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A Italian health worker loading a syringe with AstraZeneca vaccine
Andrea Fasani/EPA-EFE

COVID vaccine weekly: as approaches differ across Europe, experts encourage regional action

Following a dispute earlier in the year between AstraZeneca and the EU over vaccine supplies, the bloc introduced regulations to allow member states to stop manufacturers exporting vaccines if they weren’t fulfilling their obligations to the EU. And the Italian government exercised this right for the first time recently, withholding a shipment of AstraZeneca vaccines destined for Australia.

Then, just a few days later, Italy halted a batch of AstraZeneca vaccines from being administered so that it could investigate two deaths among recent recipients. Similar precautionary pauses have also taken place in a number of other European countries.

But the European Medicines Agency (EMA) has said that blood clots don’t seem to be appearing in vaccinated people any more frequently than would be expected across the general population. In the case of Austria – one of the countries to have paused its rollout – the EMA’s preliminary view is that the AstraZeneca vaccine is not linked to blood clots that have been witnessed there, though the agency is continuing to monitor the issue across the continent.

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Regardless of the EMA’s findings, this could prove a setback. Unfounded claims about it being ineffective in older people have already dented confidence and uptake in some European countries, writes Jonathan Kennedy, Senior Lecturer in Global Public Health at Queen Mary University of London. In late February, over three-quarters of AstraZeneca vaccines in France remained unused; in Germany, the figure was two-thirds. Although COVID-19 vaccine confidence has improved in Europe in recent months, it remains fragile.

The UK, though, has not witnessed any of these events, and its vaccine rollout is continuing at pace. Once its initial priority groups have been vaccinated, the government has said that the remainder of the population will be prioritised according to age.

This is unfair, argue Annika Hjelmskog and Caitlin Robinson. Yes, the risk of COVID-19 increases with age, but it arrives earlier for those in poor health, who are often more socially deprived. Less affluent people are also more likely to be exposed to the virus. There’s a strong case therefore for building deprivation into the prioritisation model alongside age.

Three young people in masks
Young people may be called to take a vaccine to avoid it going to waste. Volurol/Shutterstock

And even though the current system is age based, there have been reports of people accessing vaccines early in the UK, ahead of their age group being called up. Is this wrong? For Jonathan Pugh and Dominic Wilkinson at the University of Oxford, it all boils down to one question: whether you’re delaying someone else being protected. If not, getting an early vaccine is arguably fine – even if you travel abroad to receive one privately. This would, though, undermine the sense that “we’re all in this together”, which is perhaps a reason not to.

Our podcast this week marks a year since the World Health Organization (WHO) declared COVID-19 a pandemic, and takes a look at where the organisation goes from here. All three experts interviewed agree that how the WHO responds to future pandemics will be different. But the changes they propose vary: getting regional organisations, such as Asean in south-east Asia or Mercosur in South America, more involved; keeping the WHO independent from countries’ political decisions; or focusing more on diseases spilling over from wild animals.

It looks like pandemic preparedness could be different on the vaccine front too. Cepi, a global partnership to accelerate vaccine development, has called for the creation of a library of prototype vaccines that could quickly be adapted for specific diseases if they arise. It would be a smart move – vaccines for both Ebola and COVID-19 were able to be rapidly created because their early stages of development had already been done. The funding needed, in the grand scheme of the pandemic, is small: US$3.5 billion (£2.5 billion).

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