KAMPALA, Uganda (AP) – The suspension of the AstraZeneca vaccine in several European countries over the past week could spark skepticism about the shot far beyond their shores, potentially threatening the introduction of an essential vaccine for the global strategy to counter the coronavirus pandemic, especially in developing countries.
As things stand now, it may be AstraZeneca or nothing to some poorer countries. The Anglo-Swedish drug manufacturer’s vaccine is cheaper and easier to store than many others. It will include nearly all doses sent in the first half of the year by COVAX, a consortium intended to ensure low- and middle-income countries receive vaccines.
With little choice, most developing countries that had the AstraZeneca on hand continued to use it, even as major countries in Europe stopped using it in the past week following reports that unusual blood clots were found in some recipients of the injection – despite urging from international health authorities that there was no evidence that the vaccine was responsible.
But while governments in Africa and elsewhere have expressed their determination to continue using the shot, not everyone is convinced.
“Why should I allow it to be used on me? Aren’t we people like those in Europe? Peter Odongo, a resident of a town in northern Uganda, told the Daily Monitor newspaper this week.
The East African country has so far received 864,000 AstraZeneca doses via COVAX, but had less than 3,000 administered on Tuesday. Authorities blamed the logistical challenges of transporting the vaccines deep into the country, but newspaper reports cite resistance to the vaccine.
Even before the latest debate on AstraZeneca, vaccine skepticism was a concern around the world as many people are hesitant about injections being developed in record time. African countries have faced particular hurdles on a continent wary of being a testing ground for the West. Some leaders have pulled back against the skepticism, while others, like those in Burundi and Tanzania, have fueled it by denying the seriousness of COVID-19.
“Unfortunate events” in Europe will “clearly not be helpful to our public confidence, especially in building public confidence in the use of that particular vaccine and other vaccines,” John Nkengasong, director of the Africa Centers for Disease Control and Prevention, told reporters Thursday, as he encouraged African countries to continue their vaccinations.
That came hours before the European Union drug regulator gave the same message to its 27 members. The European Medicines Agency said its experts concluded the vaccine has not been linked to an overall increase in the risk of blood clots, although it could not definitively rule out an association with rare types of blood clots and the vaccine. In response, countries such as Italy, France and Germany announced that they would resume the shot.
Even before those reversals, several developing countries had said they would stick to the shot.
“We will continue with the vaccinations,” said Lia Tadesse, Ethiopia’s health minister, who received 2.2 million doses of the AstraZeneca vaccine last week.
Authorities in India – home to the vaccine manufacturer that is likely to make a large portion of the doses destined for developing countries – said on Wednesday that they would continue the AstraZeneca vaccinations with “full force” as the infections take place in various parts of the country. reared its head. After initially saying it would delay the use of the vaccine, Thailand said on Tuesday it would go ahead with AstraZeneca, and the prime minister even got his chance in public.
Brazil’s Fiocruz Institute delivered the first AstraZeneca shots bottled in Brazil on Wednesday, while the Health Ministry sought to allay concerns about the blood clot reports and push for calm.
Few developing countries broke the trend. Congo, for example, has discontinued the use of AstraZeneca and stopped the vaccination campaign before it even started, as it has no doses of anything else. Indonesia initially also paused the shot, but then said on Friday it would resume it.
European and other wealthy countries have several vaccines to choose from, but AstraZeneca is currently pivotal in the strategy to vaccinate the rest of the world. Some developing countries have received doses of Chinese or Russian-made vaccines – often as donations – but, at least in Africa, this allocation has usually been relatively small. The Chinese and Russian vaccines have not yet been approved by the WHO and therefore cannot be distributed by COVAX.
Africa, with a population of 1.3 billion, hopes to vaccinate 60% of its population by the end of 2022. That goal will almost certainly not be achieved without widespread use of AstraZeneca. And experts have warned that as long as vaccination coverage around the world isn’t high, the virus will remain a threat everywhere.
The eroding confidence in the AstraZeneca vaccine only exacerbates the difficulties Africa will face in rolling out their vaccination campaigns. The continent is home to some of the world’s weakest health systems. Nations there have struggled to test enough people for the coronavirus, and the true toll is unknown due to challenges in tracking cases and deaths. According to the Africa CDC, more than 4 million cases of coronavirus have been confirmed across the continent, including more than 108,000 deaths.
In an analysis released Thursday, the World Bank found that 85% of low- and middle-income countries had plans to vaccinate, but less than a third had public engagement strategies to combat vaccine hesitation and misinformation.
That means that such confusion caused by the AstraZeneca hiatus across Europe is difficult to resolve.
“It complicates the situation,” said Dr. Misaki Wayengera, head of a technical task force advising the response to a pandemic in Uganda, citing the suspension. “It’s the best shot we have here and we should be able to make it.”
The blow to public confidence was felt in countries like Somalia, which started vaccinations on Tuesday, but some said were reluctant to get the AstraZeneca shot, while many in Europe weren’t using it.
“This immunization makes no sense if the countries of the EU have stopped using it,” said Abdulkadir Osman. “We can’t just trust it.”
In Rwanda, which received 240,000 doses of AstraZeneca and just over 102,000 of the Pfizer vaccine, Justin Gatsinzi said he was initially reluctant to receive the injection but admitted fearing he would be denied some public services if he refused .
“It’s actually very tricky,” says Gatsinzi, a teacher, adding that he was not told what vaccine he received.
Associated Press journalists David Biller in Rio de Janeiro, Ignatius Ssuuna in Kigali, Rwanda, Ashok Sharma in New Delhi, Mohamed Sheikh Nor in Mogadishu, Somalia, Lori Hinnant in Paris and Maria Cheng in London contributed to this report.