The Economist December 18th 2021 43
BritainCovid-19A dose for the world
I
n a solemnprerecorded address, Boris
Johnson warned Britons that a “tidal
wave” of Omicron was on its way, and that
the best chance of escape lay in booster
vaccines. All adults, the prime minister an
nounced on December 12th, would be of
fered one by the end of 2021. Yet their
choice is to be more limited than in the last
vaccination push, with Moderna and Pfizer
leading the way. Nearly a year after it was
first approved, Britain’s flagship Oxford
AstraZeneca jab will be rarely used.
It is the latest indignity for a vaccine
that is both a national symbol—praised by
royalty, hawked around the world by the
prime minister, made by the country’s
most famous university and biggest listed
company—and a source of angst. Astra
Zeneca has taken flak for datapresenta
tion issues, delayed deliveries and rare ad
verse events. The share prices of Moderna
and Pfizer have soared since covid19
struck; AstraZeneca’s is pretty much back
where it started (see chart 1 on next page).
Nor, to the bemusement of many in
volved, has the company won a great publicrelations victory. On some measures, it
manufactures the most successful covid
vaccine there is. According to Airfinity, a
data firm, 2.2bn doses have been delivered,
compared with 2bn by Pfizer and 0.5bn by
Moderna (see chart 2). Because rich coun
tries increasingly use other jabs, and poor
countries mostly use their supply for ini
tial doses rather than for boosters, Astra
Zeneca’s vaccine is almost certain to have
saved more lives than any other.
Yet it was always unlikely to be a big
moneyspinner. Ministers were happy for
it to be sold at a small profit; the University
of Oxford, which came up with the vaccine,
was not, both for humanitarian reasons
and to avoid being “seen to be cashing in
on what was inevitably going to be an enormous amount of human suffering”, says
Sir John Bell, Regius professor of medicine
at the university. A dose sells at less than
$4, compared with more than $20 for Pfiz
er. “Do [AstraZeneca bosses] look at Pfizer’s
[profit and loss] and say, ‘Oh, shit, how did
that happen?’ You know, they might,” says
Sir John. But it was agreed to be the right
thing to do, he adds.
AstraZeneca’s vaccine has struggled for
market share in the rich world. Relations
with America’s Food and Drug Administra
tion (fda) soured after the firm failed to
notify the regulator about a possible ad
verse event in a trial elsewhere; the fda has
still not approved the vaccine. After Astra
Zeneca failed to meet the European Un
ion’s delivery targets, national leaders crit
icised it and the commission placed an
enormous order with Pfizer. “The truth is
AstraZeneca had signed an exclusivity deal
with us and a bestefforts deal with the
European Union,” says Matt Hancock, Brit
ain’s health secretary at the time.
The vaccine, which uses an adenoviral
vector, has proved less effective than its
mrnarivals at stopping infection, further
reducing demand in the rich world, and is
perhaps marginally less effective at pre
venting death. Soon after it became avail
able, evidence emerged that in rare cases it
caused blood clots (as does Johnson &
Johnson’s vaccine, another adenoviral
vector jab). This helped persuade thejcvi,
an expert body, to recommend using other
vaccines in Britain’s booster round. Sir MeThe Oxford-AstraZeneca vaccine has attracted lots of criticism. It is still a triumph→Alsointhissection
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