The situation has become so fraught that European Commission President Ursula von der Leyen said Wednesday that Brussels was considering whether to block vaccine exports to make sure “Europe gets its fair share” — an announcement that drew many angry responses from non-E.U. countries expecting doses.
The supply problem has been compounded this week by a number of European governments’ decisions to block the use of AstraZeneca’s coronavirus vaccine because of safety concerns — not only disrupting the supply of the vaccine but potentially causing long-term public concerns about the drug, even if it is later proven safe, as many experts predict.
Germany, Italy, Spain, Ireland and France are among the countries that have suspended the use of the vaccine, which was developed amid much fanfare by researchers at Oxford University and makes up a significant part of the vaccine supply across the continent. Their worry is related to a number of blood-clotting incidents, some fatal, among those who have received the jab.
The prevailing view among scientists is that these incidents are likely to be unrelated to the inoculation — essentially, that correlation does not mean causation.
“Vaccines protect against one thing: the infection or the infection plus disease,” Susan Ellenberg, a biostatistician at the University of Pennsylvania, told Stat News this week. “They don’t protect you against everything else that might possibly happen to you.”
Europe’s top drug regulator, the European Medicines Agency (EMA), is expected to announce the initial results of a safety review Thursday, hopefully providing some much-needed clarity. But the toll has already been high for Europe either way, with expired doses, surging cases and weakened morale.
As The Washington Post’s Michael Birnbaum, Chico Harlan and Stefano Pitrelli report, some parts of Europe are now already in their third wave of infections. “With every day of vaccination delay, there are hospitalizations and deaths,” said Fabrizio Pregliasco, a virologist at the University of Milan in Italy — a country once again locking down because of a surge in cases.
In Europe, the biggest problem is not recklessness, but cautiousness. The continent was hit hard and early in the pandemic. Its success in the year since has varied across the Europe, with almost all nations — even ones that followed most recommended measures — suffering large tolls.
And that’s where Europe’s leaders, including those praised for their reason and technocratic inclinations, such as Germany’s Angela Merkel, have fallen behind the brasher political-decision making of countries including Britain, Israel and the United States, as well as nimbler governments like Chile.
Those nations adopted strong-arm tactics to ensure a variety of doses, quickly seeking out independent deals with manufacturers. Most European nations, meanwhile, stuck with the E.U.’s more measured approach and finalized deals later. The sticking point, according to accounts from insiders, was price.
Another wrinkle came later, when Europe watched mass rollouts of the vaccine produced by Pfizer and developed by BioNTech — a German company — take place in the United States, Britain and Israel, before the EMA had even approved the drug.
The EMA has now approved four different vaccines. But there have been significant concerns among national regulators about AstraZeneca, which was initially restricted in Germany and elsewhere for use on those over 65 because of limited data for that age group. The move was reversed after results from England, where the vaccine is being widely used, were studied.
The new concern about blood clots reflects the chaotically cautious nature of many European authorities, which have halted vaccinations even though both the EMA and the World Health Organization have said they should continue during the investigation. And the motivation may not simply be public health.
“It was a political choice,” Nicola Magrini, the director of Italy’s Medicines Agency, told La Repubblica newspaper Monday. Leaders saw other countries pausing the drug and made the decision to do so as well, rather than listen to global public health bodies.
In some ways, the situation is a product of the strengths and weaknesses of the E.U. It is a 27-member bloc, with a larger and more varied population than the United States, as well as a bigger economy. When it moves in unison, it can be powerful, but its decision-making is often unwieldy and unpredictable.
The E.U. was, for example, largely able to procure cheaper vaccine doses than the United States through its heft — a significant financial move, considering the supply needed. But its consensus-based decision-making process has contributed to the slow delivery of those doses, potentially negating any economic benefits.
The contrast stands starkly against the rollout in Britain, which was technically a part of the bloc until last year. London opted out of Europe’s vaccine procurement and instead forged ahead alone; that looks like a bright spot for Prime Minister Boris Johnson amid Britain’s otherwise disastrous pandemic performance.
Only a handful of E.U. states broke with the bloc’s vaccine orthodoxy. Hungary has vaccinated some of its citizens with Russia’s Sputnik V and Chinese vaccines, citing the need for a broader range than the EMA was approving. Other nations are moving to follow suit, albeit slowly.
But the panicked responses to the blood clot concerns, despite the recommendations from the EMA to continue administering AstraZeneca doses, are a reminder that the E.U. is not a technocratic behemoth. It is made up of individual national states that will act their own way when they feel the need.
For now, that might be a uniquely European problem. Outside of Europe, many countries are still eagerly seeking to administer the AstraZeneca jab.
“There are people who have concerns,” Thai Prime Minister Prayuth Chan-ocha said Tuesday after he received the first dose of the AstraZeneca vaccine. “But we must believe doctors, believe in our medical professionals.”
