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Explainer: How will Canada's COVID-19 vaccine program work?

By Allison Martell

TORONTO (Reuters) - Canada has ordered more COVID-19 vaccine doses per capita than any other country - at least 194 million and up to 414 million doses for its population of 38 million.

With limited manufacturing capacity, six of the vaccines the country has ordered will have to be imported and the first are unlikely to arrive before early 2021, while a candidate from Quebec's Medicago is likely at least six months from approval.

The following outlines what to expect for COVID-19 vaccines in Canada:

WHICH VACCINES COULD BE AVAILABLE IN CANADA?

Canada has announced purchase deals with Moderna Inc, Pfizer Inc, Novavax Inc, Johnson & Johnson, Sanofi SA with GlaxoSmithKline Plc , AstraZeneca Plc, and Medicago.

In the unlikely event all seven are approved, Canada could buy enough doses to vaccinate the country more than five times over.

The vaccines will be distributed free through the provincial health services.

WHEN WILL THE FIRST DOSES ARRIVE?

Moderna, Pfizer and AstraZeneca have announced trial data that showed their vaccines were highly effective. They are seeking to accelerate the essential regulatory approval for their vaccines by using Canada's new rolling review process.

Canadian officials have not given a precise timeline for deliveries, but said they expect to receive a combined six million doses of Moderna and Pfizer's vaccines by the end of March 2021.

Prime Minister Justin Trudeau warned Canadians on Tuesday that manufacturers are likely to provide their own countries with vaccines first.

"Countries like the United States, Germany and the UK do have domestic pharmaceutical facilities, which is why they are obviously going to prioritize helping their citizens first,” he said.

Michael Mullette, managing director of Moderna's Canadian unit, said timing of shipments will depend in part on which countries have approved its vaccine, noting that Canada has been working to speed up the regulatory process.

"Canada is certainly one of the first countries to have an agreement with us, and will be serviced very quickly," he said.

Canada announced a deal with Moderna on Aug. 5. The European Union finalized a supply deal with Moderna on Tuesday.

WHEN COULD THE FIRST CANADIANS BE VACCINATED?

This depends on regulatory approvals. Health Canada said last week that it could approve one or more vaccine early in the first quarter of 2021.

Procurement Minister Anita Anand said on Tuesday that under Canada's purchase contracts, vaccine makers will not make deliveries until their products are approved.

WHO WILL GET THE VACCINE FIRST?

Canadian provincial governments will have the final say, Health Minister Patty Hajdu told a parliamentary committee recently.

According to preliminary guidance published by the federal government in early November, more vulnerable people will be prioritized for vaccination. They would include those at high risk of severe illness or death from COVID-19, such at the elderly.

Others likely to be in the early waves of inoculations are healthcare workers, people providing essential services such as workers at food processing plants and grocery store staff, and other people whose living or working conditions put them at elevated risk of infection, "and where infection could have disproportionate consequences, including Indigenous communities."

WILL CANADA REQUIRE VACCINATION?

Hajdu in late August said no vaccines are federally mandated in Canada, and the COVID-19 vaccine would be no different.

She noted that there are provincial rules related to school admission, with exceptions.

"We believe that people have a choice in Canada about whether or not to be vaccinated, but we also believe that we have an important responsibility as Canadians to take vaccinations to protect our communities," she said.

(Reporting by Allison Martell; Editing by Steve Scherer and Bill Berkrot)