As Britain and Europe Butt Heads in the Battle for Access to Vaccines - Who Will Win?

Caroline de Braganza

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(Image by Shafin Al Asad Protic from Pixabay)

AstraZeneca is the scapegoat.

It’s no surprise vaccine nationalism would raise its ugly head as many nations across the globe struggle to get the quantities they need to inoculate their populations.

Naturally, the priority for each country is to protect its own citizens—the "me-first" approach is understandable.

Interrupted supplies of doses have dominated the pandemic conversation in recent weeks as demand outstrips what manufacturers can produce.

Both Oxford-AstraZeneca and Pfizer-BioNTech have struggled with production issues, leading to their inability to fulfil contractual obligations to the EU and the UK.

The current battleground is over the supply chain of the Oxford-AstraZeneca vaccine. The EU is threatening to withhold export to the UK to safeguard doses for its own citizens.

UK Health Secretary Matt Hancock counters that as the British government had funded the research and development of the vaccine, it has a legal right to the doses.

“We set up the supply chain, not just here in the UK but indeed, we helped set up the supply chain in the EU. We legally signed a contract for delivery of the first 100 million doses here for people in the UK, as you would expect, both to ensure that people in the UK can get their jab and also because this is a UK-funded, UK-delivered vaccine.” he said.

The Serum Institute of India (which manufactures the AstraZeneca vaccine) has now advised that the New Delhi government is planning to withhold exports in April, as there are concerns over an upsurge of cases in India.

Many will recall the excitement in South Africa when the first batch of 1-million AstraZeneca doses arrived from the Serum Institute on 1 February this year.

The euphoria was short-lived as studies showed it was only 22.5% effective against the B.1.351 variant, commonly referred to as the South African variant.

The South African government halted the rollout and on February 8 started vaccination of health workers with the Johnson & Johnson vaccine from Janssen Pharmaceuticals, which requires only one jab and can be stored at normal refrigerator temperatures.

(My niece in Flint, Michigan, USA, received her J&J jab on Monday, 15 March. Sadly, it’ll be a long wait before SA citizens get theirs. At the current rate, experts estimate it will take 18 years to vaccinate 67% of the population to achieve herd immunity. Scary thought!)

AstraZeneca has suffered further reputational damage as twenty-four countries have now halted rollout because of unsubstantiated evidence the vaccine causes blood clots.

The list includes Germany, France, Italy, Spain, Ireland, Denmark, Norway, Iceland, Austria, the Netherlands, Indonesia and the Democratic Republic of Congo.

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(Graph courtesy Statista)

On Sunday, 14 March, AstraZeneca denied there was any evidence of increased risk of blood clots from its vaccine, after a review of safety data of people vaccinated with its vaccine.

"A careful review of all available safety data of over 17 million people vaccinated in the European Union and UK with the COVID-19 vaccine of AstraZeneca has shown no evidence of an increased risk of pulmonary embolism, deep vein thrombosis or thrombocytopenia, in any defined age group, gender, batch or in any particular country."

The company stated that as of 8 March, 15 cases of deep-vein thrombosis (DVT) and 22 cases of pulmonary embolism had been reported.

The World Health Organization and the European Medicines Agency (EMA) have both insisted there is currently no evidence linking the vaccine to blood clots. They recommend countries continue using it.

Emer Cooke, director of the EMA, reiterated in an online press conference on Tuesday stated that the agency remains firmly convinced that the benefits of the vaccine outweigh any risks.

Both the WHO and EMA are performing a thorough analysis of all the available data and the EMA will be making a statement with its conclusions on Thursday 18 March.

The problem is, once a rumor starts, there’s no stopping it.

Michael Head, a senior research fellow in global health at the University of Southampton in the United Kingdom said,

“There's still a lot of Covid around Europe, so given that this is a public health emergency, you would need to see a pretty strong signal in the data to suspend a vaccine program. If we have this scare and there's nothing there, will there be more cases and deaths from Covid-19 because of delays in the vaccine rollout? Will it increase vaccine hesitancy?”

Stephen Evans, a professor of pharmacoepidemiology at the London School of Hygiene & Tropical Medicine, said the suspensions seemed premature, especially without more information about the incidents of blood coagulation disorders.

He said blood clots are, for instance, a complication of Covid-19.

"We need to be sure that these cases didn't occur in people with undiagnosed Covid, because people with Covid-19 are at increased risk of thrombosis."

This action by countries feeds the fire of fear in those who were already wary of vaccinations. Those who were persuaded to change their minds and get the jab, may now be reluctant to do so.

Even if medical science produces proof that the AstraZeneca vaccine is safe, the damage is already done.

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(Graph courtesy Statista)

In the meantime, people wait and wonder who will win—and at what cost to lives.

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