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Few people care about who made their flu shot or their vaccinations against a variety of deadly diseases. Covid changed that by turning vaccine makers into household names and asked to choose.
Dose remains scarce for now amid global dose skarrel ignited by a dispute between European Union and British drugmaker AstraZeneca Plc. Most of the more than 90 million people who have been given a chance consider themselves lucky for any protection against the pandemic. But vaccines are on the rise, with positive trial data from Johnson & Johnson en Novavax Inc. place their candidates next in line for approval.
Health officials will have to figure out how to administer all of these different vaccines. The European Medicines Agency approved the AstraZeneca vaccine for all adults on Friday, but limited trial data on its efficacy in the elderly led some countries to impose restrictions. Germany said it should only be used for those under 65, while Italy notes that it should not be administered to those over 55.
Many people who increase the effectiveness, dosing schedules or side effects want to decide for themselves. If the options are a survey of a Western drug manufacturer being investigated by an independent regulator or one of a Russian or Chinese laboratory with less transparency, the desire is even greater.
“We demand that the government offer people the 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 ranks with other EU members to approve Russian Sputnik V and a vaccine from China Sinopharm Group Ltd., together with the three shots fired by the European Drug Regulator – from Pfizer Inc., Moderna Inc. and AstraZeneca. While Prime Minister Viktor Orban is technically offering a choice, his promotion of the Chinese and Russian shots jeopardizes people’s willingness to be vaccinated ‘, Arato said at a press conference this month.
In the US, where the only two shots so far authorized – from Pfizer and Moderna – have used similar technology and shown virtually identical test results, the choice may matter less at first. Elsewhere, however, some health authorities have begun to address people’s concerns about vaccine differences.
Dubai, Hong Kong
In Dubai, residents over 60 or with existing conditions can access the survey with which Pfizer was developed BioNTech SE, or the one from Sinopharm.
In Hong Kong, officials ordered enough doses of vaccine from Pfizer-BioNTech, Sinovac Biotech Ltd. and AstraZeneca – along with plans to acquire a fourth option – to cover the 7.5 million inhabitants.
The Pfizer survey will be available at community vaccination centers, with the Sinovac and Astra options offered in private hospitals and clinics, and people will have the choice they want to receive. This is important in Hong Kong, where some people are wary of taking a Chinese vaccine.
“If residents do not want to take a certain vaccine, they can choose to get the shots at a different time and place,” CEO Carrie Lam said in December.
Stocks are so tight in most parts of the world that choice remains impossible. Those who get shots often do not know which one they will receive before walking through the door of a vaccination center or doctor’s office. But it could change if vaccines like J&J, Novavax and CureVac NV is set to launch in the coming weeks, and like pharmaceutical giants like Sanofi en Novartis AG give their contribution to the production effort.
EU approval
Even if they do not have a choice, health officials have to decide who gets what. By the Cleveland Clinic, Cassandra Calabrese asked patients to take the vaccine they were given, although some asked her which one she would recommend. “Things may be different as more are approved,” she said in an email.
Vials with the Pfizer-BioNTech Covid-19 vaccine.
Photographer: Oliver Bunic / Bloomberg
The European Union, which is criticized for the slow deployment of the Pfizer-BioNTech and Modern vaccines, expanded its offer on Friday by approving AstraZeneca’s shot. In a sign of the increasing tide of people wanting to vote, the approval came after days of tense debate over the effectiveness of the shot.
In the UK, where infections and deaths are much higher than in Hong Kong, health authorities prioritize the rapid vaccination of as many people as possible. The second dose of two-graft vaccines is delayed in an effort to get first injections into as many arms as possible. Other countries are considering similar steps.
Distribution is based on ‘supply and logistics, such as the availability of very cold freezers’, a spokesman for the UK Department of Health said in an email. The Pfizer BioNTech and Moderna shots should be kept frozen for long-term storage, while the AstraZeneca vaccine is sufficient for cooling.
Efficiency rates
Although the UK has compiled a priority list for vaccine recipients – starting with the oldest, most vulnerable people – the different shots are not allocated based on a person’s profile, the agency added. Thus, one 80-year-old patient may receive the AstraZeneca admission, while someone else with the same age and health conditions may receive the Pfizer one.
Some Britons express a preference based on patriotism rather than what they have read about different effectiveness figures or side effects. No matter, the US vaccine was 95% effective in large trials, compared to AstraZeneca’s shot averaging 70%.
“They say they want to wait for the British one,” Jimmy Whitworth, a professor of public health at the London School of Hygiene and Tropical Medicine, said in a telephone interview. “I think it’s purely a nationalist view.”
– With help from Veronika Gulyas, Jinshan Hong and Adveith Nair
(Updates with German, Italian guidelines in third paragraph)