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Few people have taken their flu shot or vaccinated their childhood against a range of deadly illnesses. Covid changed that, turning vaccine makers into household names and calling for choices.
Doses remain scarce for now, amid a global one to rinse together inflamed by a dispute between the European Union and the British drug manufacturer AstraZeneca Plc. Most of the more than 90 million people who have been given a chance consider themselves lucky for some protection from the pandemic. But vaccines are spreading, with positive research data from Johnson & Johnson and Novavax Inc. then puts their candidates in line for approval.
Health officials will have to figure out how to allocate all of these different vaccines. The European Medicines Agency approved the AstraZeneca vaccine Friday for all adults, but limited research data on its effectiveness in the elderly has led some countries to impose restrictions. Germany said it should only be used for people under 65, while Italy warned against giving it to people over 55.
Many people who have bloated efficacy, dosage schedules, or side effects want to decide for themselves. If the options are a shot from a Western drug manufacturer vetted by an independent regulator or one from a Russian or Chinese lab with less transparency, that desire is even greater.
“We demand that the government give people freedom of choice,” said Gergely Arato, a member of the opposition Democratic Coalition party in Hungary.
Sputnik V Covid-19 Vaccines.
Photographer: Andrey Rudakov / Bloomberg
Hungary broke with other EU members to approve Russian Sputnik V and a vaccine from China Sinopharm Group Ltd. in addition to the three shots approved by the European drug regulator – van Pfizer Inc., Moderna Inc. and AstraZeneca. While Prime Minister Viktor Orban is technically offering choice, his promotion of the Chinese and Russian shots jeopardizes people’s “willingness to get vaccinated,” Arato said at a news conference this month.
In the US, where the only two so far authorized shots – from Pfizer and Moderna – use similar technology and showed nearly identical test results, the choice may not matter for now. Elsewhere, however, some health authorities have begun to address people’s concerns about vaccine differences.
Dubai, Hong Kong
In Dubai, residents over the age of 60 or with pre-existing conditions can access the shot that Pfizer was developed with BioNTech SE, or that of Sinopharm.
In Hong Kong, officials ordered adequate doses of vaccines from Pfizer-BioNTech, Sinovac Biotech Ltd. and AstraZeneca – along with plans to acquire a fourth option – to cover its 7.5 million residents.
The Pfizer injection will be available at local vaccination centers, with the Sinovac and Astra options offered in private hospitals and clinics, and people will be given the choice they want to receive. That’s important in Hong Kong, where some people are reluctant to take a vaccine made in China.
“If residents don’t want to take a particular vaccine, they can choose to get the injections at a different time and location,” Chief Executive Carrie Lam said in December.
Stocks are so tight in most of the world that choice is impossible. Those who receive an injection often have no idea which one they will receive until they walk through the door of a vaccination center or doctor’s office. But that could change if vaccines from the likes of J&J, Novavax and CureVac NV will come into operation in the coming weeks, and as pharmaceutical giants want Sanofi and Novartis AG lend their weight to the production effort.
EU approval
Even if they don’t offer a choice, health officials must decide who gets what. At the Cleveland Clinic, Cassandra Calabrese, has told patients to take any vaccine they get, although some have asked her which vaccine she would recommend. “Things could be different if more are approved,” she said in an email.
Vials containing the Pfizer-BioNTech Covid-19 vaccine.
Photographer: Oliver Bunic / Bloomberg
The European Union, criticized for slow rollout of the Pfizer-BioNTech and Moderna vaccines, expanded its offerings Friday by approving AstraZeneca’s shot. As a sign of the growing stream of people wanting to choose, the approval came after days of discussion about the effectiveness of the shot, with the German Immunization Commission recommending its use in seniors.
In the UK, where infections and fatalities are much higher than in Hong Kong, health authorities are prioritizing the rapid vaccination of as many people as possible. The second dose of dual vaccines is being delayed in an effort to get the first injections into as many arms as possible. Other countries are considering similar steps.
Distribution is based on “delivery and logistics, such as availability of very cold freezers,” a UK Department of Health spokesperson said by email. The Pfizer-BioNTech and Moderna shots must be stored frozen for long-term storage, while refrigeration is sufficient for the AstraZeneca vaccine.
Efficacy rates
While the UK has established a priority list for vaccine recipients – starting with the oldest, most vulnerable people – the different shots are not assigned based on a person’s profile, the agency added. So an 80-year-old patient can get the AstraZeneca shot, while someone else with the same age and the same health problems can get the Pfizer shot.
Some Britons express a preference based on patriotism rather than what they’ve read about different efficacy rates or side effects. It does not matter that the American company’s vaccine was 95% effective in large studies, compared to an average of 70% for the AstraZeneca injection.
“They say they want to wait for the British,” said Jimmy Whitworth, professor of public health at the London School of Hygiene and Tropical Medicine, in a telephone interview. “I think it’s a purely nationalist position.”
– With the help of Veronika Gulyas, Jinshan Hong and Adveith Nair
(Updates with German, Italian guidelines in third paragraph)