Vaccine preference a problem for EU leaders

AstraZeneca’s painful rollout in Europe is a warning to the rest of the world
Vaccine preference a problem for EU leaders

A woman receives a dose of the Pfizer-BioNtech Covid-19 vaccine at a vaccination centre in Garlan, western France, on Tuesday. Picture: Fred Tanneau/Getty Images

The scientist in charge of France’s vaccine rollout, Alain Fischer, must sometimes feel like Sisyphus, forever rolling his boulder up the hill.

After months of patiently working to win over a doubting public’s acceptance of the groundbreaking mRNA vaccines from Pfizer and Moderna, he’s now fighting to convince French doctors to offer AstraZeneca’s more traditional shot to their patients.

Resistance runs deep — even as doses pile up, more data about efficacy emerges, and president Emmanuel Macron, along with other EU leaders, frantically tries to speed up inoculations.

The challenge is not dispelling kooky theories about vaccination’s side effects or effectiveness, but the more complex informed scepticism that leads to damaging “comparison shopping”.

One doctor took to social media to criticise AstraZeneca’s less spectacular clinical efficacy levels of 62% compared to Pfizer and Moderna’s 95%, and its apparent weakness against variants, and said he’d “wait” before offering it.

Even some nurses, seen as an ideal target audience for the shot, say they’d rather hold out for Pfizer — the “Rolls-Royce” of vaccines, in their view — instead of AstraZeneca, presumably the Renault in this metaphor.

Fischer’s response has been to patiently explain that AstraZeneca’s shot is in no way a “bargain-basement” vaccine, and to cite encouraging real-world data that is piling up from the UK, where low vaccine hesitancy, ambitious inoculation goals and weeks of gruelling lockdown have led to a rollout that puts most of the EU to shame.

Europe isn’t exactly swimming in shots, and doesn’t have the luxury to start picking and choosing vaccines based on ideal efficacy percentages, especially given it needs at least seven months to vaccinate 70% of adults.

Still, the damage has been done: Only 15% of France’s 1.7m AstraZeneca doses have been administered.

It’s a similar story in Germany, with low take-up from the public and medical personnel.

It’s worth trying to understand how we got here and how to fix this mess: Not just for the EU but for the world, as more vaccines similar to AstraZeneca’s — like Johnson & Johnson’s, which may also be perceived as a “runner-up” — start being rolled out.

Any fresh delays will only benefit Covid-19 and new emerging coronavirus variants.

Part of the confusion in AstraZeneca’s case stems from a string of setbacks involving clinical data: An initial announcement of 90% efficacy last year turned out to only cover a small number of people who were given the wrong dosage.

Last month, a relatively small trial in South Africa revealed the shot showed only 10% efficacy against the B.1351 variant.

Real-world studies gauging its impact as it is rolled out obviously help, but lingering questions over the clinical trial data are partly why the US has not even approved AstraZeneca yet, unlike the EU. So better, more transparent studies will help.

There’s also probably been too much politics and not enough pragmatism. In Britain, where health secretary Matt Hancock models himself on the pandemic disaster movie Contagion, bold bets on vaccines have paid off — but promoting its success as some sort of Brexit victory also led some patients to snub rival vaccines for the “English” one.

Meanwhile, in France and Germany, where the cinematic equivalent might be the arthouse movie, the opposite has happened: Caution over AstraZeneca’s data easily fell into exaggeration when Macron said the shot was “quasi-ineffective” for over-65s.

It’s a misconception that’s stuck, even as he’s walked it back and Fischer debunked it. On Monday, France’s health agency lifted its age limit on the AstraZeneca shot from 65 to 75 years for patients with comorbidities.

Communication, key in the heat of any public health crisis, has been poor.

Perhaps EU politicians should have echoed Canada’s government, which eloquently pointed out that the benefits of being vaccinated outweighed the risks of not getting the shot.

If we are in a race against variants, it makes more sense to jab now than to jab not.

One idea might be to change the inoculation strategy if positive messaging on these vaccines is not cutting through to their current target audience. Estonia and Slovakia, for example, worked through their AstraZeneca supply by offering it to frontline workers and teachers.

If nothing improves uptake while Pfizer and Moderna deliveries ramp up, then it is time to do the right thing and share the doses with the developing world, where countries are being forced to wait for scraps as the rich world hoards vaccines.

Maybe the risk of sacrificing supply, and the sight of doses leaving the region is what it will really take to get Europeans to wake up to how lucky they are.

If not, this boulder risks rolling downhill a few more times.

  • Lionel Laurent is a Bloomberg Opinion columnist covering the EU and France. 

'Stunning' data shows effectiveness of Oxford and Pfizer jabs

Real-world data on the effectiveness of the Oxford and Pfizer vaccines is "stunning" and countries across Europe will take note, a scientist behind one of the jabs has said.

Professor Andrew Pollard, director of the Oxford Vaccine Group, welcomed the new study from Public Health England (PHE) which found that protection against developing symptomatic Covid-19 in the over-70s was around 60% for both Oxford and Pfizer after a single dose, while among the over-80s the vaccines offered more than 80% protection against hospital admission.

A man exits a Covid-19 vaccination truck parked outside his residential building in the Parisian suburban city of Stains on Tuesday. Picture:  Anne-Christine Poujoulat/Getty Images

A man exits a Covid-19 vaccination truck parked outside his residential building in the Parisian suburban city of Stains on Tuesday. Picture:  Anne-Christine Poujoulat/Getty Images

Prof Pollard told BBC radio that the findings were "stunning", and this was for two reasons.

"First of all, because these data come from the hardest group to protect — those who are the frailest, the oldest adults in our population — and we're seeing an 80% reduction in hospitalisation in that group, which is stunning," he said.

Second... both of the vaccines performed exactly the same, there was no daylight between them.

"We've had all this difficulty with communication, particularly around Europe, with uncertainty about the evidence, whereas in the UK we've been rolling out both vaccines in the confidence that they would both give high levels of protection.

"And that's absolutely what we've seen now in this real-world evidence — that whether you've had a Pfizer vaccine or the Oxford AstraZeneca vaccine, you have very high levels of protection."

Prof Pollard said around 5,000 people are dying every day from Covid across Europe, where some leaders have shunned the Oxford vaccine for older age groups.

Prof Pollard said: "It just shows how critical it is to improve public confidence across the continent about the vaccines, and that's why the data that appears today is so important — to show that both of the vaccines which are widely available in Europe can have this big impact."

Asked about France reversing its decision not to recommend the Oxford jab for over-65s, Prof Pollard said he thought many countries would now be looking at the latest data.

Asked if concern over the Oxford jab had been disappointing, he said it was "disappointing in some senses, but it's important to remember that the way in which scientific committees in different countries make their decisions is quite different.

Prof Pollard said future vaccines may well be able to tackle the P1 Brazil variant that has been found in the UK as well as the South African variant.

"The work at the moment is partly to understand whether a vaccine for one of them might actually protect against both so there's a lot more that we don't know yet about this, but all the developers are working on new vaccines to make sure we are ready if we need to be," he said.

Trials of the Oxford vaccine have already started on younger age groups down to 12 years of age, with trials on younger groups starting soon, and results expected towards early summer, he added.

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