OTTAWA — A small number of the most vulnerable Canadians could be immunized against COVID-19 before the holidays as the first doses of Pfizer's vaccine are set to arrive next week.

Prime Minister Justin Trudeau said Monday the contract with the U.S. pharmaceutical company and its German partner, BioNTech, was adjusted this week to reflect that up to 249,000 doses of their vaccine will be delivered to Canada before the end of December.

Everything hinges on Health Canada approving the Pfizer vaccine, with a decision expected on that in the coming days. Trudeau said that if approval comes by the end of the week, Canadians will begin getting vaccinated next week.

"It has been a difficult year, and we are not out of this crisis yet," Trudeau said Monday at a news conference in Ottawa.

"But now, vaccines are coming."

Maj.-Gen. Dany Fortin, named vice-president of logistics at the Public Health Agency of Canada to oversee the vaccine rollout plan, said once the vaccine is in Canada, it should take a day or two more for it to thaw and be prepared for an injection.

The Public Health Agency of Canada is overseeing the vaccine distribution to the provinces, but provincial governments decide who gets it and when, and puts in place the plan for that to happen.

The National Advisory Committee on Immunizations last week recommended priority be given to residents and workers in long-term care homes, front-line health workers, people over the age of 80 and adults living in Indigenous communities. 

Most provinces are following that guidance at this point, however Trudeau said remote locations, including northern Indigenous reserves, won't be getting the Pfizer vaccine for now because of the need to keep it so cold before it is ready for use.

"It is not easy to roll them out to more remote locations," he said. "But this process will allow us to stand up our processes for delivering and handling this first vaccine as quickly as possible. There will be more doses of other vaccines at later dates on a priority basis for Indigenous Peoples, particularly those who are in northern and remote (communities)."

Pfizer's vaccine has to be kept frozen below -70 C until just before it is diluted to be injected into a patient. The vaccine from U.S. biotech firm Moderna, which is on track to be approved in Canada after Pfizer's, only needs to be kept at -20 C.

Health Canada is also reviewing vaccines from AstraZeneca and Johnson & Johnson, both of which can survive at temperatures of around 4 C.

All but Johnson & Johnson currently require two doses to be effective.

Because of the temperature issue, Pfizer is shipping its doses from its manufacturing plant in Puurs, Belgium directly to 14 receiving sites in each province that are equipped with at least one ultralow temperature freezer.

There are two delivery sites in Ontario, Quebec, British Columbia and Alberta, and one in each of the other six provinces. None of the early shipments are headed for the territories. Fortin said last week all the provinces were asked to have the sites ready to receive vaccine by Dec. 14th.

Canada and the provinces enacted a "dry run" Monday, said Fortin, with empty boxes shipped from Belgium to test Canada's readiness.

"This is one way this week where we will learn how the process will flow, if adjustments need to be made," he said.

Pfizer has developed special thermal shipping boxes that can carry the doses, packed on dry ice, for up to 10 days. The shippers can be used as temporary storage on sites where the vaccines are going to be injected as well. In between they must be stored in ultralow temperature freezers.

The vaccine can be kept in a refrigerator, at temperatures between 2 C and 8 C for up to five days, and then at room temperature for no more than two hours.

Each shipping box is equipped with a GPS-enabled thermal tracker to monitor the location and temperature during shipping.

Most provinces indicated they are ready now to receive the vaccine, including having ultralow temperature freezers set up at the receiving sites. 

Newfoundland and Labrador Premier Andrew Furey said he anticipates receiving 1,950 doses at the receiving site in St. John's next week.

Quebec Health Minister Christian Dubé said four shippers with about 4,000 doses are to go to Quebec next week, which will be distributed to long-term care homes and residential seniors' homes first. 

That would be enough to vaccinate about 2,000 people to start, with Dubé saying more doses will arrive between Dec. 21 and Jan. 4, enough to vaccinate between 22,000 and 28,000 people.

Retired Gen. Rick Hiller, who is leading Ontario's vaccine task force, said a very small number of doses would land in that province next week, but that he anticipates 2.4 million doses in the first three months of next year.

Until Monday, Canada had said it expected to receive six million doses of vaccines between January and March, including four million doses from Pfizer, and another two million doses of the vaccine being made by U.S. biotech firm Moderna. 

Trudeau said that plan was fast-tracked, though he denied politics played any role. He said his comments before today, including that Canadians may have to wait for vaccines behind people in the countries where they are being made, were designed "not to get people's hopes up."

Canada appears to be on track to be second to get the Pfizer vaccine. The United Kingdom approved it for use there last week, doses have been delivered and the first vaccinations are to start Tuesday.

The United States is set to decide on Pfizer's approval Friday.

But unlike the U.S. and U.K. and some other countries, Canada will not be giving "emergency use approval" to any vaccines, Trudeau said later Monday in a pre-taped interview broadcast as part of the Wall Street Journal's CEO Council winter summit.

Such approvals are used to allow unapproved medical products to be used in an emergency.

"We're not doing any approval for emergency use. We are doing our regular process of approving vaccines," Trudeau said.

"We're saying, 'Do we approve this vaccine. Is it safe for Canadians or not?'  So, it's the full, regular process."

This report by The Canadian Press was first published Dec. 7, 2020.

Mia Rabson, The Canadian Press