Vaccine Wars – Political Posturing Putting Populations at Risk


Happy New Year

UK politicians have made many, many blunders in their handling of the coronavirus pandemic. The data make this only too clear. The UK heads the world ranking in terms of Covid deaths per million population, at 1,863 as of 25 March, followed by Italy (1,759), the US (1,628), Spain (1,584), and Mexico (1,544). At the time of writing, over 126,000 people have died in the UK within 28 days of testing positive for the virus.


Vaccine Success

But the UK can now claim a resounding success with its vaccine purchasing policy and the speedy roll-out of the Pfizer/BioNTech and Oxford/AstraZeneca vaccines. By 28 March, around 57% of all adults had received at least one vaccine dose (over 30 million vaccines). In the EU, the percentages for Greece, France, Germany, Spain and Italy, for example, were between 9.9% and 9.3% (March 25th data).

The UK government looks set to meet its target of at least a first dose for vulnerable groups and all those aged over 50 by mid-April. However, plans to move on to those aged between 40 and 50 appear to be on hold because of supply issues. There are suggestions that this could hinder efforts to lift the strict lockdown in force in the UK for the past three months.


Unseemly Row

The UK’s rapid vaccine roll-out has provoked an unseemly row between the EU – notably the European Commission aligned mainly with France, Italy and Spain – and the UK government. AstraZeneca has been caught up in the centre of this, accused by the Commission of not meeting its contractual obligations for supplies. In January, AstraZeneca said it would have to cut the number of doses it could deliver to the EU, blaming production delays in Belgium and the Netherlands. The company said its agreement with the EU allowed the option of supplying Europe from UK sites, but only once the UK had sufficient supplies.


Commission President Ursula von der Leyen, with the UK in her sights, threatened an export ban on vaccines from the EU. In the event a summit meeting of EU leaders on 25 March stopped short of an export ban but agreed in principle to toughen export controls. However, the EU’s internal market commissioner Thierry Breton says the EU would keep supplies of the AZ/Oxford vaccine within the bloc until the company’s commitments are met. Also, there are still murmurings from France whose foreign minister claims the UK, having pushed ahead with first doses, will struggle to obtain second doses and the EU should not be obliged to release exports to help.


Squabbling

While EU leaders have now backed ‘global value chains’ rather than supporting the Commission in imposing export restrictions, member states are divided. The Netherlands and Belgium, for example, oppose restrictions while France, Italy and Spain support the Commission. There is also squabbling over how supplies should be distributed within the EU after Austria’s call for extra vaccines was rejected, and no agreement was reached on demands for more supplies from countries in eastern Europe where cases are spiralling.


Impact of UK Lockdown

European leaders are frustrated that, while Covid cases are surging in their countries, they are falling in the UK. But this is not entirely due to a successful vaccine programme. It can also be attributed to the UK having been, since the start of 2021, under one of the strictest lockdowns of any country.


Why has the UK been successful with the vaccine roll-out?

Mainly because:

  • the UK government’s contract with Astra Zeneca, although signed about the same time as that signed by the EU, is described as being more specific and binding in terms of delivering vaccine quantities, and it also followed a May 2020 deal on development of a “dedicated supply chain” for the UK and a commitment from the UK government to give £65 million to help Oxford University implement its production plan.

  • the UK regulator was quick off the mark with a rolling review that saw both jabs cleared for use earlier than in other countries, enabling the vaccine roll-out to start in early December 2020

  • the government invested heavily in facilities to produce vaccines and/or their components – almost all the Oxford/AZ vaccine used in the UK is supplied from UK manufacturing facilities

  • the authorities maintained their confidence in the Oxford/AZ vaccine despite concerns raised in Europe about effectiveness in the over-65s and the occurrence of clots that caused European countries to restrict and/or suspend use of the jab (concerns subsequently allayed by regulators)

  • there is very little vaccine hesitancy in the UK compared with other countries, with enthusiastic uptake of both vaccines despite widespread adverse publicity about the Oxford/AZ vaccine in Europe

What has gone wrong in the EU? In June 2020, all 27 member states agreed to give the European Commission responsibility for purchasing vaccines. But in February 2021, Mrs von der Leyen acknowledged the EU’s failures, admitting: “We were late to authorise. We were too optimistic when it came to massive production and perhaps too confident that what we ordered would actually be delivered on time.”

  • the EU also relied on agreements with Pfizer/BioNTech and Moderna which had early problems with production and distribution

  • suspensions, pauses and restrictions have been placed on the Oxford/AZ vaccine by many European countries because of reports about side-effects such as clotting, or claims of ineffectiveness in older patients

  • despite regulators’ offering reassurance about the vaccine’s safety, these moves led to increased numbers of people in Europe refusing this vaccine and doses being left on shelves – considerable damage was done by President Macron declaring that the Oxford/AZ vaccine was “quasi-ineffective” in the over 65s and then subsequently claiming it should not be used in the under-55s.

  • even apart from the controversy over side-effects, vaccine hesitancy is an issue of concern in several EU countries (notably France) which hinders uptake of vaccinations

To be fair, it should be noted that, over 77 million vaccine doses have been exported from the EU to about 33 countries since December. 21 million have gone to the UK, of which just over 1 million were from AZ while the rest were from Pfizer. At the same time, reports of many doses of Oxford/AZ vaccine lying unused in several EU countries have led to charges that it cannot be shortages of this vaccine that have hindered the EU’s vaccination programmes. France and Germany have used only about half of the Oxford/AZ vaccines they received, according to the European Centre for Disease Prevention and Control (ECDC). As one commentator observed: “Is this a question of the EU having its cake but not wanting to eat it.”


Lose-lose Situation

Vaccine producers have tried to steer clear of the political posturing, although are clearly concerned. Commenting on EU discussions of export restrictions, Pfizer’s Swiss country manager said that these would be a “‘lose-lose’ situation for everyone, also for members of the EU”. AstraZeneca, which is the main target of the Commission’s ire, must be feeling aggrieved that it is being condemned over a vaccine that has full backing from regulators and is being supplied at cost.


Worrying for vaccine producers is political leaders’ apparent lack of understanding or willingness to take account of the complexities of vaccine production and distribution. For example, threats to ban exports of the Pfizer/BioNTech vaccine to the UK from EU manufacturing plants takes little account of the fact that some ingredients are manufactured in the UK.


Will Reason Prevail?

Perhaps reason will prevail. At the time of writing, there were suggestions that the UK and EU were close to reaching an agreement under which the EU would lift its threat to ban exports of the Pfizer/BioNTech jab in return for the UK agreeing to surrender some of its quota of the Oxford/AZ vaccine.


While politicians squabble in ‘vaccine wars’ and accuse each other of ‘vaccine nationalism’, they will continue to put their populations at risk, particularly the vulnerable who stand to gain most from vaccines that have already proved to be highly effective in preventing hospitalisation and death from Covid-19. Confrontation instead of collaboration will prevent vaccine programmes being extended worldwide to the extent that no country will be safe until all countries are protected.


“Vaccine Apartheid”

Sir Jeremy Farrar, director of the Wellcome Trust predicted that the pandemic would first lead to health consequences, then societal/economic ones, and thirdly what we are now seeing – geopolitical consequences. He is worried. “We are looking at petty politics at a time when we need global leadership … It’s not just vaccine nationalism any more. It’s vaccine apartheid”, he told The Times newspaper.


Also, politicians attacking companies that have worked so hard to produce the vaccines are ‘biting the hand that feeds them’ and this can only be counterproductive.

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