While the federal government was successful in procuring COVID-19 vaccines amid an urgent pandemic situation, the Public Health Agency of Canada (PHAC) fell short when it came to minimizing the number of doses wasted and now millions are about to expire, according to Canada's auditor general.
In an audit of the federal government's COVID-19 vaccine procurement, tabled in the House of Commons on Tuesday, Karen Hogan found that while federal departments "secured COVID-19 vaccine doses so that everyone in Canada who chose to be vaccinated could be," once the vaccines arrived the systems to keep track of them were lacking.
Hogan's performance audit focused on assessing the job Public Services and Procurement Canada did in procuring vaccines, and how the Public Health Agency of Canada and Health Canada did in keeping track of the inventory as well as seeing the vaccines delivered across the country and later donated globally.
The audit found that PSPC's "efficient" work—led by then-procurement minister Anita Anand—and the decision to sign advance purchase agreements with seven COVID-19 vaccine manufacturers ensured that Canada would have enough doses to meet the demand. However, Hogan noted that this approach came with the risk of Canada having a surplus of doses.
As this played out in real time, and six of the seven potential vaccines were authorized for use in Canada, the federal government paid for 169 million doses of COVID-19 vaccines between December 2020—when Canada's COVID-19 vaccine authorization and immunization rollout began—and May 2022.
Of those, the federal government administered more than 84 million doses across the country, making it the largest mass vaccination campaign in Canadian history.
That left 85 million COVID-19 vaccine doses unused, 50.6 million of which the audit found were deemed surplus and offered for donation. However, just 15.3 million doses have been given to other countries while 13.6 million expired before they could be donated.
That meant that as of the end of May, Canada had 32.5 million doses—worth an estimated $1 billion—sitting in inventories across the country.
Tuesday's report flags that the majority of these shots may have already or are set to expire by the end of the year, resulting in more wastage if they are not used or donated soon. In addition to these shots, the government has gone on to procure doses of newly-developed bivalent booster shots.
Questioned by reporters on the status of Canada’s current COVID-19 vaccine overstock, Health Minister Jean-Yves Duclos said that most of the doses that went to waste were AstraZeneca doses which couldn't be used in Canada.
While the audit does not include concrete figures when it comes to how much Canada ended up spending on COVID-19 vaccines during the December 2020 to May 2022 period given confidentiality clauses, Hogan's report does provide a "benchmark" estimate based on publicly-available data.
As of the end of May, the average cost of a single dose was approximately $30 before taxes, and while the overall cost will vary based on factors including demand, the auditor general concluded that the federal government has spent approximately $5 billion on the 169 million doses procured.
DATA-SHARING, TRACKING ISSUES
While vaccine distribution and logistics responsibilities are typically left to each province and territory, the federal government took a leading role in the COVID-19 context.
The auditor general said that while PHAC "equitably allocated" COVID-19 vaccine doses to the provinces and territories and oversaw their delivery in a "timely way," efforts to cut down on wasted doses was "unsuccessful."
This was in part due to delays in the agency developing and implementing an information technology planning system called "VaccineConnect," meant to help track and manage vaccine usage. By the end of the audit, the report states that even still "not all of the system’s functionalities were being used."
According to the report, "Vaccine Connect" has come with an estimated contract cost of $59.1 million, of which $37.4 million had been spent by the time the audit ended. As a result of "key" features not being ready at the height of Canada's vaccine rollout, PHAC ended up having to manually track expiry dates and wastage in spreadsheets.
Another factor that contributed to more doses potentially going to waste than necessary was that the agency did not have in place finalized data-sharing agreements with the provinces and territories, a long-standing issue the AG's office has brought up repeatedly with this and previous governments, most recently in the 2021 audit on pandemic preparedness.
"This meant that the agency relied on voluntary reporting by the provinces and territories. Although some provinces and territories consistently reported to the agency, the agency was unable to obtain complete data from most," the audit said, putting some of how the overflow of doses are being managed on the provinces. "This meant that the status of these doses was unknown and reduced the agency’s ability to predict supply needs and plan for donations."
Hogan found that while the federal health bodies were timely in responding to the trio of confirmed vaccine safety signals, including myocarditis and pericarditis, the data-sharing gap also impacted the case-level safety surveillance data that Canada could share with the World Health Organization and vaccine companies, as it pertained to incidents of adverse reactions in Canada.
"Canada is the only G7 country that does not follow World Health Organization guidance that countries share with the organization detailed case-level data on COVID-19 adverse events following immunization. The agency shared summary-level data with the organization," the report states.
HOW HAVE THESE FINDINGS BEEN RECEIVED?
The federal auditor general is now calling for the government to come up with a plan to see that as many of the excess doses as possible don't go to waste.
Hogan is also imploring the government to immediately address the data-sharing gaps she has identified "because the sharing of health data is a cornerstone of effective surveillance to keep Canadians safe.”
Duclos and Minister of Public Services and Procurement Helena Jaczek said they welcome Hogan's findings and are committed to reducing the vaccine surplus, including by looking to see more of the stockpile sent abroad.
However, as Hogan noted in a press conference with reporters on Tuesday, the market for COVID-19 vaccines doses appears to be saturated given so many other countries have already donated their leftover doses.
Asked whether she thought the overall amount of wastage seen in Canada was avoidable, Hogan said the approach Canada took was overall "a prudent one,” given the global rush for viable COVID-19 vaccines at the time.
Though, "as the country continues to buy doses, whether they be bivalent doses or others, it makes sense to have a better handle on where the inventory is, and better management controls to avoid minimizing wastage in the future," Hogan said.
The ministers also said they "strongly welcome" the call to ensure that provincial and territorial governments share vaccine data with the federal government in a timely fashion. However, they offered no specifics on how PHAC will step up in this regard, after decades of the auditor general drawing attention to shortcomings.
Responding to Hogan's findings, NDP MP and health critic Don Davies said it was "unacceptable" that Canada has let nearly 154 million COVID-19 doses expire.
"There is no excuse for such waste," Davies said in a statement. "The Liberals must act swiftly to ensure our remaining doses are delivered to the people who need them most."
The Conservatives focused in their criticism on the $59.1 million "Vaccine Connect" contract as "another expensive government data program which has failed to live up to its price tag," a reference to their concerns with the ArriveCan application.
While the Conservatives conceded that signing the seven advanced purchase agreements was the right thing to do, even if it meant Canada would be facing a surplus of shots, "not having a data sharing capability resulted in significant waste," said Conservative MP and health critic Stephen Ellis.
Ellis was also critical of the Liberals' decision to in the early days, access doses through the global vaccine sharing COVAX system amid heavy political pressure, including from the Conservatives.
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