BARCELONA — Initially hailed as “the vaccine for the world” when it appeared on European shores early this year, the Oxford/AstraZeneca COVID inoculation, which was created in just 65 days and costs around $2 a dose, far below competing shots made by Pfizer and Moderna, held the promise of turning the tide on the pandemic.
But after eight months of mounting frustration over still undelivered doses along with worries over rare associated blood clots, studies showing that it wasn’t as effective as other vaccines and a court action alleging the drug company was in breach of contract, the European Union is all but ditching the shot.
The story behind the AstraZeneca vaccine’s European sojourn has been rife with putdowns, broken promises, rancor and vaccine nationalism that at times looked like it would turn into an export war between the EU and the U.K., the country that at the end of 2020 “Brexited” — leaving the European Union it helped create.
Even before AstraZeneca’s shot came to market, Russian officials were indulging in crudely comical insults, calling it “the monkey vaccine.” (Kremlin spokesman Dmitry Peskov claimed in September that, unlike Russia’s vaccine Sputnik V, the AstraZeneca drug, which is derived from a chimpanzee adenovirus, would turn those who got it into simians.)
“Such narratives are apparently directed at countries where Russia wants to sell its own vaccine,” EU official Joseph Borrell said in blog post about what he considered to be Russian disinformation.
But there were more credible sources of criticism from the start. Dr. Anthony Fauci made waves in November, saying AstraZeneca’s vaccine presented a dilemma: While preliminary studies showed the Pfizer and Moderna vaccines provided protection against COVID-19 by upwards of 90 percent, AstraZeneca appeared to have efficacy rates around 70 percent — higher than the 50 percent deemed necessary for vaccines to work, but relegating it to runner-up status compared to the mRNA vaccines.
“Who are you going to give a vaccine like that to?” Fauci asked, and he and his colleagues at the National Institutes of Health questioned the data included in AstraZeneca’s clinical studies submitted in the U.S., effectively telling them to try again.
The original clinical studies confusingly employed trials using two dosing schedules and two different doses of the drug. The larger trial, among the studies which AstraZeneca submitted to the U.K., showed efficacy of 60 percent and in late December was swiftly granted emergency use approval. Following suit, the European Medicines Agency also approved its use for all adults in the EU while noting that the trials did not include enough results in participants over 55 years of age. But the health authorities in a dozen European countries, including Germany and France, refused to grant the vaccine approval for anyone over the age of 65, a decision that quickly led to confusion and mistrust. The German newspaper Handelsblatt incorrectly reported that the vaccine was only 8 percent effective for those 65 and older, a rumor that spread.
In January, French President Emmanuel Macron dealt another blow, erroneously calling the AstraZeneca vaccine “quasi-ineffective for people over 65, some say those 60 years or older.” Though he did reverse that assessment a month later, the damage was done. The French, who were given a choice as to which shot they wanted, were choosing Pfizer over AstraZeneca in far greater numbers — a situation which prompted the head of France’s doctors union to urge the French to stop “AstraZeneca bashing.”
Adding to AstraZeneca’s woes, the company had promised to ship 90 million doses of the vaccine to the EU in the first quarter of 2021, but less than a third of that number showed up. As a result, the continent’s vaccine program for its 445 million citizens looked pathetic, particularly in comparison to the U.K., which appeared to be swimming in the British-made immunization.
“AstraZeneca has unfortunately underproduced and underdelivered — and this painfully, of course, reduced the speed of the vaccination campaign,” Ursula von der Leyen, president of the European Commission, announced in March, promising that whatever it took, the EU would get its fair share of the AstraZeneca inoculation.
By March, less than 10 percent of Europeans had been vaccinated, while the U.K. was approaching 45 percent immunization levels. And then Germany reported that of the 2.7 million Germans who had received the AstraZeneca vaccine, 31 people, most of them young women, had developed rare blood clots, and nine had died.
Countries across Europe slammed on the brakes, suspending use until the European Medicines Agency investigated. The EMA soon reported that while there appeared to be a link to blood clots, the risk was minimal and certainly less than the danger of COVID-19 itself. However, health authorities in Germany, Italy, Spain, Belgium and beyond that had earlier advised the shot shouldn’t be used in those over 55 or 65, in March reversed their positions and said the vaccine should now be used only for those over 60. Those flip-flops further undermined public trust. (A recent study found that both AstraZeneca and Pfizer vaccines could both produce blood clots, but that COVID-19 produced more clots than either vaccine.)
That month, health authorities in Denmark, then Norway, followed by Austria in May stopped using AstraZeneca altogether, while those countries that were relying on it continued to experience shortages due to delivery delays; Spain, for one, was forced to temporarily halt its vaccination programs. AstraZeneca revised second-quarter delivery estimates downward from 180 million doses to just 70 million.
Upon learning that some AstraZeneca vaccines were being made in Europe and exported to other countries, the EU threatened to ban exports and raided a plant in Belgium in February and another in Italy in March, generating more embarrassing headlines and doing little to alleviate supply shortages.
In May, after signing eight additional contracts with other pharmaceutical countries, the EU announced it would be taking AstraZeneca to court, and demanded 90 million more doses by July and $12 million in damages for delayed deliveries. AstraZeneca, which called the suit “unfounded,” countered that it had lived up to its contractual obligation to make the “best reasonable effort” to deliver the doses.
Ruling in June, the court largely sided with AstraZeneca, saying the drugmaker was obliged to deliver only 50 million more doses to the EU by September. By then, after 65 million EU citizens had been vaccinated with AstraZeneca, the EU was fed up; it declined to put in additional orders with the British-Swedish firm and across the continent, health authorities began phasing out the drug’s use.
Along with other European countries, Germany announced that it would start mixing vaccines, a practice currently not approved by the World Health Organization. The first AstraZeneca shot that German Chancellor Angela Merkel received was followed up by a dose of Moderna’s mRNA vaccine, a practice that Germany’s health minister said yielded “clearly superior” results than two doses of AstraZeneca. Italian Prime Minister Mario Draghi’s AstraZeneca jab was followed up with a shot from Pfizer. Overlooking pleas from the WHO to forestall booster shots until poorer countries are immunized, Germany will offer a third shot of an mRNA vaccine in September to elderly and immune-compromised citizens — and to those who received two shots of AstraZeneca.
On the heels of learning that the EU will now be relying on mRNA vaccine, Pfizer and Moderna both announced price hikes. As reported by Financial Times, Pfizer’s price per shot is jumping to around $23 from $18.50, while Moderna’s is increasing to around $25.50 a jab from $22.60.
Meanwhile, millions of doses of AstraZeneca’s shots from European countries are being donated to COVAX and to low-income countries, where health officials say it can still help defeat the pandemic.
“The AstraZeneca vaccine has the potential to be the real workhorse of immunization programs,” Jonathan Kennedy, a public health lecturer at Queen Mary University of London, told Yahoo News. “It’s cheaper than the other vaccines, and it’s easy to transport.” And without the extreme temperature requirements of mRNA vaccines such as Pfizer, which is kept at 94 degrees below zero Fahrenheit, he added, “It’s easy to store.”
With only 1.1 percent of populations in low-income countries having received at least one shot, the WHO is now calling for vaccinations of “at least 10 percent of the population of every country in the world by September, at least 40 percent by the end of the year, and 70 percent by the middle of next year,” Dr. Siddharta Datta, regional adviser to the WHO/Europe’s Vaccine-Preventable Disease program, told Yahoo News. “These are the critical milestones we must reach together to end the pandemic, and AstraZeneca vaccine doses together with the other available and approved vaccines will indeed play an important role in achieving them.”
Earlier this summer, the EU announced it wouldn’t be ordering any more of the AstraZeneca vaccine, and countries across the continent say they have begun donating unused vials to COVAX, a global coalition that distributes vaccines to countries around the world.
British media is portraying Europe as having squandered its AstraZeneca riches, while some politicians are accusing the EU of making a scapegoat of AstraZeneca “to cover up their own failures.”
“The European leaders who trashed the AstraZeneca vaccine have blood on their hands,” one unidentified politician, concerned that other countries may now reject it, is quoted as telling Politico’s London Playbook.
As of this month, the AstraZeneca shot makes up some two-thirds of the vaccines being supplied by COVAX, doses donated by countries and some donated by the drug maker itself.
“AstraZeneca’s vaccine is highly effective against severe disease and hospitalization across all adult age groups,” a spokesperson for the drug company told Yahoo News. “It has demonstrated a high level of protection against all variants of concern and its overall safety profile is comparable to other vaccines.”
“Our vaccine is being supplied at no profit and is truly a vaccine for the world,” the AstraZeneca spokesperson continued. “We have now crossed the 1 billion dose milestone supplying more than 170 countries, and those doses have helped to save tens of thousands of lives. We are doing more than any other company to make the vaccine available to low- and lower-middle-income countries, as it is only through providing broad and equitable access to vaccines that we can end this pandemic.”
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