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EU vaccine roll-out in desperate need of an injection of pace

Hundreds of health workers line up to be vaccinated at a facility set up in an exhibition centre in Naples near the city's football stadium - Credit: KONTROLAB/LightRocket via Getty

JASON WALSH reports on Europe’s varying fortunes on vaccination roll-outs.

The European Union performs many roles for its citizens. The most important – if one of the least-discussed – is to keep them safe from harm.

And that is the issue causing grave concern across the continent right now, as the EU and its member states try desperately to speed up the process of coronavirus vaccinations, amid mounting criticism at its slow pace.

Brussels is responsible for co-ordinating the purchase of vaccines for all of the union’s 27 members, and has been the focus of much of the anger at its supposedly sluggish response. But national governments – which deal with the administration of the vaccines – have also been coming under pressure, as they slip behind in the global league tables for vaccination rates.

The European Medicines Agency (EMA) has thus far authorised two vaccines: the Moderna and the BioNTech/Pfizer jabs. Approval  for a third, the AstraZeneca/Oxford one, is expected in the coming days, which will bring the bloc into line with the UK, where all three options are already authorised. The comparison with the UK is a fair one. Many Europeans have been looking enviously at Britain’s early pace-setting and wondering why they are not doing more to close the gap.

Just across the Channel in France, for instance, the rollout has been a fiasco: last week France had vaccinated only 500 people. By the weekend that number had reached 45,000 – an improvement, but not enough to put an end to consternation.

Speaking on Europe 1 radio following the arrival of 50,000 doses of the Moderna vaccine, health minister Olivier Veran promised that 100,000 of France’s 65 million people would be vaccinated by this coming weekend and that 300 vaccination centres were being opened, with a focus on the hard-hit east of the country.

Research minister Frédérique Vidal sounded defensive when she insisted: “France is not late, it has chosen to use and prepare vaccines whose distribution and the sharing may be wider than current vaccines.” Others may not see it quite the same way: newspaper Le Journal de Dimanche reports president Emmanuel Macron has said privately that things need to change “fast and hard”. But while getting things done could almost be the slogan for Macron’s presidency, time and again reality has intervened with large sections of French society dragging their heels.

Meanwhile, hopes pinned on a vaccine co-developed by France’s Sanofi and the UK’s GSK appear to have been dashed. The vaccine from France’s pharmaceutical research standard bearer was so awaited that the lab where it was being developed not only received a visit from Macron, but was the source of outcry when Sanofi’s boss said the US would get the lion’s share of doses.

Now a reported ‘laboratory error’ means there has been a six month delay in the vaccine’s development, with Le Monde reporting the company is under pressure from the Ministry of Finance to make its production facilities available to its competitors. Certainly it’s a blow to French prestige, but the public is focussed more on the deployment of any vaccine rather than hanging on for a French-developed one.

Or some of the public is, anyway: often puzzling for visitors who see pharmacies on almost every street corner, France also has a strong anti-vaccine movement to overcome. Indeed, before the slow rollout came to dominate French complaints many wondered if significant numbers would simply refuse the vaccination entirely. One Ipsos Global Advisor poll reported that only 40 % of respondents wanted the vaccine.

Even if vaccine scepticism can be overcome, many in France, including in government, have been quick to complain that the country is not swift when it comes to getting things done and familiar themes of bureaucracy and inflexibility have come to the fore.

It will come as little consolation either to French authorities or the public but the country is not alone in its travails: other European countries have struggled.

In Germany last week over 250,000 first shots had been received but while a far cry from France’s low numbers public impatience has been pronounced. There has also been political infighting: Lars Klingbeil, general secretary of Germany’s Social Democratic Party (SPD) pointed the finger at health minister Jens Spahn, a member of Angela Merkel’s conservative CDU, and demanded that production be sped up.

Tensions over vaccine roll-outs have emerged not just within countries, but at EU level too. The revelation that Germany had apparently breached EU rules by buying extra BioNTech/Pfizer doses outside of the bloc’s own deal has undermined the idea that the vaccination process is a beacon of EU solidarity. An example of “all working together,” as Commission president Ursula von der Leyen put it.

But Germany’s unilateral actions also underlines the frustration that many have felt about Brussels’ own performance. The EU’s decision to co-ordinate the purchase of vaccines – which it then distributes between countries on the basis of their population – was intended to avoid competition, to make sure smaller countries did not miss out, to increase purchasing power and reduce costs.

However, the strategy has run into problems, with critics describing it as a “vaccination disaster”, suggesting it has not secured enough doses and has created delays. One criticism is that the EU has been caught out, as it wrongly assumed that several different vaccines would be ready at once and therefore spread its orders accordingly.

The German government has said its scheme will be complete by the end of summer. Other countries seem less optimistic. Neighbouring Austria gave its first shot on December 27, with an 84-year-old Viennese woman receiving the vaccine, but progress has been slow since then.

Notoriously, the Netherlands was the slowest to start vaccinating. The first person did not receive the jab until January 6 – 10 days after their European neighbours and nearly a month after the UK. The delay was described as “shameful” and “embarrassing” by the country’s own medics and public health experts. One of the main factors behind the delay was an upgrade needed to an IT system to allow health authorities to track appointments and check which vaccine each patient has received.

In Spain, regional divisions have opened up in the country’s vaccination rates. Last week, 140,000 first doses had been deployed with Asturias in the north of the country leading the pack by working seven days a week to get shots delivered. However, while Asturias had used its entire allocation other regions lagged behind, with Cantabria, Catalonia and Madrid all deploying under 6% of their allocated doses.

There have also been reported irregularities. An investigation has been launched into allegations that relatives and close friends of employees at a care home had received the jab, despite not being priority cases. Spain’s severe snowstorms have also added to logistical difficulties, with vehicles carrying the vaccine left stranded and hospitals inaccessible.

Though there are no blizzards cutting logistics supply chains, Irish health minister Stephen Donnelly is also under pressure. The country is now in its third national lockdown and fears are growing that the country’s health service will run out of intensive care beds. Health service chief Paul Reid has said it was under “increasing strain” and that the number of hospitalised patients could reach twice that of the peak of the first wave.

Facing this, the country would have an “accelerated vaccine plan” that would see 65 vaccination teams and the ambulance service work “seven days a week into the night”, Donnelly said. The Business Post newspaper said it calculated 585,000 doses will have arrived in the country by April 1. Still, with a population of 4.9 million this leaves a long road ahead. Indeed, the Irish Times reported this week that it could take until mid-summer for 70% of the population to be vaccinated.

This news is made all the more dispiriting by the fact that Ireland, which before Christmas had the lowest rate of Covid-19 spread in Europe, as of Monday had the highest infection rate in the world.

There are positive stories in Europe though. Italy, the first country in Europe hit hard by the coronavirus, is working fast. It had vaccinated over 400,000 people by last Friday and was one of the fastest-vaccinating countries in the bloc. Around 45% of doses that have arrived in the country have been injected, including to more than 345,000 medical and paramedical staff. The country is planning to roll-out “pop-up” vaccination booths this month.

The top performer is Denmark, which has had, by some measure, the EU’s most successful vaccine rollout. The country of 5.8 million has secured a total of 5.25 million doses. Health minister Magnus Heunicke said the majority of doses should be deployed by the spring. By last week 1.41 per cent of the population had received a first dose.

Denmark’s success, like that of the UK, appears to stem partly from a rapid start. Prime minister Mette Frederiksen told reporters in mid-December: “Even though I am a big supporter of coordination at European level, the vaccine must be run out and distributed the moment it hits Danish soil”. Beyond that, though, it has also taken a programmatic approach to vaccination, with the State Serum Institute reporting daily numbers of administered doses.

Underscoring how seriously it takes vaccination, the country has now announced plans to roll out a so-called ‘digital vaccine passport’ which will be required for those who enter the country from abroad, including Danes.

Despite Denmark leading Europe, including at the time of writing the UK, the EU as a whole lags behind not only the UK, but also the United States and world-leader Israel. Ultimately though, this race is not against other countries, but against the virus itself. As it has done in societies across the world, Covid-19 has exposed tensions and weaknesses in Europe – within nations and the EU itself. But these are still early days in the vaccination process, and those early delays, arguments and stuttering starts may be forgiven if ultimately that race is won.

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