The suspension of the AstraZeneca vaccine in several European countries over the past week could fuel scepticism about the shot far beyond their shores – potentially threatening the rollout of a vaccine that is key to the global strategy to stamp out the coronavirus pandemic.
For developing nations, the choice is AstraZeneca or nothing, as the vaccine from the Anglo-Swedish drug maker is cheaper and easier to store than many others.
It will make up nearly all of the doses shipped in the first half of the year by Covax, a consortium meant to ensure low- and middle-income countries receive vaccines.
With little other choice, most developing countries that had the AstraZeneca on hand pushed ahead with it even as major countries in Europe suspended its use over the past week after reports that unusual blood clots were found in some recipients of the shot – despite insistence from international health agencies that there was no evidence the vaccine was responsible.
While governments in Africa and elsewhere expressed their determination to continue using the jab, not everyone is convinced.
“Why should I allow it to be used on me? Are we not human beings 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 received 864,000 AstraZeneca doses via Covax so far, but had administered fewer than 3,000 by Tuesday.
Authorities blamed logistical challenges in transporting the vaccines deep into the country, but newspaper reports cite resistance to the vaccine.
Even before the latest debate over AstraZeneca, vaccine scepticism had been a concern across the world, as many people are hesitant about treatments 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 pushed back against scepticism, while others, such as those in Burundi and Tanzania, have fed it by appearing to deny the seriousness of Covid-19.
John Nkengasong, director of the Africa Centres for Disease Control and Prevention, told reporters that “unfortunate events” in Europe will “clearly not be helpful for our public confidence, in building public confidence and trust on the use of that particular vaccine and other vaccines for sure”.
That came hours before the European Medicines Agency said its experts concluded that the vaccine is not linked to an overall increase in the risk of blood clots, though it could not definitively rule out a link to rare types of clots and the vaccine.
In response, countries including Italy, France and Germany announced they would resume use of the jab.
Even before those reversals, several developing nations had said they would stick by the vaccine.
“We will continue the inoculations,” said Lia Tadesse, health minister of Ethiopia, which received 2.2 million doses of the AstraZeneca vaccine last week.
Authorities in India – home to the vaccine manufacturer that will likely make a large portion of the doses destined for the developing world – said they would continue AstraZeneca inoculations with “full vigour” as infections jumped in several parts of the country.
After initially saying it would delay use of the vaccine, Thailand said it would carry on with AstraZeneca, and the prime minister even received his jab in public.
Brazil’s state-run Fiocruz institute delivered the first AstraZeneca shots bottled in Brazil on Wednesday as the health ministry sought to allay concerns about the blood clot reports.
Very few developing countries bucked the trend. Congo, for instance, halted use of AstraZeneca, putting its entire vaccination campaign on hold since it has no doses of anything else.
On Friday, Indonesia cleared the AstraZeneca vaccine for use again.
“The benefits of using the Covid-19 vaccine AstraZeneca outweigh the possible risks, so that we can start to use it,” Indonesia’s Food and Drug Authority said in its announcement.
The Indonesian agency said the risk of death from Covid-19 was much greater, “Therefore, the community still has to get vaccination against Covid-19 according to the designated schedule.”
Indonesia has received 1.1 million doses of the AstraZeneca vaccine on March 8, through Covax.
The AstraZeneca vaccine is the second to arrive in Indonesia after the one made by Chinese biopharmaceutical company Sinovac.
Indonesia aims to inoculate more than 181 million of its 270 million people by March 2022 as part of a free vaccination drive that began in January.
European and other wealthy countries have several vaccines to choose from, but AstraZeneca is currently the linchpin in the strategy to vaccinate the rest of the world.
Some developing countries have received doses of Chinese-made or Russian-made vaccines – often as donations – but, at least in Africa, these allotments have usually been relatively small.
The Chinese and Russian vaccines have not yet been endorsed by the WHO and so cannot be distributed by Covax.
Africa, with a population of 1.3 billion, hopes to vaccinate 60% of its people by the end of 2022.
That target almost certainly will not be met without widespread use of AstraZeneca.
Experts have warned that until vaccinations rates are high the world over, the virus remains a threat everywhere.