Per Ardua ad AstraZeneca

The extent to which AstraZeneca’s dishonesty concerning its purchasing agreement with the EU is becoming clearer, and the company is increasingly engulfed by a PR disaster resulting from this and misleading claims about the efficacy of its Covid-19 vaccine (see here, here, here, etc). Perhaps they will now get their finger out and actually honour their contract?

Here in Ireland there is expected to be a delivery of “large volume” of doses of the Astra Zeneca vaccine next week, though I doubt it will be as large as their contractual obligations specify. We’ll see what actually happens. There isn’t much confidence in AstraZeneca around these parts I can tell you.

This morning the Covid-19 tracker app for Ireland was updated with the latest vaccination figures for Ireland (25th March) which are as follows:

  • First doses: 548,945
  • Second doses: 211,223
  • Total: 760,168

That is definitely speeding up, which is welcome. Not as fast as the UK, of course, who have been the beneficiaries of 21 million doses exported by the EU. That’s about 2/3 of the total shots administered there. The number exported from the UK to the EU is zero. Nada. Zilch. The same is true of the USA. There’s no doubt in my mind who the bad guys are.

Anyway, not to dwell on that issue I was wondering when I might get around to having a jab myself. I am not particularly high in the pecking order, but from April onwards Ireland is supposed to receive about a million doses per month. Assuming that this actually happens, and AstraZeneca doesn’t crap out yet again, I estimate they should get to me in May (2021).

Another question that occurred to me, given that under-18s are not given the current vaccines – is how many doses are needed to vaccinate the adult population of Ireland. The total population of Ireland is about 5 million but that includes quite a large number of children. Looking at the 2016 census I see that the number of people living in Ireland who are under the age of 18 is about 1.25 million. That means to fully vaccinate the entire adult population will take about 7.5 million doses. Currently about 14.6% of the adult population have received one dose, and about 5.6% have received two. We probably won’t get to anything like full vaccination of the adult population until the autumn.

Let me just correct yet another misunderstanding often presented in the UK press concerning unused vaccines. The number of doses imported to Ireland currently exceeds the number administered by over 100,000, but that does not mean that these vaccines have been refused or wasted. Because the vaccination programme here follows the manufacturers’ guidelines, and because the supplies have been unreliable (especially from AstraZeneca), there is a buffer to ensure that a second dose will always be available on the necessary timescale for anyone who has been given the first. That means that at any time there will always be some doses in storage. It wouldn’t be necessary to do this if we could trust the delivery schedule, but there you go.

I wouldn’t be too worried about the slowish pace of vaccination were it not for the fact that new Covid-19 cases in the Republic are on the way up again:

The demographic for these new cases is quite young (a median age of 32 yesterday) and the increase almost certainly arises from lax adherence to the restrictions by a subset of the population. The relatively young age distribution and the fact that those at greatest risk of death or serious illness are being vaccinated should mean that the mortality figures remain low even as cases rise. Although the increase in new cases is worrying it is nowhere near as bad in Ireland as on the Continent of Europe and elsewhere around the world (especially Brazil). More worrying still is the likelihood of vaccine-resistant strains arising through mutation. Indeed there is already some evidence that the AstraZeneca vaccine is not as effective against the B.1.351 South African variant, although this has been disputed. Let’s hope that all the AstraZeneca doses administered so far don’t turn out to be useless.

It seems to me that it’s very likely that in order to deal with variants we’ll be having regular (perhaps annual) updated vaccine shots for the foreseeable future, as the only way to stop mutations happening is to immunize a large fraction of the world’s population and that will take a considerable time.

13 Responses to “Per Ardua ad AstraZeneca”

  1. Dave Carter Says:

    Peter, I think your post here is really one-sided and more than a little unfair to the only vaccine manufacturer committed to producing vaccines at cost for the developing world. AstraZeneca have overpromised, that is true but it has been true of BioNTech/Pfizer too. Then AstraZeneca have pretty firmly stated that they are prioritising the UK contract over the EU one, which I don’t think they should have done, even though I have had my first dose now of tho Oxford/Astrazeneca vaccine and any change to this policy would delay my second dose. Some politicians in EU states, particularly Macron, have made some very uninformed statements about the safety and efficacy of the vaccine, even though the EMA, who are really the only people qualified to pronounce on this, say it is safe and efficacious. Along with all other vaccines trialled it seems to be less effective against the South African variant, some tweaking will be required to get over this. It also seems to be the professional consensus that developing such tweaks will take a bit longer for the platform vaccines that it will for the messenger RNA vaccines. But the mRNA vaccines are really, really expensive, especially Moderna.

    And here I think we get to the reason behind the criticism in US circles, including by the otherwise excellent Anthony Fauci. By producing their vaccine at cost, especially for the developing world, they are taking away the ability of some large US corporations, Pfizer and Moderna, and to be fair also a large German corporation in BioNTech, to fleece the developing world.

    Ok, so maybe that is a slightly one sided view as well, I do not agree with all that AstraZeneca have done. Nor do I agree with much of the UK government rhetoric, and nor do I agree with the UK decision to plough ahead with first doses without securing adequate supplies for second doses. Mistakes have been made, and people should be sitting down calmly and working through solutions.

    • telescoper Says:

      My main point about AstraZeneca is that they had a private agreement with the UK before the contract with the EU was signed (which pre-dates their agreement with the UK, incidentally) and which is inconsistent with commitments made in that contract. That seems very strong evidence that they did not negotiate in good faith with the EU,

    • Jonivar Skullerud Says:

      I agree with most of the points made by Dave, and it should be pointed out that most of the AstraZeneca vaccine is produced in India. I take it that supplies to the UK are now under threat because India is imposing restrictions following a surge of cases there.

      The problems with EU supplies are in large part due to problems with growing cell cultures in the plants in the EU, which did not happen in their plants in the UK or India. AstraZeneca appears to have been duplicitous in their negotiations with the EU, but the EU negotiating tactic, focusing on price and (idiotically) on liability over speed and security of supply, was very poor.

      However, there is no hiding that AstraZeneca did a poor job on their trials, and that their vaccine has a problem with the B1351 variant, much more so than other vaccines (we do not know how well Sputnik, Sinopharm and Sinovac do with it though).

      And i think the commentary in the UK about the recent safety issues has been ill-informed and driven by patriotism. There is very credible evidence that the very rare cerebral vein thrombosis events with low platelet count may be caused by the vaccine, with a plausible biological mechanism found within days independently by researchers in Norway and Germany. It could still be a coincidence, but the pause on AstraZeneca in Norway and Denmark, and the restriction of use for women under 55 in other countries, is unlikely to be reversed until and unless it is clear there is no cause and effect.

  2. If I understand, you are unhappy about not receiving a vaccine that you expect won’t work anyway? Would you be happy about Ireland being included in the UK vaccination program, as suggested by Northern Ireland?

    • telescoper Says:

      I dont think you do understand. My complaint is that everyone is getting the blame for the slow rollout in the EU other than the company that deserves it.
      And Northern Ireland has suggested offering surplus* doses to Ireland not including Ireland in the UK programme.
      *”surplus” here means “after the UK programme has finished” .

      • In the Netherlands, they are finding that people are not making appointments for their vaccinations when notified. There are now more vaccines available than people willing to take them. That is what comes from the weeks of negative stories about the vaccine. Please be aware that what you write can have unintended consequences. You are correct that the northern irish proposal was about surplus vaccines which doesn’t sound quite as generous.

      • telescoper Says:

        I think you should take that complaint up with AZ who are squarely to blame for their PR problems.

      • I am not as sure about that as you are. There has been a fair amount of UK-bashing behind the vaccine stories, especially in the French media (and government). It was said to be unsafe for over-60’s. That was wrong. The latest bashing is the threat to block Pfizer vaccines going to the UK, which shows that to some this is not about a company but a country. A lot of the PR is political.

      • telescoper Says:

        As Jonivar pointed out above, there are still questions to be asked about the role of the AZ vaccine in unusual cases of blood clots. Some governments – Canada is the latest to join the list – are treading more carefully than others. The data provided by AZ did not cover the older age groups, which was again a reason to be cautious.

        On the second alleged “bashing”, as I said in the post the EU has exported over 20 million doses of vaccine to the UK and got nothing in return. It seems to me entirely reasonable to withhold further exports until there is some reciprocity.

        You have of course been a beneficiary of the current state of affairs. Others have a different view.

      • Jonivar Skullerud Says:

        I do not think anyone except perhaps Macron said it was unsafe for the over-60s, only that there were not enough data to conclude that it was effective, since they had not included enough older people in their trials. So at the time it was sensible to use vaccines known to be effective in that age group.

        What makes no sense is for countries like Ireland to stick to that policy when we now know the AZ vaccine to be highly effective for older people, while any concerns there may be are with a) women under 55 and b) the immunocompromised (where the 12 week dose interval may increase the risk of a vaccine-resistant strain developing).

        It is indeed highly unfortunate that this has become a political game – including the refusal by many in the west to consider the Sputnik vaccine, which by all accounts is almost as effective as the mRNA vaccines and clearly better than AZ. Johnson&Johnson is essentially a single dose of Sputnik.

      • telescoper Says:

        As I understand it, Sputnik is currently being evaluated by the EU. Hungary is already using it anyway.

        What I don’t understand is why Russia isn’t vaccinating more of its own people with it. Perhaps Putin needs the money?

  3. Christoph Says:

    In a blog run and read by many scientists, I find some of the comments above rather chilling.
    Yes, there is a growing evidence in many EU countries for a rare side effect that is relatively dangerous and has a prevalence of ~1/10000 for young women. That’s a large number, not so far away from the mortality due to COVID in this group. The evidence is not disputed by EMA. We don’t know (and shouldn’t care about) why they come to a different conclusion than many of the national institutions.

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