The AstraZeneca COVID-19 vaccine, once expected to be a mainstay of protection for much of the world, remains shrouded in controversy as more nations limit its use, even as scientists warn of the need for governments to tread carefully.
The Netherlands has joined a growing list of about a dozen territories, including northern Italy and Ireland, moving to suspend the shot over concerns about possible side effects from two batches.
While regulators from Europe to Asia said that there was no indication of any direct link with the vaccine, reports of serious blood clotting after inoculation triggered a spate of suspensions stretching as far as Thailand.
The safety scare emerged against a backdrop of supply woes, and continue a drumbeat of bad news that started with questions about its initial trials and now extends to its potential faltering efficacy against a variant.
Even as some nations suspend its use, others such as the US are moving to protect their own stockpiles, blocking efforts to redistribute the shot’s supply to places with urgent need.
AstraZeneca has defended the vaccine, saying on Sunday in a statement that more than 17 million doses have been administered in Europe and the UK, with no evidence that the shot increased the risk of blood clots.
As of Monday last week, there had been 15 reports of clots in the legs, or deep vein thrombosis, and 22 cases where they reached the lungs, known as pulmonary embolism.
Politicians are acting with an abundance of caution, but run the risk of hurting global efforts to vaccinate, said Helen Petousis-Harris, a vaccine safety expert at the University of Auckland in New Zealand and a former WHO adviser on vaccine safety.
“You have to be very careful because it’s also sending a message that there could be something very wrong with the vaccine, when in fact, it’s very unlikely that there is,” Petousis-Harris said. “We’re doing massive mass vaccination campaigns and people get sick all the time. We can’t panic every time it happens, but we also need to take all precaution[s], and it’s a hard balance.”
The number of events are lower than what would be expected to occur naturally in a general population of that size, AstraZeneca chief medical officer Ann Taylor said.
In studies, participants getting the vaccine had fewer clots than those given a placebo.
Thailand yesterday said that it would resume its planned rollout of the shot this week, four days after suspending it, as a medical panel had decided that the vaccine did not lead to blood clots.
Thai Prime Minister Prayuth Chan-ocha and some of his Cabinet members are scheduled to receive it today.
The drama keeps AstraZeneca at the center of a political storm in Europe, weeks after manufacturing issues first put the two sides into conflict. Meanwhile, the EU is falling further behind the UK and the US in vaccinations, creating a political crisis for its leaders.
In addition to low yields producing less vaccine than planned, one plant in the Netherlands is still awaiting regulatory approval to deploy doses. The site, owned by manufacturer Halix, is making the vaccine drug substance for AstraZeneca, and forms part of both the EU and UK supply chains.
Halix did not respond to a request for comment outside of normal business hours.
The various issues mean AstraZeneca would only be able to deliver about 100 million doses to the EU in the first half of this year, it said on Friday last week, about one-third of the number originally planned.
Thirty million doses are due to be delivered by the end of this quarter, with the rest coming in the next three months.
Even as some governments suspend dosing, they are moving to protect their supply.
Italy made use of a new EU measure to stop AstraZeneca from shipping some doses to Australia on March 4 and Italian Prime Minister Mario Draghi on Friday last week indicated that he would do that again if he has to.
“The European Union has taken clear commitments with pharmaceutical companies and we expect they will be respected,” Draghi said. “We have taken some strong decisions against companies which have delayed the deliveries and we will continue to do so.”
The latest developments will do little to encourage take up of the AstraZeneca vaccine in the EU.
In a March 7 YouGov survey, perceptions in EU nations of the safety of the shot from AstraZeneca and the University of Oxford were lower compared with vaccines from Pfizer and BioNTech, and Moderna. By contrast, Britons viewed AstraZeneca’s vaccine as the safest of the three.
The UK has administered more than 25 million vaccine doses — many of those the AstraZeneca shot — without raising any alarms over clotting.
The AstraZeneca vaccine has become an emblem for growing pandemic nationalism as nations race to inoculate populations as quickly as possible. The US has already ordered nearly enough vaccines from the three manufacturers with authorization from the Food and Drug Administration to immunize its adult population twice over.
“We’re going to start off making sure Americans are taken care of, first, but we’re then going to try to help the rest of the world,” US President Joe Biden said on Wednesday last week.
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