As vaccine rollout advances globally, albeit at different speeds, concerns over the possible side effects of the Oxford/AstraZeneca vaccine continue to spread across Europe and more people are refusing to get vaccinated with it. Multiple arguments – scientific as well as political – are being put forward to either justify or denounce this phenomenon.

The world has had its eyes – and resources, when available - on the race for the Covid-19 vaccine for the last year. The main opponent in this race has, of course, been the virus itself. However, there has also been a race among countries and pharmaceuticals to be the first ones to get to the vaccine.

The evolution of the perception of pandemics from “acts of God” to problems that governments can manage has resulted in the Covid-19 pandemic becoming the first to be politicised. All the dynamics surrounding the vaccine development processes – approvals, deals, purchases, supply and lack thereof, and delays – are not only a reflection of scientific and logistical capabilities, but of international politics. Economic interests, diplomatic motives and power relations inevitably determine who one’s friends are in this whole process.

The map of the vaccine

Indeed, the map of the different steps of the vaccine process reflects that of trade and investment interests and diplomatic ties between countries. The countries in which each of the main vaccines have been trialled, approved and produced are partly a reflection of the relations between them and the countries of origin of each of the corresponding pharmaceuticals.

For instance, the first vaccines to be approved in the European Union were Pfizer/BioNTech (from Germany and the US) and then Moderna (US), followed by the British Oxford/AstraZeneca (although the EU took significantly longer to approve it than the UK), and more recently Janssen, which is also from the US. While the approval processes for these vaccines were hurried due to the urgency of the situation, the approval of the Russian Sputnik V vaccine has recently been further postponed, after waiting for months for a verdict. 

Meanwhile, Argentina started using the Sputnik V vaccine to immunize its population as early as December 2020 – and is now producing it as well -, as it was the only vaccine they managed to secure at the time, and over 60 countries are now using it worldwide. Granted, the approval of the Russian vaccine was not an option for the EU – and for many other countries – at the time because trials had not been completed yet. But this has since changed, and the Sputnik V vaccine has actually been found to have a significantly higher efficacy rate than the Oxford/AstraZeneca jab.

Parallelly, countries who have not managed to produce their own vaccine so far have often been eager to become involved in the process however possible, in order to ensure their population’s access to the vaccine once it is ready. This could explain the fact that different vaccines – such as British Oxford/AstraZeneca and Chinese Sinopharm – have conducted trials in Peru, that Spain has wanted to conduct trials for the US Janssen vaccine, or that countries like Bahrain, Egypt, Jordan and UAE have also trialled Chinese Sinopharm in their territories. Brazil, on its part, has been producing doses of Oxford/AstraZeneca and Chinese Sinovac, in an attempt to revert the negative image the government had when it failed to secure vaccines for its population fast enough in spite of the disproportionately high Covid-19 death rate in the country.

The parallelisms are easily drawn between the vaccines that countries choose to trial, produce or approve, and their economic or diplomatic interests. The EU is aware that it does not need the Russian vaccine as long as it possesses sufficient supply from other sources. It is likely that the EU will continue to stall approving the Russian vaccine to deny Moscow considerable monetary gains from its distribution and prevent any dependency on Sputnik V in Europe. It is not in the interest of the EU to inflate Russian power at a time when tensions are still very tangible between the two actors.

Many countries outside the EU, on the other hand, see Russia and especially China as important allies, due to the high level of foreign investment they bring. By trialling and producing their vaccines in their countries, they have the chance both to secure the vaccines for their population in a faster way (thus increasing their country’s public health and eventual economic recovery but also their government’s popularity), to strengthen diplomatic ties with global powers and to assert their position as vaccine players. From this point of view, the vaccine-related choices made by different countries appear only logical.

Power displays

After the trials, approvals and production, comes supply. Supply is inevitably closely linked to approvals in that, for the most part, countries that have approved a certain vaccine proceed to purchase doses of that vaccine, which are in turn delivered to it. There are, nonetheless, certain cases where the vaccine supply – or lack thereof – has not responded to this seemingly evident progression of events.

Issues surrounding supply – vis-à-vis purchases - have been notable in the EU. Oxford/AstraZeneca’s failure to supply the agreed amount of doses to the EU (in favour of UK supply) resulted in the EU suing the British pharmaceutical in April and threatening to halt the supply of Pfizer/BioNTech doses and of vaccine components produced in the EU that were supposed to be delivered to the UK. Since then, the EU’s legal allegations against AstraZeneca have managed to get a breach of contract recognised in court, but they have failed to force the pharmaceutical company to speed up its vaccine supply. Prior to that, the EU had already announced that it would not renew its contract with the pharmaceutical past June.

Details of the development of the dispute aside, the positions adopted by these two actors are worth analysing, as they can be read as the different messages that each of them is trying to tell the world. On the one hand, the exit of the UK from the EU after a lengthy and complicated negotiation process left many expectant to see whether the UK would manage to overcome its losses and rise as a strong actor again.

Having begun its vaccination rollout sooner than any EU country and remained in the lead in terms of share of the population vaccinated in the continent, the UK has tried to show the world that it can rely on itself to manage its own affairs, to secure adequate resources for its population and thus to stand strong on the road to post-pandemic recovery. For the EU, on the other hand, it is imperative to prove to the world (including to the UK and to its own member states) that it does not need the UK to remain strong and relevant, and that it still has significant bargaining power to protect its interests.

These two postures have been further exacerbated by the image that each of them have depicted of one another at home. There is a notable difference in the language each of them has used to explain the dispute to their respective public. British press emphasizes the EU’s failure to speed up its vaccine rollout (especially in comparison to the UK) and its decision to block vaccine exports, and it often pays particular attention to including the words “the EU claims…” when it mentions the allegations against the British pharmaceutical.

The EU, on its part, has repeatedly raised the alarm against the Oxford/AstraZeneca vaccine due to repeated claims of a high risk of clotting associated with its use. In fact, after stopping and then resuming its use, Spain began to advise its citizens against this vaccine, and it started offering people who had received the first dose to get a second dose of Pfizer/BioNTech to complete their vaccination (after conducting a study that confirmed its viability). In Italy, the Oxford/AstraZeneca doses were initially made available to the younger sections of the population earlier than expected because of the surplus of doses they had as a result of many people refusing to get vaccinated with them. More recently, however, vaccination with the Oxford/AstraZeneca vaccine has been completely halted for people under 55.

There are, to be sure, many sides to this story. Although the number of reported clots that people have suffered after receiving the Oxford/AstraZeneca vaccine do seem to be higher than with other vaccines, several studies point towards two different issues that have nonetheless failed to feature in official discourse. Firstly, the clot probability after receiving the vaccine is still said to be low enough for benefits to outweigh risks by far. Apparently, the risk associated with the second Oxford/AstraZeneca shot is ten times smaller than it is with the first dose. 

Secondly, clot risks also exist in the cases of the other vaccines – with some even claiming that there are no scientific grounds for discriminating against the British vaccine over the others -, yet this does not make the news in some EU countries in the same way that the problems with the Oxford/AstraZeneca shot do. This has generated widespread scepticism towards the British vaccine among citizens in several EU countries. Although it should be noted that attempts have been made to clarify that the discourse against Oxford/AstraZeneca – both over the disputes and the risks – is not aimed at antagonising the UK per se but just the pharmaceutical, the connection between the two seems inevitable, at least for a significant part of the public.

The vaccine’s potential as a popularity enhancing tool

The vaccine is not only useful for sending messages to the world. It has also served repeatedly to try to gain popularity or shift the attention away from mistakes at the national level. One clear example is the already mentioned attempts by Bolsonaro to revert the reputational damage done by his handling of the pandemic in Brazil – which has already cost him numerous requests for impeachment and legal allegations against him – by signing deals to produce the vaccine in Brazilian territory.

Another interesting event that can be explained by governments’ hurry to portray themselves as strong and reliable leaders is the fact that both Russia and China approved their national vaccines for emergency use even before the customary large-scale trials had been carried out. By doing so, both countries remained ahead of the race alongside other vaccines (mainly from the US) who were already starting to be approved for use after the completion of successful trials.

Iran, on its part, initially resisted importing the vaccine because it was betting on the development of its own national vaccine, and this later changed in response to public pressure to import the vaccine (although it should be noted that the country’s original delay in importing the vaccine was also due to issues related to the US-imposed sanctions). Jordan was one of the first countries in the world to announce the inclusion of refugees in its vaccination programme. North Korea has repeatedly claimed to have registered zero positive Covid-19 cases. All of these discourses are a reflection, to a lesser or greater extent, of the message of trust, reassurance and/or national pride that each government wants to give its citizens, as well as the rest of the world.

Global community

Ultimately, the different strategies adopted by governments and global actors are also a reflection of the norms by which their international action abides. Aside from strength or political assertiveness, there has also been an important display of solidarity since the beginning of the pandemic. This has been visible both bilaterally – with countries supplying protection equipment, masks and vaccines to other countries – and multilaterally, with the creation of the Covax programme to ensure that countries with insufficient resources also have access to the vaccine.

All in all, the use of the Covid-19 vaccine as a tool for international as well as domestic politics, reputation-building and power projection comes naturally in a globalised world where countries need to ensure their position within the international community for self-preservation purposes. Judging the adequacy of diverse strategies for that is up to others, but what is certain is that it is easier to understand why some dynamics look the way they do if these considerations are kept in mind.

Although significant advancements in terms of vaccine rollout have been achieved, there are still large parts of the world with insufficient access to them, and the pandemic will not be fully tackled until herd immunity is reached at the global level. There are many difficulties standing in the way of this objective, such as insufficient means, production delays, possible side effects and the corresponding fear they generate, or problems with delivering in hard-to-reach areas.

When dealing with these obstacles, each country or each actor’s own interests will inevitably be present. Therefore, the future of the battle against the pandemic will come down to whether these interests are the primary element guiding global cooperation, or whether they are simply part of the structure around which countries decide to commit to fully cooperating with each other.