It is the best of decisions and the worst of decisions. Everyone can claim to be right. Everyone is partly wrong, writes John Lichfield on the pausing of the AstraZeneca vaccination campaign across Europe.
The European Medicines Agency handed down its judgement on Thursday. The AstraZeneca vaccine is effective and safe to use. Most European countries which had suspended AZ vaccinations are expected to resume today or in the next couple of days.
But – despite what is being reported by some – the EMA did not dismiss out of hand concerns that AZ shots can lead to blood clotting disorders in perfectly healthy young people.
The agency said that there was indeed evidence of “a small number of cases of rare and unusual but very serious” clotting problems associated with AZ. Nonetheless, on balance, the EMA said, it had come to a “clear scientific conclusion” that AZ shots were safe to use. The huge benefits far outweighed the tiny risks.
Fair enough. Balance and clarity have been in short supply in this sorry saga until now.
Unfortunately, there is no sign that will change soon.
Were European governments wrong to suspend their AZ roll-out at the start of the week? The pause will undoubtedly have dangerous side-effects on vaccine resistance, and specifically AZ resistance, in European countries.
On the other hand, ploughing ahead regardless of the evidence of rare clotting disorders emerging in several places – in Norway, in Germany, in Austria and in Italy – might have had an even more calamitous effect on public opinion.
Let us, for once, be fair to governments. They were placed in a very difficult situation. France, for instance, where there were very few AZ side-effects, did not want to suspend an AstraZeneca programme which had just started to take wing.
President Emmanuel Macron was bounced into his decision by a domino-tumble of suspensions imposed by Germany, the Netherlands, Italy and others.
France is the most vaccine-sceptic country in the world. How could Macron say that there was no reason to stop briefly to think when all his neighbours were stopping briefly to think?
Little of this was reflected in the coverage in the British media. With some honourable exceptions, the consensus view in the UK was that the EU was being “stupid” or seizing on flimsy reasons to attack the AstraZeneca vaccines because a) AZ was British or b) AZ had failed to supply the EU with all its promised doses.
In other words, it was all “political”. In truth, it was the opposite. Politicians in a score of European governments decided, rightly or wrongly, that their political interest – the belatedly accelerating vaccine programme – must briefly give way to medical and legal considerations.
Only Belgium stood up to this trend. The Belgian government said that it would be “irresponsible” to interrupt an AZ vax roll-out which WOULD save thousands of lives because very rare side-effects MIGHT take a handful of young, healthy lives.
That was a courageous decision by Belgium but I don’t think that it makes the decision taken by the others irresponsible. We live in a time of instant experts and easy answers but sometimes there are no easy answers.
It has been widely asserted in the UK media, and by the UK government, that there is no obvious connection between the AZ vaccine and clotting disorders. It is also asserted that such “thromboses” have actually been less common among the AZ-vaccinated than in the population as a whole.
Neither of these things, it now turns out, are true.
A Norwegian study found on Thursday that there was a clear link between AZ vaccinations and three youngish Norwegians who suffered rare brain thromboses or strokes, one of whom died. On Tuesday, Germany’s health ministry of health said that there had been seven cases of “cerebral venous sinus thrombosis (CVST), including three deaths, among the 1.6m million Germans people who had received an AZ shot. That was three or four times higher than the normal rate.
Science magazine reported that in five countries 13 people aged 20 to 50 had suffered from widespread blood clots, low platelet counts, and internal bleeding. Seven had died. This was “more frequent than would be expected by chance”.
“It’s a very special picture” of symptoms, said Steinar Madsen, medical director of the Norwegian Medicines Agency. “Our leading haematologist said he had never seen anything quite like it.”
I am not trying to start – or re-start – a scare story.
I think vaccination is great. I think the AZ vaccine is wonderful. One week ago I had my first shot in a French doctor’s surgery. It was AstraZeneca. I have a history of blood clotting problems. I have no regrets that I took the shot. I’m looking forward to my second in June.
The EMA and Belgium are right. The need to vaccinate rapidly against Covid is so urgent that, on balance, a small risk of clotting problems is a risk worth taking.
But that’s not so simple a choice as much of the British media – BBC included – would have us believe. Life-death accountancy is not straightforward.
Is it worth risking the lives of few young people who are broadly unthreatened by Covid to protect the lives of tens of thousands of vulnerable older people?
European governments had little choice but to stop to review the evidence. The easiest way to fuel anti-vaccine feeling in France – and probably other EU countries – is to create the impression that vaccination is a politico-industrial juggernaut which cares nothing for potential or actual side-effects.
Yes, EU countries are sometimes more risk-averse than Britain.
Yes, the UK has, so far, got away with, even hugely benefitted, from a series of risky short-cuts on vaccines.
Yes, the EU should find a way to make these common health decisions in advance, not after the damage is done.
Yes, President Macron and others were wrong to make baseless accusation against the AZ vaccine in the past.
Yes, the blood-clot scare will cause greater AZ-scepticism in the EU for a while (and then the effect will, hopefully, fade).
But for Britain to shout down understandable caution as “stupid” or “political” or “an EU attack on our vaccine” is foolish and hazardous.
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