Slow vaccination rollout puts EU strategy under scrutiny

The EU’s vaccine procurement strategy is under scrutiny after member states struggled to roll out rapid vaccinations in the first weeks of the year, falling behind the UK and the US in the early race to inoculate citizens against Covid-19.

While the UK has administered almost 10 doses per 100 residents and the US has administered just over six per 100, the EU is languishing at under two doses per 100 residents, according to FT data.

The widening gap has sparked growing anxiety in European capitals, especially as already strained supplies of vaccine have suffered further setbacks. In the latest blow to vaccination plans, European officials on Friday said first-quarter deliveries of AstraZeneca’s shot were likely to be cut by more than half because of what the company had warned was reduced capacity in its EU supply chain.

EU officials said that the bloc would hold talks with AstraZeneca on Monday in an effort to speed up production.

The US, UK and EU have all ordered or optioned similar numbers of vaccines on a per capita basis — more than five doses per person. But by accelerating approval processes, betting on some manufacturers and not others, and in the case of the UK and US, investing more in advance to help companies boost development and production capacity, London and Washington have made a faster start than Brussels.

In total, the UK and US have each spent about seven times more upfront, per capita, on vaccine development, procurement and production than the European bloc, according to data gathered by Airfinity, a London-based life sciences analytics company. 

While the figures include different types of funding and might not be exactly comparable, the data suggest EU member states should have used more economic firepower earlier to finance upgrades of factories and vaccine raw materials suppliers, said Rasmus Bech Hansen, Airfinity’s chief executive. 

“It’s tricky but I just think there are special circumstances in a pandemic,” he said. “Everything is a trade-off and timing is just so critical — weeks and months mean a lot.”

The European bloc has also been hampered by slower regulatory approvals. The leading BioNTech/Pfizer vaccine was signed off in the UK on December 2, the US on December 11 and in the EU on December 21. Washington and London shortened the process by giving emergency authorisations, in which the government takes the risk of product liability away from the manufacturer.

The EU was similarly later to embrace the groundbreaking mRNA technology behind the vaccine. The UK and US put in extra orders for the BioNTech/Pfizer jab within weeks of its encouraging early trial results in July. Brussels did not do its deal until November. EU officials say the time lag was due to necessary, rigorous discussions of issues such as liability.

A lack of transparency around the delivery schedules in each bilateral vaccine deal makes it difficult to know exactly how many doses each region has received or when they can expect more.

EU member states reacted with particular alarm this month when Pfizer and BioNTech said they needed to temporarily cut supplies in order to increase production in the future. Pfizer has insisted it will make up for the shortfall and honour the total first-quarter deliveries to which it has committed. Still, the disruption — compounded by the news of delays to AstraZeneca shipments — has fuelled concerns of shortages.

The EU, which has done deals for more than 2bn doses of eight vaccines, has said it expects manufacturers to make a big step up in deliveries to member states only from April. It now has combined orders of 760m doses of the two-shot BioNTech/Pfizer and Moderna vaccines, but just 355m of those are confirmed to be delivered by September. So far the European bloc, which has a population of almost 450m, has received about 3.5m doses of the BioNTech/Pfizer jab a week, according to EU officials.

The US, with a population of more than 330m, has orders for about 1bn doses and options on a further 1.2bn doses. It says it should receive 200m doses from BioNTech/Pfizer and 200m doses from Moderna by July — although 100m of the BioNTech/Pfizer consignment may not arrive until June or July.

In the UK, home to 67m people, the government has been increasing vaccinations using jabs from BioNTech/Pfizer and AstraZeneca. It has also not published details on the timing of future supplies. AstraZeneca is said to be on target to deliver an average of 2m doses per week for the rest of the year, although this is likely to vary week by week, according to people familiar with the matter.

The EU may benefit from a bump in supply later in the year, once Moderna, the US biotech, raises its production. The EU has ordered 160m doses, while the UK has bought only 7m. European officials hope their strategy of buying moderate amounts of a range of vaccines will, over time, pay off as more come on stream.

Lawrence Gostin, a public health law professor at Georgetown University in the US, said the competition between high income countries chasing relatively scarce initial vaccine production had been “unhealthy”, creating inefficiencies and leaving poorer countries behind.

As limits on manufacturing capacity start to further constrain supply, Prof Gostin said timing and geography would be crucial in affecting who gets served first.

“Pharmaceutical companies are rolling vaccines off their manufacturing plants, and they’re likely to give those vaccines, based on two conditions,” he said. “What are the earliest and most binding contracts and . . . the realpolitik: whether you’re situated in a country.”

Additional reporting by Clive Cookson and Anna Gross in London.

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