Left to right: A woman from New Delhi waits in an observation room after a dose of the Covishield vaccine (the name used for the AstraZeneca product in India) on May 26. British Prime Minister Boris Johnson leaves a vaccination center in London after his first dose of AstraZeneca on March 19. On March 9, Nairobi began vaccinating groups including health workers and the elderly with AstraZeneca.

From left to right: Prakash Singh, Aaron Chown, Robert Bonet / Getty Images

From the outset, the Oxford-AstraZeneca The COVID-19 vaccine was different.

It was a non-profit collaboration between top academic researchers at the University of Oxford in the UK and a major pharmaceutical company. It was not developed by a government to be used exclusively for the people or the political whims of a nation. The company touted it as the “vaccine for the world,” costing a tenth of what some of its rivals cost – and licensed it to other manufacturers around the world to boost its production. And that was going to be the backbone of the COVAX international vaccine sharing initiative, making it the primary vaccine for low- and middle-income countries. The AstraZeneca company had the ambitious goal of putting 2 billion doses in people’s arms this year.

But like so much during the coronavirus pandemic, the path forward for this vaccine has been anything but smooth. Five months after its launch and after 400 million doses administered worldwide, this vaccine is one of the most controversial on the market. Just this week, Canada announced that it was almost completely renouncing the use of the vaccine. After suspending use of the AstraZeneca vaccine for the first doses in May across much of the country, the government is now offering Canadians who were waiting for a second dose of the AstraZeneca vaccine the option to switch to another brand to complete their vaccination.

The Oxford-AstraZeneca vaccine was first approved in the UK on December 30.

The first blow was given five days later in a hospital in Oxford, England, to an 82-year-old retired maintenance manager named Brian Pinker.

“The vaccine means everything to me,” Pinker said after receiving the injection in front of a phalanx of media. “For me, it’s the only way to get some normal life back.”

But in the months that followed, a myriad of problems arose.

At times, Operation Oxford-AstraZeneca seemed sloppy. In clinical trials, some participants mistakenly received only half a dose of the vaccine. This error would have been even more embarrassing for the researchers, except that a smaller dose was found to work better than the full dose.

In addition, the company faces lawsuits in the European Union for production delays. There have been questions about the accuracy of some of its clinical trial data. Despite large-scale testing in the United States, it still has not achieved the coveted seal of approval from U.S. regulators. One factor may be that the urgency to get clearance in the United States diminished when it became clear that the United States would have an adequate supply of other vaccines.

Importantly, the AstraZeneca vaccine has been linked to very rare but potentially fatal blood clots. The European Union temporarily suspended its use in March.

Some countries, including Norway, have stopped using it altogether. The Canadian provinces stop offering it. Yet the AstraZeneca vaccine remains the primary vaccine offered to many low- and middle-income countries through COVAX. But people in those countries don’t necessarily embrace it.

As in so many smaller and less wealthy countries around the world, Uganda’s primary source of vaccines is the COVAX program managed by the World Health Organization, the Coalition for Epidemic Preparedness Innovations and Gavi, the Alliance of vaccine.

“We only rely on the WHO to negotiate for us,” says Rose Wakikona, lawyer at the Center for Health, Human Rights and Development in Uganda. “And the best they could negotiate for us was AstraZeneca.”

Wakikona says there is a perception in her country that the only vaccine available to them is a second tier product.

“But what choice do we have? she asks. “Honestly speaking, what choice do we have?”

Wakikona says if she could choose, she would likely take the Moderna or Pfizer-BioNTech vaccine.

But, she said, “no one offered us any other options. None at all.”

When she says she feels like some people around the world are getting second-line immunizations, she’s right. The AstraZeneca vaccine is less effective at preventing infections than those from Moderna and Pfizer (although it is very effective at preventing severe cases of COVID-19). The efficacy rate of the AstraZeneca vaccine is approximately 70%, compared to approximately 95% for the Pfizer and Moderna vaccines.

Additionally, in limited studies, the AstraZeneca vaccine barely appears to work against certain variants of the coronavirus.

But Adam finn, a vaccine expert at the University of Bristol, says concerns about the AstraZeneca vaccine are overblown.

“It’s an amazing vaccine,” Finn said of the AstraZeneca injection. “We have used it a lot in the UK now. It is one of the two main vaccines in our [national immunization] program, as well as the Pfizer vaccine. And the results we are seeing with its use are truly impressive. “

Finn has advised the UK government and the WHO on several vaccine trials. He says the AstraZeneca vaccine has helped contain the outbreak in the UK.

And, he adds, “I think that’s going to be a really key part of trying to get COVID under control around the world.”

The AstraZeneca vaccine continues to be one of the leading vaccines in the world in terms of the number of vaccines given each day. But its role – especially as a workhorse for the COVAX vaccine sharing program – has been compromised by supply issues.

One of the main The suppliers of the AstraZeneca vaccine were supposed to be the Serum Institute of India, the world’s largest vaccine manufacturer. As the COVID-19 crisis exploded in India this spring, Serum said he will not resume exports possibly until the end of the year to deal with the Indian domestic crisis.

“We have a global supply chain, and it’s going very well in some parts of the world and more difficult in others,” said Pascal Soriot, CEO of AstraZeneca. He was speaking in May at a virtual forum hosted by Devex, a media platform for the global development community, during the current World Health Assembly. Soriot said the cut to exports from India has had a huge impact on the availability of the AstraZeneca vaccine around the world.

“We are running out of supplies for COVAX and other countries,” he said. “So what we’re trying to do is increase supply from elsewhere. But it’s very difficult because our supply chains are already very stretched.”

Soriot says vaccine manufacturing is complicated and his company lacks the capacity to set up new manufacturing facilities at this time. Even if the company did, it would take time for these production lines to be up and running. “What people need today is a vaccine,” Soriot said. “And that creates a lot of challenges.”

Despite these challenges and despite the production shortfalls of some factories, AstraZeneca still produces millions and millions of doses of its vaccine every day from its two dozen other manufacturing sites around the world. And COVAX still expects the AstraZeneca vaccine to be the dominant vaccine given this year in low-income countries. Significant supplies from other manufacturers, Pfizer, Moderna and others, are not expected to ship until later in 2021 or 2022.

And that leaves many countries dangerously exposed to epidemics. In Uganda, for example, less than 2% of adults in a country of 47 million people have received even a single injection of the COVID-19 vaccine.

Copyright 2021 NPR. To learn more, visit https://www.npr.org.



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