A little balance

Yes, it is absolutely true. There is no question about it. The implementation of the EU vaccination programme has been very slow in getting going. Much slower than anyone would have wanted; much slower than anyone had planned. However, despite the hugely frustrating political and commercial wranglings that have dogged the programme’s roll-out, it has not been quite the ‘shambles’ or the ‘disaster’ that large sections of the UK press and media would have people believe.

Firstly, in an impressive gesture of solidarity, the twenty-seven EU member states unanimously agreed on a collective procurement policy in order to prevent a bidding war that might have seen see its smaller and weaker members losing out and/or its larger and stronger members potentially hoarding supplies. On the basis that ‘no one is safe until everyone is safe’, as practically every public health official given air time continues to point out, this collective approach is, I would contend, intrinsically sound, both morally and rationally, and stands in sharp contrast to some other countries’ grossly individualistic and ultimately self-defeating ‘vaccine nationalism’. And I would further contend that the unmitigated balls up that has admittedly been made of the external and, to a degree, the internal politics of the matter does not detract from the inherent worthiness of this overarching objective.

Secondly, the EU’s collective purchasing power also enabled it to secure more favourable prices for its members than many individual states, whether inside or outside the EU, would have (or in fact have) been able to achieve. For example, the UK is paying approximately £2.17 per dose for the Oxford-AstraZeneca vaccine and £15 per dose for the Pfizer/BioNTech vaccine, while the EU is paying £1.56 and £10.60 respectively per dose (vs. £2.90 and £14.27 per dose in the US). And in view of the pressures the pandemic has placed on every country’s economy, this surely has to be seen as more than mere penny-pinching. The EU’s collective negotiating clout also resulted in higher standard of accountability for the vaccine manufacturers; the UK’s fast-track approach, by contrast, gives manufacturers complete immunity from legal liability in civil cases. But I would again contend that the balls up – to which one manufacturer itself has contributed significantly – that has also been made of the supply chain elements of the deals the EU has struck, does not detract from the essential rationality and worthiness of these objectives either.

The EU’s approach to product liability was also partly a strategic response aimed at alleviating vaccine hesitancy: the possible risks of negative side-effects being seen to be acknowledged and taken account of is intended to provide reassurance for those with concerns over the speed with which vaccines have been approved and rolled out. That same keenness to reassure people that their concerns are being taken seriously has also been behind the ubiquitous ‘abundance of caution’ currently being shown by various national governments in suspending use of the AstraZeneca vaccine for certain age groups. And with regulatory authorities even in the UK having paused trials of the vaccine in teenagers and recommending that 18-to-24-year-olds now have a different vaccine if it is available, the EU’s arguably more far-sighted approach to product liability may turn out not have been quite so misplaced as some of its critics have suggested.

As for things ‘on the ground’ within the EU, naturally I can only speak of Italy in any detail. Like all other member states, it orders its own supplies of its preferred vaccines direct from the manufacturers with whom the Commission has concluded EU-wide supply contracts. All member states consequently receive vaccines under the same conditions – at the same price, and on a pro-rata basis according to population size – with the option to make adjustments according to need. The Pfizer-BioNTech jab currently accounts for about 60% of Italy’s supplies, Astra-Zeneca for about 30% and the Moderna version for about 10% – although these proportions are set to change as new allocations become available and other manufacturers begin deliveries, for instance Johnson & Johnson and Sanofi-GSK. Incidentally, all this information is readily available from a number of different online sources which are updated at least daily and which can be interrogated in relation to a wide range of parameters.

When it comes to domestic distribution of the vaccine and actually getting it in people’s arms, this is a national responsibility, as is deciding precisely which groups to prioritize. Along with most other countries, Italy gave priority to the over-80s, of which we have a disproportionately large number: very nearly one million over-90s have so far had at least one jab. Then came health and social care staff, the most medically vulnerable, the armed forces and school and college staff, with younger age groups and lower levels of vulnerability to follow. For the record, we are due ours later in the summer.

The government website tells me that there are now well over 2000 formal vaccination points across the country (plus drive-throughs and pop-ups) although in certain circumstances it is also possible to arrange for vaccinations to be carried out at home. The site also indicates that supplies are doubling every 3-4 weeks,and that nationally over 80% of the doses delivered so far have currently been administered – a good third of which, incidentally, are already second doses.  With every region having received another consignment in the last couple of days, it will take a few days to return to its typical level of around 90%, with the rate varying a little from one region to another. For the record, Le Marche is currently is pretty well on the national average.

Much more significantly, however, actual numbers nationally are not that far behind what was projected by the EU at the start of the roll-out, with things still potentially on course for a daily rate of 500,000 injections per day within the next couple of weeks: yesterday, some 370,000 jabs were administered in Italy, while France and Germany both hit that half-million target. Which is far from shambolic and even further from disastrous.

Image: Matteo Bazzi/Reuters

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