COVAX, but a government official said late last week that they were on board after all.

“We are taking this concrete step to ensure equitable distribution of vaccines, especially to developing countries, and hope more capable countries will also join and support COVAX,” Chinese Foreign Ministry spokesperson Hua Chunying .

Organized by the Gavi Vaccine Alliance, an organization that attempts to get vaccines to kids in poorer countries, COVAX was designed to do two major things. The first is to function as a global pool of vaccines — richer countries are able to combine their money, invest in a bunch of different vaccines, and then share the pre-purchased doses of any successful candidates.

But there’s a second, critical piece to this: COVAX also raises money as fast as it can so that countries who can’t afford to buy in can participate anyway. A lot of advocates are worried that without this effort, poor countries will be left out, with vaccines going to the highest bidder.

Canadian federal politicians have long said they’re big fans of COVAX, and the federal government has invested a total of $440 million — half of which is to buy vaccines for Canadians, and half of which is to support doses for poorer countries.

However, major players like the U.S. and India have chosen not to join and instead are prioritizing their own vaccine needs. So, as a big global fish, China signing on is a major show of support for the global effort.

While it’s not clear how much exactly China is contributing, officials have said they plan to buy vaccine doses for one per cent of their population through COVAX.

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Canadians cooling on mandatory vaccines

Support for making an eventual vaccine mandatory seems to be cooling, according to a by Leger and the Association for Canadian Studies released this week.

While the majority of respondents in earlier polls said they were in favour of the government making people get inoculated, the new poll found only 39 per cent of those surveyed though it should be mandatory.

That’s a decline of 18 percentage points from a similar poll in July. Just over half now say a vaccine should be voluntary.

The online poll was conducted from Oct. 9 to 11 and surveyed 1,539 adult Canadians. It cannot be assigned a margin of error because internet-based polls are not considered random samples.

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With files from The Canadian Press and Associated Press

Key advisers to Ford government on pandemic response support more transparency

Two members of a key table of experts whose public health advice to senior government officials has been kept confidential are in favour of more transparency, they told the Star.

One of those advisers says the province’s colour-coded response framework should include stronger controls and clearer requirements for lockdown — but said he can’t divulge whether he recommended those measures originally because of the province’s confidentiality requirements.

On Monday, Toronto medical officer of health Dr. Eileen de Villa said she and all members of the province’s public health measures table were , requiring them to keep their discussions and advice confidential. The table, a group of public health leaders and experts, provides advice on the province’s response to Ontario’s chief medical officer of health Dr. David Williams, who in turn provides advice to Premier Doug Ford’s cabinet.

The news sparked renewed scrutiny after the Star reported last week that the province — members of which sit at the public health measures table — when it released its colour-coded framework for implementing new restrictions.

Dr. Charles Gardner, a member of the table and the medical officer of health for Simcoe-Muskoka, said he believes the group’s advice should be made public.

“The provision of information from that table would help people understand the reason for recommendations, and I think that would help with buy-in from the public as well. So I think in general it would be a good idea,” Gardner said in an interview.

“I believe when people have good information they understand things better, and they’re more likely to abide by restrictions,” he said, adding it is difficult for people to adhere to pandemic-related restrictions for such a long time.

Gardner said the higher levels of the provincial framework “may require” stronger controls than the plan currently recommends, noting local medical officers of health in red-zone regions have already had to implement additional restrictions “to protect their population.” And he said it would be “beneficial” for the framework to spell out what would trigger a full lockdown, thresholds the document currently lacks.

But Gardner said he could not divulge whether he had recommended these measures already.

“I don’t think I will speak further about what I recommended in the past — I should not, in fact … out of respect for the agreement that I signed and what transpired at meetings.”

Dr. Marlene Spruyt, another member of the table and the medical officer of health for Algoma, said the issue was “complex.” Sometimes the group’s advice includes options or considerations that are not meant to be definitive; advice also changes as they get more information, she added.

However, “I favour some additional transparency,” she said, though she does not believe all information discussed at the table should be public.

The Toronto Board of Health on Monday moved a motion to ask the provincial government to “immediately implement a fully transparent process of receiving public health advice,” including making public the advice provided to the chief medical officer of health and cabinet. The motion from board chair Coun. Joe Cressy was adopted unanimously.

Gardner said it was “typical” for the province to ask members of advisory committees to sign nondisclosure agreements, though he couldn’t comment on whether it was typical in other jurisdictions.

A spokesperson for the Ministry of Health said “members have not signed NDAs. Rather, the terms of reference of the public health measures table do include a standard confidentiality clause that supports candid discussions that ultimately lead to guidance and advice being provided to the chief medical officer of health.”

Asked if the ministry will respond to the Toronto Board of Health’s call to increase transparency around the province’s advisory tables in any other way, the spokesperson said: “We respect the work of all our public health experts and the expertise and advice they provide.”

“As we have done throughout this pandemic, we will continue to be transparent with the people of Ontario and provide them with clear and comprehensive information.”

Last week, the Star reported that the from its own public health agency when it created its new colour-coded COVID-19 response framework, setting thresholds for regional restrictions two to four times higher than what experts at Public Health Ontario had recommended. Dr. Shelley Deeks, the agency’s chief health protection officer, said she didn’t see the province’s much-higher thresholds until they were released to the public. The province lowered the thresholds Friday in the wake of the Star’s reporting, and said the controls associated with each threshold would be discussed this week.

Deeks and at least one other member of Public Health Ontario sit at the public health measures table. A spokesperson for the agency referred questions to the table’s lead, Dr. David McKeown, who had not responded to the Star’s inquiries by Tuesday evening.

“Public Health Ontario does believe in the importance of transparency,” a spokesperson for the agency said in a statement. “However, we also recognize that confidentiality may be needed in some cases and contexts.”

Dr. Chris Mackie, another member of the table and the medical officer of health for Middlesex-London, said: “I believe that this is primarily a political matter and not a public health matter, and as such it’s the government’s decision, and not for me to judge.”

Other members of the table had not responded to the Star’s inquiries by Tuesday evening.

Kate Allen is a Toronto-based reporter covering science and technology for the Star. Follow her on Twitter: