Thursday, February 4, 2021

On vaccines, Europeans are shooting themselves in the foot... again (EN)

After the European Commission's blunder on invoking - even briefly for a couple of hours last Friday - Article 16 of the Northern Ireland protocol, which offered a golden opportunity to the UK to pressure the EU into making further post-Brexit accommodations, the Europeans are again scoring an own goal in the vaccines saga.

This time it's not so much about Brussels, but about national leaders and authorities.

The decision by several countries (Germany, France, Portugal, Sweden, Austria, Poland, Belgium... and counting) to limit the use of the Oxford/AstraZeneca covid vaccine to those under 65 (or even under 55 in one country), compounded by statements such as this one by French president Emmanuel Macron, is a big mistake and an act of self-harm on many levels.

It is wrong on the facts. It undermines the EU vaccination strategy and the countries' own vaccination efforts. And it weakens the legal case that the EU has against AstraZeneca for non-performance of their contract to supply vaccines.

Wrong on the facts

President Macron's statement that the AstraZeneca vaccine is ineffective in older people doesn't deserve much discussion, it's simply a dishonest, misleading assertion in purely Trumpian style. But even the more measured approach by some national authorities to refrain from giving the vaccine to seniors for the time being appears exaggerated.

There is no evidence whatsoever that the AstraZeneca jab is ineffective for the elderly. The issue is that the data on its efficacy among this group is yet insufficiently robust from a statistical viewpoint, due to the small sample of seniors in the main clinical trial carried out so far. Even so, other evidence (e.g. on the immune response, or on the reduction in virus transmission) strongly suggests that the vaccine is working as intended. The evidence was deemed good enough by the European Medecines Agency (EMA) to approve the AstraZeneca vaccine on 29 January for use in all age groups in the EU.

The extensive clinical trial that is ongoing in the US should soon plug the gap on the statistical strength of data on the vaccine's efficacy among the elderly. One can hope that the authorities in EU countries who have been hesitant so far will be as quick in dropping their reservations once the evidence becomes compelling.

Undermining the EU's vaccination strategy

The EU and its member states committed to a joint approach to vaccination against the coronavirus, meaning centralised approval of the vaccines by the EMA, centralised procurement and equitable distribution of vaccines to all the countries. Indeed, there is no other reasonable way for an integrated continent, with a single market and a right to free movement of people across borders.

National authorities second guessing EMA's authorisation of the AstraZeneca vaccine are undermining one of the main tenets of this common approach, and undermining trust in EMA's competence at a time when the Agency is already under huge political pressure for the time it is taking to give its authorisations. So EMA is criticised for being too slow, and when it comes through its decisions are questioned. Such discredit of the EMA by the very EU countries who decided to entrust it with the centralised approval of the vaccines plays perfectly into the hands of the Hungarian government, which has already gone its own way by approving unilaterally vaccines from Russia and China in a non-transparent way.

Undermining national vaccination efforts

In addition to affecting EU unity, countries are shooting themselves in the foot by restricting the usage of the AstraZeneca vaccine for the elderly.

All EU countries are facing significant vaccine shortages that hamper their efforts to immunise as many people as possible before they are imminently hit by the third wave of the pandemic (driven by the more contagious variants of the virus). The elderly are the most vulnerable population, with the highest mortality from covid. So reducing the availability of vaccines to the elderly will very likely translate in extra deaths in the coming period.

Moreover, sending mixed signals about one of the few vaccines available will only revive anti-vaxxer conspiracy theories and the general reluctance of a non-negligible part of the population. Indeed, if we are to take seriously all the decisions by different authorities, one would have to conclude that the vaccine is not good for a French senior, but works well for a Bulgarian or a Brit of the same age. Not exactly a recipe for building trust in science.

Weakening EU's legal case against AstraZeneca

The scandal of AstraZeneca refusing to meet its contractual obligations to the EU (while at the same time delivering on schedule to the UK) is far from over. Despite some de-escalation and a pledge to reduce the shortfall in the first quarter of 2021, AstraZeneca is still in breach of contract. Indeed, some EU countries have announced that they are considering legal action against the pharma company for failure to deliver its promised vaccines. The extra covid victims in the coming period due to the shortage of vaccines is bound to be a powerful argument in the future litigation.

But by refusing the usage of the vaccine for the most vulnerable population group, EU countries are giving away that argument and undermining their own legal case. They will be responsible for the additional victims, not AstraZeneca's not delivering on their contract in bad faith.

You may say that making such calculations involving possible lives lost is cynical. I disagree: if anything, what is cynical is to keep potentially life-saving vaccines from the people who are most at risk.

Let me be clear: all this saga is very complicated and far from over. It combines many different threads, from health to social and economic issues, from covid waves to vaccination, from science to conspiracy theories, from virus variants to Brexit politics.

Until very recently, the EU and its member states appeared to be the "adults in the room", understanding the need for cooperation, more or less keeping their cool (after a bout of panic at the very beginning of the pandemic), acting responsibly and in sync. But the past few days have seen a series of unforced errors that threaten to unravel their whole effort.

It is urgent that coordination and clear-headedness take again center stage.

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