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OPINION: European governments were cautious on AstraZeneca vaccines but they were neither stupid nor 'political'

John Lichfield
John Lichfield - [email protected]
OPINION: European governments were cautious on AstraZeneca vaccines but they were neither stupid nor 'political'
Vials with the AstraZeneca COVID-19 vaccine against the novel coronavirus are pictured at the vaccination center in Nuremberg, southern Germany, on March 18, 2021. - Germany on March 15 halted the use of AstraZeneca's coronavirus vaccine after reported blood clotting incidents in Europe, saying that a closer look was necessary. (Photo by Christof STACHE / AFP) / “The erroneous mention[s] appearing in the metadata of this photo by Christof STACHE has been modified in AFP systems in the following manner: [AstraZeneca] instead of [AstraZenaca]. Please immediately remove the erroneous mention[s] from all your online services and delete it (them) from your servers. If you have been authorized by AFP to distribute it (them) to third parties, please ensure that the same actions are carried out by them. Failure to promptly comply with these instructions will entail liability on your part for any continued or post notification usage. Therefore we thank you very much for all your attention and prompt action. We are sorry for the inconvenience this notification may cause and remain at your disposal for any further information you may require.”

It is the best of decisions and the worst of decisions. Everyone can claim to be right. Everyone is partly wrong, writes John Lichfield on the pausing of the AstraZeneca vaccination campaign across Europe.

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The European Medicines Agency handed down its judgement on Thursday. The AstraZeneca vaccine is effective and safe to use. Most European countries which had suspended AZ vaccinations are expected to resume today or in the next couple of days.

But – despite what is being reported by some – the EMA did not dismiss out of hand concerns that AZ shots can lead to blood clotting disorders in perfectly healthy young people.

The agency said that there was indeed evidence of “a small number of cases of rare and unusual but very serious” clotting problems associated with AZ.  Nonetheless, on balance, the EMA said, it had come to a “clear scientific conclusion” that AZ shots were safe to use. The huge benefits far outweighed the tiny risks.

Fair enough. Balance and clarity have been in short supply in this sorry saga until now.

Unfortunately, there is no sign that will change soon.

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Were European governments wrong to suspend their AZ roll-out at the start of the week? The pause will undoubtedly have dangerous side-effects on vaccine resistance, and specifically AZ resistance, in European countries.

On the other hand, ploughing ahead regardless of the evidence of rare clotting disorders emerging in several places - in Norway, in Germany, in Austria and in Italy -  might have had an even more calamitous effect on public opinion.

Let us, for once, be fair to governments. They were placed in a very difficult situation. France, for instance, where there were very few AZ side-effects, did not want to suspend an AstraZeneca programme which had just started to take wing.

President Emmanuel Macron was bounced into his decision by a domino-tumble of suspensions imposed by Germany, the Netherlands, Italy and others.

France is the most vaccine-sceptic country in the world. How could Macron say that there was no reason to stop briefly to think when all his neighbours were stopping briefly to think?

READ ALSO How worried should France be about its vaccine-sceptics?

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Little of this was reflected in the coverage in the British media. With some honourable exceptions, the consensus view in the UK was that the EU was being “stupid” or seizing on flimsy reasons to attack the AstraZeneca vaccines because a) AZ was British or b) AZ had failed to supply the EU with all its promised doses.

In other words, it was all “political”. In truth, it was the opposite. Politicians in a score of European governments decided, rightly or wrongly, that their political interest – the belatedly accelerating vaccine programme – must briefly give way to medical and legal considerations.

Only Belgium stood up to this trend. The Belgian government said that it would be “irresponsible” to interrupt an AZ vax roll-out which WOULD save thousands of lives because very rare side-effects  MIGHT take a handful of young, healthy lives.

That was a courageous decision by Belgium but I don’t think that it makes the decision taken by the others irresponsible. We live in a time of instant experts and easy answers but sometimes there are no easy answers.

It has been widely asserted in the UK media, and by the UK government, that there is no obvious connection between the AZ vaccine and clotting disorders. It is also asserted that such “thromboses” have actually been less common among the AZ-vaccinated than in the population as a whole.

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Neither of these things, it now turns out, are true.

A Norwegian study found on Thursday that there was a clear link between AZ vaccinations and three youngish Norwegians who suffered rare brain thromboses or strokes, one of whom died. On Tuesday, Germany’s health ministry of health said that there had been seven cases of “cerebral venous sinus thrombosis (CVST), including three deaths, among the 1.6m million Germans people who had received an AZ shot. That was three or four times higher than the normal rate.

Science magazine reported that in five countries 13 people aged 20 to 50 had suffered from widespread blood clots, low platelet counts, and internal bleeding. Seven had died. This was “more frequent than would be expected by chance”.

“It’s a very special picture” of symptoms, said Steinar Madsen, medical director of the Norwegian Medicines Agency. “Our leading haematologist said he had never seen anything quite like it.”

I am not trying to start – or re-start – a scare story.

I think vaccination is great. I think the AZ vaccine is wonderful. One week ago I had my first shot in a French doctor’s surgery. It was AstraZeneca. I have a history of blood clotting problems. I have no regrets that I took the shot. I’m looking forward to my second in June.

The EMA and Belgium are right. The need to vaccinate rapidly against Covid is so urgent that, on balance, a small risk of clotting problems is a risk worth taking.

But that’s not so simple a choice as much of the British media – BBC included - would have us believe. Life-death accountancy is not straightforward.

Is it worth risking the lives of few young people who are broadly unthreatened by Covid to protect the lives of tens of thousands of vulnerable older people?

European governments had little choice but to stop to review the evidence. The easiest way to fuel anti-vaccine feeling in France - and probably other EU countries -  is to create the impression that vaccination is a politico-industrial juggernaut which cares nothing  for potential or actual side-effects.

Yes, EU countries are sometimes more risk-averse than Britain.

Yes, the UK has, so far, got away with, even hugely benefitted, from a series of risky short-cuts on vaccines.

Yes, the EU should find a way to make these common health decisions in advance, not after the damage is done.

Yes, President Macron and others were wrong to make baseless accusation against the AZ vaccine in the past.

Yes, the blood-clot scare will cause greater AZ-scepticism in the EU for a while (and then the effect will, hopefully, fade).

But for Britain to shout down understandable caution as “stupid” or “political” or “an EU attack on our vaccine” is foolish and hazardous. 

John Lichfield is the former foreign editor of the UK's Independent newspaper. He also worked in Brussels covering the EU and spent 20 years as the France correspondent for the newspaper. He now writes opinion & analysis articles for a number of publications including The Local.

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Anonymous 2021/03/24 08:38
I read a very long and detailed analysis of the issue with vaccine production and supply, especially as it relates to the AstraZeneca vaccine and the exclusivity clause that the British government inserted into their contract for supply (which is behind a large part of the supply issues into Europe). One comment that was made in that very long chain of discussion that is relevant here is this: Most EU countries take responsibility for the welfare of their citizens, and that demands caution when side effects were reported from this vaccine (as the side effects were statistically higher than expected). The UK government appears to have thrown caution to the wind and is willing to take risks with its population in its drive to get everyone vaccinated. You can decide for yourself which approach you prefer...If you think the risk is acceptable...I suspect if you think it is, it will remain acceptable only so long as it is not you or your loved ones that fall victim to that risk...
  • Anonymous 2021/04/01 19:00
    Hi Rob. I think in reply I would say the view that the UK government has thrown caution to the wind and doesn't take care of its citizens welfare is inaccurate, indeed very harsh. It was the UK government that financed the development of this vaccine which holds huge distribution advantages over many of the others when it comes to a global vaccination program. Equally, they have pursued strong lock-down measures, even if a week late in the first wave. Surely their strong pro-active vaccination approach including the 12 week vaccination gap (so that more people get protection) fully supports just how much they are caring for public health. The debate about this vaccines safety may continue for some time. Of course I understand that potential side-effects should not be ignored - that would be insane. But as at this time there is no proven link with the vaccine; indeed I have read (but not fact-checked) that the risk of clots is lower than that from taking the contraceptive pill. However what is for sure is the risk of hospitalization and death, even amongst the 18-49 year age group, from Covid, is significantly higher without being vaccinated. Meanwhile the virus is again out of control leading to further EU lockdowns and further economic hardship which will bring its own repercussions. I noticed Merkel said "everything is based on one principal and that is trust". I wonder how many trust Sputnik V, a still unauthorised, adenoviral vaccine that may now be sourced from our beloved, trusted Russian friends. Terrible times. I hope everyone can receive their jab asap, whichever one is offered.
Anonymous 2021/03/22 22:58
This vaccine has undergone rigorous trials in the face of a pandemic. It has been authorised by the WHO, the EMA and MHRA and after today’s latest trials, shortly by the FDA. Macro et al should hang their heads in shame.
Anonymous 2021/03/22 22:44
The EU “governments” have been both “stupid” and “political” sir, and many Europeans will now pay for it with their lives. The worst article I have read during this whole pandemic.
Anonymous 2021/03/22 13:03
Why don't the authorities just get on with vaccinating the 'forgotten' tranche, and stop this pointless arguing about who's vaccine it is. All the while its not in somebodies arm its useless.
Anonymous 2021/03/20 13:21
France waited on the EMA authorisations before starting their vaccination programme so why didn't they follow their advice before stopping it ?
steve_60375a917082d 2021/03/19 18:16
It would help if a greater number of available vaccines had been administered instead of being left in the fridge or freezer! The EU is woefully slow in organising an effective vaccination programme, the result of which, the alarming resurgence of incidence and death rates, euro-wide.
Anonymous 2021/03/19 18:06
Mr. Lichfield, how many people do you estimate will become seriously ill or die as a result of the suspension? I'II be surprised if that figure is lower than the estimated 40 (forty) in 17 million that caused the now discredited link between the vaccine and blood clotting; because there is no proven causal link. More damaging, is the further undermining of confidence to now take up the vaccine (look at earlier post as it's now typical). You say you're not trying to restart a scare story, then suggest that the UK has "so far, got away with, even hugely benefitted, from a series of risky short-cuts on vaccines." A company wouldn’t usually consider mass producing a new vaccine until they were sure that it worked, that's obvious. However, the UK initiative took the financial risk to mass-produce the AZ vaccine in advance of study results, just in case they were successful, which they were. The 'risk' was to the UK government. If this is what you meant, you should make it clear rather than leave it open to misinterpretation that the risk is applied to the vaccine itself. However, I'm pleased that you have received the AZ vaccine yourself. For clarity, to all readers, my understanding is that the WHO, the EU drug regulator, and the Medicines and Healthcare products Regulatory Agency (MHRA) approved the vaccine as safe to use for all adults.
Anonymous 2021/03/19 13:48
Just refuse AZ, than the goverment will soon give a choice of vaccins! They want everyone vaccinated, I do not think many younger healthy people who will not die from covid like this risk! Why would you want to take it? Pain in the arm, feeling a bit tired, yes no problem to help others. Risking a brain bleed or death? not really. And even without the blood problems, nobody knows long term side effects yet, so how much risk is acceptable for the healthy younger population. Pain in arm plus tiredness plus some vague other side effects plus 0% guarantee this is safe long term, is enough risk in itself. So who refuses AZ is not a granny killer or selfish in my books! Am I going to take it when it is my turn in May or so? To be honest I feel very reluctant right now! Today they say A, tomorrow B. I think J&J is a better option, but who knows?
  • Anonymous 2021/03/20 13:01
    Refusing the vaccine without a good medical reason to do so should absolutely not result in you getting a choice of other vaccines - it should put you to the bottom of the queue after absolutely everyone else. The only people who should have a "choice" in which vaccines in this circumstance are those who are medically at risk from a certain type due to allergy or preexisitng medical condition which makes a certain type of vaccine an issue for them. There are too many people waiting for vaccines for fussy people to be catered for. If you dont want the vaccine fair enough but then you shouldn't expect another until after everyone else has had theirs. Just remember EMA, WHO and all of the recognised bodies have repeatedly stated these vaccines are safe (except in very limited circumstances for very specfiic types of people).
  • Anonymous 2021/03/19 15:21
    Yes I'd rather wait for the J & J.
Anonymous 2021/03/19 12:16
You have to make exceptions for the gammons as most only "read" the British guttersnipe press and believe every word that they print. Brexit is a prime example of that.
  • Anonymous 2021/03/20 08:34
    Boggy, glad to see you and Joanne are sticking up for the privileged youth of Europe, lucky to have a choice of vaccines (when the EU eventually gets its act together?) Can I suggest that when you both are offered a vaccine, you decline to have it and request that your dose be donated to an older less privileged person in Africa or some other poor country who have no chance in the for seeable future of getting a life saving drug. You would of course give up any other entitlement to a vaccine, as this would mean stealing another person's. Only fair don't you think. As for me, i'm a gammon, guttersnipe reading older person who will have any vaccine offered and be thank full for it.

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