COVID-19 immunization: Federal, provincial and territorial statement of common principles

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Preamble

Canada's response to COVID-19 is founded on collaborative processes predicated on our common purpose of treating health as a public good by serving the people of Canada, their communities, and the public interest. Federal, provincial and territorial (F/P/T) governments are working together and in consultation with their respective populations to combat this virus and its health, social and economic impacts. Governments will approach decisions on COVID-19 immunization in their respective jurisdictions taking into consideration the unique needs and perspectives of their populations, including First Nations, Metis and Inuit Peoples.

Safe and effective vaccines offer the potential for substantial reduction in the transmission of the virus that causes COVID-19 and associated illness and deaths. As governments prepare to provide Canadians with equitable access to vaccines, we share the commitment to a principled approach to COVID-19 immunization. This approach affirms the need to plan now for implementation of COVID-19 immunization in Canada.

The world awaits the availability of safe and effective COVID-19 vaccines. A number of potential vaccines are in various stages of research, development and clinical evaluation due to unprecedented collaboration amongst governments, industry and the global scientific community. The Government of Canada has secured agreements with leading vaccine candidate manufacturers to ensure a supply of vaccines and will ensure access to sufficient vaccines and related supplies for all Canadians.

Public health systems across all governments are mobilizing to be ready to deliver safe and effective vaccines to their respective populations, despite some uncertainty around timing and availability of specific vaccines. Vaccine distribution will only occur when vaccine safety and efficacy have been determined, and vaccines are authorized for use by Health Canada.

Roles and responsibilities

F/P/T governments share responsibility for ensuring that all Canadians have access to safe and effective vaccines against COVID-19. The federal government has a responsibility for the regulatory approval of vaccines. In addition, the federal government is procuring vaccines on behalf of provinces and territories, providing scientific guidance on their use, and supporting efforts in partnership with all jurisdictions. Provinces and territories are responsible for, and have processes in place to, prepare their health systems and health care providers to allocate, deliver, store, distribute, administer, monitor and report on vaccines within their jurisdictions. Provinces and territories will ensure that their residents are immunized in a safe and timely way. Where requested by provinces and territories, the Government of Canada will partner with them on capacity enhancements for delivery of the vaccines.

This statement of common principles is a guiding document to support those jurisdictional processes. Since immunization is largely a provincial and territorial responsibility, with the federal government responsible for immunization of federal populations and on-reserve Indigenous communities, these principles do not supersede the flexibility governments have to make decisions that best meet the needs in their jurisdictions of their respective populations.

Many other actors will be involved in COVID-19 immunization efforts, including drug manufacturers who will supply the vaccine, Indigenous health service delivery organizations, health care providers, and individuals across the country who will be vaccinated.

Principles

To bring the benefits of COVID-19 immunization to Canada, F/P/T governments will work within their respective jurisdictions according to the following principles:

Science-driven decision-making

Governments' decision-making on COVID-19 vaccine use in Canada will be based on science, independent regulatory review and the advice of medical and other experts, including the National Advisory Committee on Immunization (NACI), to establish and maintain public confidence in the processes to approve, procure, administer and monitor vaccines. This principle reflects the fundamental value that F/P/T governments place on public health expertise and the independence of scientific enquiry.

Transparency

Reliable, comprehensive, and transparent information about all aspects of the development, evaluation, recommended use, and the surveillance and monitoring of vaccines is fundamental in order to support public trust. Misinformation threatens the health and safety of Canadians by undermining confidence in science, vaccines and in public health authorities.

F/P/T governments will provide appropriate information to their respective populations on COVID-19 vaccines and on what governments are doing to plan COVID-19 immunization programs through their own accountability processes. Messaging and engagement with the public should be informative and designed to support public confidence, with consideration given to using accessible language and culturally safe approaches to vaccine delivery as would most benefit their populations. 

Coherence and adaptability

F/P/T governments recognize the need for overall coherence in approaches to and communication regarding immunization based on scientific and epidemiological evidence, while allowing for adaptability and flexibility in immunization planning and implementation. Canada's approach respects jurisdictional roles and responsibilities and is commensurate with the epidemiology of COVID-19 and realities on the ground.

Limited vaccine supply will be available initially. Therefore, F/P/T governments will work together to develop a clear and transparent process for the allocation of vaccines across jurisdictions, with F/P/T governments being responsible for vaccine allocation to their respective populations.

Expert advice from public health, scientific and medical experts, including the NACI and provincial immunization committees, will be the basis for F/P/T government decisions on priority groups for immunization for the populations under their respective responsibilities while vaccine supplies are limited and for recommended use of authorized vaccines in Canada.

Fairness and equity

Fair and equitable access to vaccines underpins F/P/T governments' overall approach to immunization. These principles will be elaborated in an allocation framework for COVID-19 vaccines. Governments recognize the unique needs of rural, remote, and isolated communities, Indigenous Peoples, as well as smaller jurisdictions. Provincial and territorial governments are committed to ensuring fairness and equity in access to vaccines in their own jurisdictions.

Public involvement

People are at the centre of effective immunization programs. This means that engaging respective communities, non-governmental organizations, and Indigenous organizations in dialogue and understanding their needs is essential to how governments plan immunization strategies. F/P/T governments will work with their respective populations on what is important to them as planning proceeds. Governments agree to consider those disproportionately affected by the pandemic.

Consistent reporting

F/P/T governments recognize that timely access to data is essential to an effective pandemic vaccine response. Public health systems need timely and accurate information to monitor program implementation and inform decision-making. F/P/T governments are committed to report to their own populations on core elements of vaccine distribution, administration, safety and effectiveness, in a manner that could benefit all jurisdictions. Accurate and timely data will enable effective delivery and use of these novel vaccines across all jurisdictions. The Government of Canada can provide supporting resources to implement consistent reporting, where requested by provinces and territories.

Commitment

F/P/T governments share the commitment to provide safe and effective COVID-19 vaccines according to the principles in this statement. F/P/T governments will implement their roles and responsibilities in the spirit of collaboration that has characterized this pandemic response.  

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