Canadian Immunization Research Network

Canadian National Vaccine Safety (CANVAS) Network

The Canadian National Vaccine Safety (CANVAS) Network uses self-reported, web-based surveys from members of the public to collect information about vaccine-related health events. The network currently collects data from individuals across Canada who have recently received RSV, seasonal influenza and COVID-19 vaccines. Unlike other vaccine safety surveillance systems, CANVAS also collects information from an unvaccinated control group, which enables more rigorous analysis and detection of health events.

During the COVID-19 pandemic, the network maintained active surveillance of vaccine safety and provided rapid, weekly data to the public and public health authorities. This data encompassed over one million vaccinated Canadians in six provinces and two territories. CANVAS has also evaluated the safety of other vaccines used in mass immunization programs such as the meningococcal B vaccine and mpox vaccine.

Clinical Trials Network (CTN)

The Clinical Trials Network (CTN) conducts both traditional and rapid clinical trials in the general population and specialized groups. These trials provide safety, immunogenicity, and efficacy data on candidate vaccines. The network also evaluates marketed vaccines to provide data on altered dosing, schedules, and vaccine combinations; program delivery and outcome research; and vaccine program demonstration projects.

During the COVID-19 pandemic, CTN collaborated on four phase 1 trials of domestic COVID-19 vaccines launched in Canada. In total, the network contributed to clinical trials of more than a dozen SARS-CoV-2 vaccine candidates, 8 of which progressed to synopses, full protocol or pre-CTA meetings with the regulator. The Clinical Trial Network maintains readiness to conduct controlled prospective clinical trials of novel vaccines across Canada for future public health emergencies, and to pivot to trials to address priority knowledge gaps for immunization decision making as identified by public health partners.

CTN is an active participant in three of the five research hubs (CP2H, CIEBH, and ECaPPH) of the Canadian Biomedical Research Fund – Biosciences Research Infrastructure Fund (CBRF/BRIF), components of Canada's Biomanufacturing and Life Sciences Strategy (BLSS).

Immunity of Canadians and risk of epidemics (iCARE) and Laboratory Science (iCLS) Network

The Immunity of Canadians and risk of epidemics (iCARE) and Laboratory Science (iCLS) Network conducts vaccine serosurveillance research to provide evidence for local, provincial, territorial and federal policy-makers. iCLS has built serology and neutralization testing capacity for measles, rubella, varicella, pertussis, and tetanus. The network also performs cellular immunity assays for infections like influenza, measles, and varicella and supports other CIRN networks with laboratory testing for influenza, Streptococcus pneumoniae, and varicella.

During the COVID-19 pandemic, the iCARE and iCLS network demonstrated ability to rapidly develop laboratory methods to characterize emerging pathogens and led the laboratory component of multiple clinical studies conducted by the Clinical Trials Network (CTN). This included developing laboratory methods to measure humoral response to SARS-CoV-2 infection or vaccination using serology and avidity tests, plaque reduction neutralization tests, pseudoneutralization tests, and cellular immunity assays.

Modelling and Economics Research Network (ModERN)

The Modelling and Economics Research Network (ModERN) conducts mathematical modeling studies of immunity and immunization. Through epidemiological and economic analyses, the network also studies the cost-effectiveness and population-level effectiveness of public health interventions.

During the COVID-19 pandemic, ModERN developed models to determine optimal rollout strategies of vaccines that would consider age and health equity concerns. The contact mixing data from the CONNECT study conducted by the network was used intensively by Canadian modelers during the pandemic. This data is also actively used in modelling studies for other viruses of concern in Canada.

Real-world Evidence on Vaccines using Existing Data (REVivED) Network

The Real-world Evidence on Vaccines using Existing Data (REVivED) Network uses routinely collected laboratory, vaccination and health administration data, along with other large-scale data sets, to conduct population-based assessments of real-world vaccine applications. By evaluating vaccine effectiveness, safety, coverage, and program impact, the network assesses how effectively vaccine programs achieve their intended goals of preventing disease and reducing health inequities.

Throughout the pandemic, REVivED investigators posted pre-prints and presented preliminary results to decision-makers and expert immunization groups, informing policy with timely Canadian data. REVivED remains well positioned to rapidly address questions of importance to public health decision-makers, supporting evidence-driven policy.

Special Immunization Clinic (SIC) Network

The Special Immunization Clinic (SIC) Network aims to standardize and improve immunization practices for patients who have experienced adverse events following immunization (AEFI) or who have medical conditions that may affect their response to immunizations, such as allergies. SIC physicians conduct standardized patient assessments and make vaccination recommendations based on network guidance. The network also conducts research to evaluate vaccine safety in patients with previous AEFIs and in those with immunocompromising conditions.

During the COVID-19 pandemic, the SIC Network helped develop and implement protocols evaluating suspected allergic reactions and myocarditis/pericarditis after COVID-19 vaccination. These protocols supported the completion of primary vaccination schedules for many individuals across Canada. SIC also contributes to the International Network of Special Immunization Services (INSIS) and is partnering with the POPCORN network. With sites in Nova Scotia, Ontario, Quebec, Saskatchewan, Alberta, and British Colombia, SIC remains positioned to provide invaluable support and capacity to national efforts managing and responding to AEFI and navigating medical barriers to vaccination during future pandemics.

Serious Outcomes Surveillance (SOS) Network

The Serious Outcomes Surveillance (SOS) Network conducts active surveillance for broadly defined acute respiratory illness at hospital sites in four Canadian provinces. SOS also develops research methodologies to test the effectiveness of vaccines, including vaccines already implemented in the general population, and evaluates vaccine safety. The network's research provides empirical data for use in modelling studies and generates real time surveillance data, using data sharing to inform decision-makers. SOS is also able to use its robust database to retrospectively examine questions of high public health stakeholder and decision-maker importance, such as RSV burden of disease, trends in invasive and pulmonary pneumococcal infections, and comparisons with other respiratory viruses that are being considered as potential novel vaccine targets.

Using coordinated methodology, SOS is able to efficiently conduct surveillance for multiple pathogens. Past research has included pathogens such as influenza, SARS-CoV-2, RSV, hMPV, and Pneumococcus and has demonstrated a particular focus on frailty as a factor that influences vaccine effectiveness and consideration of outcomes over short and longer terms (e.g., impact on function and institutionalization). The SOS network's approach is readily adaptable as novel pathogens or vaccine targets are introduced. During the COVID-19 pandemic, SOS was able to rapidly implement surveillance of the SARS-CoV-2 virus using well established infrastructure. The network remains positioned to support Canada's pandemic readiness and a coordinated surveillance response to the next public health emergency.

Social Sciences and Humanities Network (SSHN)

The Social Sciences and Humanities Network (SSHN) assesses evolving drivers of vaccine access, acceptance, and uptake and identifies effective approaches to improve vaccine confidence and coverage. The network focuses on improving equity for populations that have experienced marginalization or inequitable health outcomes due to structural, social, behavioral, and biomedical determinants of health. More than 25 projects have been conducted since 2014.

In response to the emergence of the COVID-19 pandemic, nine SSHN projects were rapidly deployed to provide evidence-based data to support public health communication about COVID-19 vaccines and interventions. Research on the social determinants of adoption of preventative behaviours, including vaccination, and on building trust in our vaccination system is key for future health crises preparedness.