Canada’s surprising history and questionable partnership with a Chinese company and its military-backed COVID-19 vaccine

When Prime Minister Justin Trudeau announced last month that Canada would soon be holding human trials of a new COVID-19 vaccine, there was a lot of excitement, and some confusion.

The developer of the would-be vaccine was a Chinese company called CanSino Biologics, hardly a household name in the pharmaceutical industry.

But not only is CanSino a leader in the international race to find a preventive solution to the pandemic — working alonside the Chinese military’s medical-science division — it has surprisingly deep roots in this country.

The vaccine is based on a cell line developed by the National Research Council. The company has worked with the NRC previously on an Ebola vaccine, and with scientists at the council and McMaster University on a tuberculosis shot. More recently, it partnered with a Vancouver-based bio technology company that came up with its own COVID-19 vaccine candidate.

CanSino reached a significant milestone last month, becoming the first company in the world to publish peer-reviewed results of a COVID-19 vaccine trial.

But at a time of historically sour relations between Canada and China, some experts are questioning Ottawa’s decision to invest in the project.

Those early trial results were a mixed bag at best, argues Amir Attaran, a University of Ottawa health policy professor, while other COVID vaccines seem more promising and are backed by major Western universities and companies.

“Why would we not choose to be affiliated with those efforts, and instead pick as our preferred partner the Chinese military and a Chinese company?” asked Attaran, who has a doctorate in immunology from Oxford University. “This vaccine candidate is nothing but a dead man walking now.”

Gary Kobinger, a Laval University professor who famously helped develop an Ebola vaccine and treatment while at Canada’s National Microbiology Lab, said he actually applauds the government for ignoring politics and working with China. But the phase 1 results suggest CanSino’s vaccine is not the one to bet on, he said.

“There are a lot of challenges this vaccine platform will face … This will be a little bit like winning the lottery to get this to the end,” he said. “That’s why I’m a bit at a loss about this. I still don’t understand: how did that work? What was the decision mechanism to invest in this?”

Others argue that CanSino’s product — called Ad5-nCoV — seems to have at least some potential, and that even an imperfect vaccine is better than none.

What was the decision mechanism to invest in this?

“You can raise issues, less with safety than with efficacy, with most of the vaccines that are under development,” said Dr. Allison McGeer, a Toronto-based infectious disease specialist who critiqued the trial results in The Lancet journal. “This one makes sense as much as anything else.”

CanSino could not be reached for comment.

Meanwhile, the company said Monday that China’s military has received the green light to use the vaccine for one year, even though the usual three phases of trials are not complete.

“The Ad5-nCoV is currently limited to military use only and its use cannot be expanded to a broader vaccination range without the approval of the Logistics Support Department,” CanSino said, referring to China’s Central Military Commission, which approved military use of the vaccine.

Trudeau announced May 12 that Canada had struck an agreement with the Tianjin-based firm to conduct another phase 1 trial, which essentially measures whether the vaccine is safe and generates an immune response, followed if successful by phase 2 and 3 trials here.

The government refuses to reveal how much it’s spending on the studies, to be overseen by Dalhousie University’s Canadian Centre for Vaccinology. Particulars of the CanSino deal are shielded by “commercial confidentiality,” said Hans Parmar, an Innovation, Science and Economic Development Canada spokesman. But Ottawa has committed $1 billion to COVID-19 research generally.

The National Research Council would produce the vaccine for the Canadian market at a manufacturing facility in Montreal if the trials prove successful. It says it should be able to make 70,000 to 100,000 doses a month by the end of the year.

It’s a mass-production role the council doesn’t typically play, but it would potentially make Canadians “among the first in the world to have access to a safe and effective vaccine against COVID-19,” says the agency.

The vaccine is based on relatively recent technology that genetically engineers an adenovirus — effectively the drug’s delivery vehicle — to include the new coronavirus’s spike protein. That ideally prompts the body’s immune system to stave off COVID-19.

The company’s phase 1 results, published in the Lancet, were a good-news, bad-news story.

The study found an immune response to SARS-CoV-2, the virus causing COVID-19, in most of the 108 subjects, but it was “dampened” in about half of them. The trial confirmed worries that the vaccine’s adenovirus type-5 backbone curbs the immune reaction. That’s because most people have been exposed to Ad-5, which causes colds, and have antibodies that reject it.

Kobinger noted that the best immune response came from the highest dose, but that version also produced significant side effects, like elevated fever. A phase 2 trial now starting in China is studying only lower doses.

“A vaccine that gives you grade-3 side effects in phase 1 is not a prime candidate,” he said.

Still, McGeer said it’s unclear how much of an immune response is needed to repel the COVID-19 virus, and even the lessened effects at lower doses might be enough.

And in fact, the federal government says it hasn’t put all its COVID-19 eggs in the CanSino basket. It is funding a number of Canadian vaccine projects, including one at the University of Saskatchewan that’s moving toward human trials soon.

But if Canada wanted an international partnership, other projects seem to have more potential, insists Attaran. He points, for instance, to one led by Oxford University and AstraZeneca, which is in phase 2 trials and has been setting up manufacturing arrangements worldwide. Canada has yet to join.

Ottawa has invested in a small Boston-area company, VBI Vaccines, developing a vaccine against COVID-19 and two other coronaviruses, SARS and MERS. And the government is seeking to partner with major international vaccine-makers and the UK’s Vaccine Task Force, said Parmar.

Attaran also questions what benefit, if any, Canada received from CanSino in exchange for the NRC’s cell lines and, now, an unknown amount of funding for clinical trials.

The research council stresses the agreement would provide Canadians rapid access to the vaccine. But asked whether it was paid for the cell lines, NRC said only that it had provided CanSino non-exclusive licences, as it does other firms and researchers. As for getting preferential pricing for the vaccine in Canada, drug costs are not the council’s responsibility, a spokesman said.

This is far from the first dance between the Canadian government agency and the Chinese company. They’ve worked together for more than a decade, starting with a joint venture in 2007 to develop a tuberculosis vaccine. A few years later, in 2013, the NRC licensed its version of the HEK 293 cell line to CanSino to produce one of the world’s first Ebola vaccines.

In 2011, CanSino says it acquired global rights to a TB vaccine developed by researchers at McMaster University in Hamilton. The McMaster team was assisted by $3.6 million in federal funding, the university said in a later article that described CanSino as an “industrial partner.”

Similar to the new COVID-19 vaccine, CanSino worked on the Ebola product with the Chinese Academy of Military Medical Sciences’ bioengineering institute.

If we want to vaccinate the world, that’s a big, big challenge

There’s no evidence the academy has played any inappropriate role in the coronavirus project.

But the military appellation is no mere formality, according to an article last year by U.S. researchers. China’s defence planners are increasingly interested in “biology as an emerging domain of warfare,” warns the piece coauthored by Elsa Kania, a research fellow at Georgetown University’s Center for Security and Emerging Technology.

The Chinese academy’s then-president wrote in 2015 that biotechnology will become the new “strategic commanding heights” of national defense.

CanSino’s Canadian connections, meanwhile, did not end with the federal vaccine collaboration inked in May.

A week later, it announced a deal to help develop a COVID-19 vaccine created by Vancouver’s Precision Nanosystems. Based on totally different cutting-edge technology, it uses “messenger RNA” to trick the body into making coronavirus proteins, which in turn, theoretically, provoke an immune response.

Precision CEO James Taylor called CanSino “very reputable” and typical of smaller biotech companies that are the industry’s innovators, not multi-national pharmaceutical giants. CanSino sees the B.C. firm’s product as a way of diversifying its approach to COVID-19, said Taylor.

“If we want to vaccinate the world, that’s a big, big challenge and it’s going to take multiple shots on goal and multiple successes.”