A Red Cross volunteer is preparing the AstraZeneca Covid-19 vaccine at a vaccination center in Saint-Jean-de-Luz, southwestern France.
Photo:
Bob Edme / Associated Press
It is difficult to think of a recent fiasco to coincide with the launch of the Covid vaccine in the European Union. Protectionism, mercantilism, bureaucratic ineptitude, lack of political responsibility, crippling security ism – everything is here. Keystone Kops in Brussels and European capitals would be funny if the consequences were not so serious.
But hospitalizations and deaths are rising again in Italy, Germany and France, while successful vaccinations are suppressing disease and death in the United States, the United Kingdom and Israel. To date, the United States has administered 34 doses per 100 inhabitants, the United Kingdom has struck 40, and Israel has 111. Most vaccines require two doses. Compare this with about 12 in France, Germany and Italy.
As the pandemic enters a reopening phase, Europe’s mistakes will cost the rest of the world economically as the continent struggles to break free.
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Take the last fumble first. Various European regulators and politicians have spent this week complaining about the Oxford / AstraZeneca vaccine – the only one currently widely available in the EU – could be uncertain, just to rethink and now beg people to start accepting it.
This time the concern was that the jab caused blood clotting or problems with blood platelets in some patients. Some people who received the vaccine developed blood clots, but the European Medicines Agency (EMA) found that the vaccine was not associated with an increase in the overall risk.
Of the approximately 11 million vaccinated in the UK, severe clots were less common than would have been expected in the general population. People can develop clots for several reasons, including other health conditions and medications. Covid-19 can also cause clots, so any risk-benefit calculation favors vaccination.
This is a piece with a distinct European certainty, which led the vaccination program from the beginning. The introduction of the AstraZeneca jab has been suspended even after the EMA approved it, as German bureaucrats have argued that there is no evidence that it works in patients over the age of 65.
Fewer elderly patients were included in the sample during the vaccine trial phase, but that is ultimately the truth of this statement. It was quickly rejected – real-world evidence available even then in the UK showed high effectiveness in the older cohort – but not before French President Emmanuel Macron addressed the issue.
Such a careless discussion discouraged vulnerable elderly Europeans from accepting the vaccine last month. It also distorted priority lists. Younger teachers and university professors in Italy received blows in front of the sick and the elderly as part of a plan developed when officials argued that the shooting would not work for the elderly.
One problem is that no one seems to be fully responsible for monitoring safety and effectiveness. In nominal terms, this is the task of the EMA, and the agency has managed it with typical Eurocratic aplomb. The EMA approval process is more bureaucratic, requiring input from all EU Member States. Imagine if the FDA would consult all 50 states.
But national governments are also allowed to make their own safety decisions on an “emergency” basis. The UK used this option to quickly approve the Pfizer and AstraZeneca photos, despite still being a member of the EU late last year.
Other governments have used this discretion to slow down vaccines. EU capitals refused to follow the UK in granting the emergency use permit, apparently for fear of affecting European solidarity. But some governments have been happy to impose unilateral blockades on the vaccine, as in the case of AstraZeneca. European regulators live by the maxim “better safe than bad”, but in this case they receive harm without added security.
At least now, millions of doses are available for Europeans who really want to. This was not always the case, after a bungalow of purchases delayed deliveries and almost triggered several trade wars. Officials in Brussels took the opportunity last year to push for joint purchases of vaccines to strengthen the EU’s credibility with European voters. The purchase on behalf of 500 million Europeans should also have given the bloc extra leverage with pharmaceutical companies.
It was chaos. The EU bureaucracy has little experience in procurement at this scale and has also endeavored to conclude block-level agreements for fans and protective equipment. Brussels officials signed vaccine contracts a few months after the US and Britain did so last year – and only after some European governments threatened to organize their own procurement.
Washington and London have realized that it is essential for mass procurement to throw large sums of money into research and development to many companies, in the hope that some will work. Brussels has focused on reducing the cost per dose. Europeans pay a few dollars less per dose, but they ended up at the back of the shipping line.
The EU’s response – a combination of threatened export borders, noisy trade disputes with pharmaceutical companies and sour grapes discussing imaginary effectiveness issues – has mainly undermined Europe’s credibility in trade matters. It also risks fueling vaccine nationalism and trade restrictions elsewhere.
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Could things have been different? The Trump administration’s Warp Speed operation has shown how a large government can use its fiscal resources to fund research and development in a crisis. The United Kingdom and Israel have shown that small countries can benefit from regulatory agility to move forward. But, in a way, the European Union – a political bloc across the continent of smaller nation-states – has managed to get the worst of both worlds. It suffers from the stifling bureaucracy of a large government and the quarrelsome inefficiency of a small government.
Europeans can debate in their spare time who to come for and how to prevent this from happening again. The rest of the world can only hope that they will get their vaccination certificate soon.
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It appeared in the printed edition of March 20, 2021.