By: Julia Shephard
Excessive caution will cost lives and affect those outside the continent
Should nations criticize companies delivering a pandemic panacea, or do their objections distract from the public good? While Pfizer, BioNTech and Moderna expect to make upwards of $15 billion yearly from COVID-19 vaccines, the Oxford-AstraZeneca collaboration has vowed to distribute its version with almost no regard to profit. AstraZeneca (AZ) jabs cost just three or four dollars per dose, can be stored in a conventional fridge, and may inoculate 2.9 billion people this year. Yet, despite manufacturing what is effectively a magic bullet for the global crisis, the company has been slammed by E.U. regulators and the mainstream media for purportedly lower efficacy rates and blood clotting. The European Union announced on April 14th that it would not renew contracts with the Swedish company. While nations in the E.U have the option to use alternative shots, negative portrayals of the AstraZeneca vaccine undermine global trust in public health and do more harm than good.
Critics level two main complaints against the AZ vaccine: its efficacy numbers are markedly lower than Pfizer-BioNTech and Moderna’s, and some users taking it have experienced blood clotting. On the surface, the clinical trial results do appear different, with Moderna reporting 94% case prevention, Pfizer reporting 95% efficacy, and AstraZeneca at 79%. However, all three vaccines are 100% effective in stopping hospitalization due to COVID-19. Furthermore, the primary goal of a vaccine is not to completely eliminate Sars-COV-2 cases but to decrease the severity of any given case. Differences in the design of the AstraZeneca study further complicate the public perception of their product’s quality, when, in fact, a variety of vaccine designs will be necessary for any region to reach herd immunity and decrease the strain of the virus on public health systems. The most significant complaint surrounding the vaccine is blood clots, of which 79 were reported during March in the U.K. In early April, Marco Cavaleri, a senior vaccine evaluation official at the European Medicines Agency, declared “there is an association [of clotting] with the vaccine.” However, he did not use data to support the claim, pointing to an overly cautious assessment of the situation.
The data surrounding the AstraZeneca vaccine demonstrates that for the vast majority of people, the benefits outweigh the risk, something that E.U. governments have failed to make clear to their public. The odds of dying from a blood clot caused by the AstraZeneca vaccine are similar to the odds of being struck by lightning in a two-year period, or, indeed, getting a blood clot from COVID-19, which is over eight times as likely. By imposing suspensions to investigate blood clots that occurred in roughly one in a million cases, the bloc lost valuable time and doses that they could have used to protect more people. Continuing an investigation while allowing injections to continue could have provided an equally credible evaluation without setting back rollout. Indeed, much of the sudden caution surrounding the vaccine likely came from countries feeling pressured to follow their counterparts; once Germany suspended dosage over blood clot fears, France, Spain and Italy were quickly compelled to follow them despite minimal evidence that the vaccine posed a severe risk. In general, the E.U.’s reaction has erred on the side of caution with largely negative regional implications.
Admittedly, some countries have better reasons than others to pause the AstraZeneca vaccine. Nations that have already vaccinated their higher-risk populations may find that in 20-30 year-olds, clotting risks from the AstraZeneca vaccine may encroach upon the benefits. However, as of April 16th, Spain, France, and Germany had injected just 23 vaccination shots per hundred people, meaning that swathes of its elderly and middle-aged population remained unprotected. For reference, at the same time, the U.S. had delivered 45 and the U.K. 53 per hundred residents. Exacerbating the slow administration process, just 50% of the French population self-report as likely to take a COVID vaccine, a number that is far too low to reach herd immunity and will be further battered by heightened mistrust in the AZ vaccine.
The most damaging effect of the AstraZeneca backlash will not take place in the E.U. but in nations that already rely heavily on the vaccine to achieve herd immunity. While E.U. member states can cavalierly fall back on mRNA technology, fears have risen in countries such as the Democratic Republic of the Congo, which has 1.7 million unused AZ doses lingering in facilities and no backups. Based on the signals that European governments and media send, the hesitance of other countries is understandable. Here, deeds speak louder than words, and suspensions fuel waves of hesitancy that the world, grappling with a pandemic that has killed nearly three million people, cannot afford.
Of course, scientists globally should continue to investigate the safety of vaccines, to assuage public concerns and ensure recipients’ well-being. But governments’ messaging impacts public opinion, and the European Union is not alone in needing to change its approach. Recently, the U.S. froze the Johnson & Johnson vaccine over clotting fears, which has lowered the population’s confidence in the life-saving injection. The U.S.’s stance should be clear as well: all medical procedures carry risks, but those of COVID-19 dwarf any carried by its current treatments. Once excess caution is unleashed by heads of state, dangerous vaccine hesitancy is likely to follow.
The AstraZeneca vaccine