Canada is testing its first potential COVID-19 vaccine as the world races to find solutions to the ongoing coronavirus pandemic.
It’s one of 12 recorded vaccines ready for or already undergoing trials around the world.
Prime Minister Justin Trudeau announced on Saturday that researchers in Halifax’s Canadian Centre for Vaccinology (CCfV) at Dalhousie University will be working with a Chinese developer to run clinic trials for a possible vaccine.
“There’s a huge rush to get something out,” said Dr. Jeff Kwong, the interim director of the Centre for Vaccine Preventable Diseases at the University of Toronto. “Finding a vaccine that works is necessary, but that’s really only the first step.”
Because there are many more steps ahead, here’s what happens next.
How do trials work?
Typically, vaccine trials are separated into three phases: phase one recruits about 10 to 100 people to try the vaccine; phase two includes 100 to 1,000 people; and phase three recruits 1,000 to 10,000 people. Halifax is in phase one. Participants are monitored for weeks at a time to see how they respond.
“At first (researchers) look at whether the vaccine creates antibodies,” Kwong said. “So the people are followed for a certain period of time to see if there are side effects and if the vaccine is helpful.”
A fourth phase occurs once the vaccine is mass produced and scientists can monitor how the general public reacts to it; it’s possible a rare side effect isn’t discovered during the clinical trials.
How are participants chosen?
A lot of variables influence how quickly the trials and (hopefully) subsequent mass production of a vaccine happen. At the onset, trials need to recruit people who are willing to undergo the trials.
Researchers will likely seek out healthy participants who don’t already have COVID-19 antibodies (people who haven’t recovered for the virus), Kwong said.
In Halifax, researchers are recruiting "very healthy individuals" between the ages of 18 and 55.
Diversity matters, too.
“It’s just as simple as males and females are distinct,” Kwong said, adding that in every country, COVID-19 has resulted in more severe cases among men.
“There is something going on that we don’t totally understand when it comes to sex,” Kwong said. That means, clinical trials will ideally monitor how COVID-19-fighting antibodies are created in both males and females.
Is this the first vaccine being tested?
No. Globally, there are at least 169 possible vaccines, or “candidates,” with 12 currently undergoing trials, including the one in Halifax.
Beijing Institute of Biotechnology is the only institution to get a vaccine candidate into phase two.
At least four additional labs in Canada, including researchers at Laval University and the University of Saskatchewan, are working on potential vaccines that aren’t ready for clinical trials yet.
When will we see a viable vaccine?
There could be a vaccine by the end of the year, but it could also take a year or two—no one knows yet, Kwon told VICE.
We know that several possible vaccines are being tested, but there’s still a lot we don’t know, Kwong said, and the journey to find a viable—and easily accessible—vaccine is just beginning.
So, what happens after a vaccine is proven to work?
This is where things get complicated.
The world will need factories to manufacture billions of COVID-19 vaccines. That’s a lot when compared to influenza, which only requires tens or hundreds of millions of vaccines annually, Kwon said.
Plus, the country where the effective vaccine originates ends up with a lot of power, according to Kwon. “It wouldn't surprise me if in the U.S., any vaccines they produced, the government will say the country isn’t allowed to ship it anywhere else until they’ve vaccinated all Americans,” he said.
Same rings true for Canada, which is why Kwon said he hopes countries play fair.
“Hopefully, if Canada finds a vaccine, it won’t nationalize our supply,” Kwon said. “We will share with those countries in need, and the more vaccines are produced, then the greater likelihood that we can share this common good.”
How long until we can all get immunized?
Because Canada has universal healthcare, we’re probably in a better position than the U.S. when it comes to administering the vaccine widely. But that doesn’t mean people will be able to access a vaccine equally, Kwon said—it all depends on who administers the vaccine and when.
If public health takes sole charge of doling out the vaccine during regular business hours, for example, people who work 9-to-5 jobs might have a harder time breaking away from work to get a vaccine, Kwon said. (Pharmacists can administer flu shots in Canada, making them accessible.)
“What do you do with someone who let’s say works at a McDonald’s and can’t leave work during certain hours to get to a clinic (where the vaccine is available)?” Kwon said.
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This article originally appeared on VICE CA.