The continent’s suspensions are eroding vaccine confidence just when the world needs it the most.
Sweden became the latest European nation to suspend use of the AstraZeneca Covid-19 vaccine on Tuesday, following in the footsteps of a dozen other countries who have stopped using the vaccine in the past week citing concerns over potentially fatal blood clotting. Experts say these decisions are eroding confidence in vaccines just as the world is racing to keep up with a mutating virus which has already killed more than 2.6 million people globally.
Denmark was the first country to announce a suspension of the AstraZeneca vaccine last week in order to investigate reports of blood clots, followed by Ireland, Germany, France, Italy, and Spain, among others. AstraZeneca said a review of the safety data of the more than 17 million people in the E.U. and U.K. who have received the vaccine, showed “no evidence of an increased risk” of blood clots.
“The stakes with AstraZeneca are particularly high, because this was anticipated to be a vaccine that much of the world will ultimately come to depend on for their vaccination efforts,” says Jennifer Nuzzo, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health. The suspensions, which are at odds with guidance from the European Medicines Agency and the World Health Organization, seem to be motivated more by politics than science. Both agencies announced on Tuesday that they are conducting additional reviews of the vaccine, just days after they both declared the shot safe. The U.S. has not yet approved the AstraZeneca vaccine, but is expected to in the coming months.
The consequences of slowing down or undermining ongoing vaccination programs have global implications, experts say. People will continue to get sick and die: global herd immunity is only as strong as the country with the weakest vaccination uptake. And certain countries, like Italy, are already heading back into lockdown over new coronavirus variants.
"Even if the vaccine ends up being safe and this is a problem that's solved. You have to rebuild public trust, which can be extremely challenging,” says Isaac Bogoch, an infectious disease specialist and associate professor of medicine at the University of Toronto. Vaccine hesitancy is particularly worrisome right now, as more contagious and deadly viruses circle the European continent. The B.1.1.7 variant of Covid-19, which was first identified in the U.K., quickly became the dominant strain in that country and has now been detected in more than 30 other countries.
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European Union countries are lagging behind the U.S. and U.K.
“Public health actors in Europe face a very delicate balancing act because trust in vaccines is so fragile,” Jonathan Kennedy, an associate professor in global public health at Queen Mary University of London, wrote in an email. Europeans had concerns about vaccines even before Covid. In a 2019 Eurobarometer poll, nearly half of Europeans indicated that they believe (incorrectly) that vaccines cause serious side effects. The decision to suspend AstraZeneca he says, will “undoubtedly reduce confidence in vaccines in general.”
It will also have a global ripple effect. “This news will be exploited to spread vaccine misinformation across the world via social media,” Kennedy adds. Public health officials are already fighting an uphill battle when it comes to stemming the flow of viral vaccine misinformation, and these suspensions are only adding fuel to the fire. Largely due to an inadequate supply of doses, exacerbated by the decision to suspend the AstraZeneca shot, the European Union has lagged behind other countries in terms of the vaccine rollout, with fewer than 11.4 vaccinations for every 100 people as of March. By comparison, the U.S. has vaccinated 32.6 of every hundred people, and the U.K. leads the pack with 38.4 per hundred.
“It may be some time before we are in a position to know what the impact is on vaccine confidence, and it will be difficult to disentangle these decisions from everything else that is going on,” Martin McKee, a professor of European public health at the London School of Hygiene and Tropical Medicine, wrote in an email. “There are already many challenges to reaching the probable herd immunity threshold in most European countries, and this certainly does not help.”
“What seems to be happening is that individual [countries] are making a decision on the basis of what they think will be best to maintain confidence in the system,” says McKee. “In some cases, this will be to take an ultra-cautious line. In others, it will be to express confidence in the vaccine.”
But this approach could also backfire by propagating the idea that there is a vaccine hierarchy, with some vaccines being “better” than others. “Vaccines are the only path that we have out of the death and devastation of the last year,” says Kennedy. “Any vaccine is better than no vaccine.”
With additional reporting by Alex Knapp and Aayushi Pratap.
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