How quickly we forget.
In the first few months of 2020, when the news was full of overflowing hospitals, doctors and nurses dying, shortages of personal protection equipment, respirators and oxygen cylinders and people dying in the streets from COVID-19, going outside was a hazardous business.
I well remember the first time I ventured outside as I had to go to my bank. I put on a face mask and plastic gloves before I got out of my car; parking charges had been suspended because using the ticket machine was too hazardous, and besides there no-one to refill it or even issue the spot fines for non-display of the parking ticket.
I walked from the car-park, through an almost empty pedestrianized shopping precinct, crossing to the far side to avoid a queue of anxious-looking people in facemasks, standing two metres apart, waiting to be admitted one at a time to a pharmacy - one of the only shops open.
It was surreal; the air we breathed had suddenly become toxic and touching any surface meant using a hand-cleansing anti-viral gel before we touched our face or handled anything else. Only essential shops were open. As soon as we came in the house, we used the hand-cleanser on the hall table then went straight to the bathroom to wash our hands with soap for the recommended 20 seconds - our hands had never been so clean.
When we had our weekly groceries delivered, we had them put in our garage, put on plastic gloves to put frozen food in the freezer, and of course washed our hands immediately, and left the rest for several hours before touching them, to allow the virus to die. Soon, all available delivery slots were taken by vulnerable people, and we had to use click and collect.
Our son, who was on a visit from the Czech Republic when the pandemic hit, got stranded here by the ban on travel, until, in April 2020, the Czech government arranged a repatriation coach for Czech nationals, with strict quarantine regulations. His Czech mother-in-law had made some face masks for him for the journey, but they arrived two weeks later. I drove him to Victoria in London through eerily empty streets, fully prepared to pay any fixed penalty for making a ‘non-essential’ journey. Trafalgar square, normally packed with people, was deserted and the normally heavily congested streets of London were strangely empty. Nothing moved on the M40 motorway.
Life had become strange and rather frightening, and we lost 50 lbs in weight to give ourselves a better chance if we caught the virus. We had gotten used to click and collect food shopping as a weekly routine - checking which local supermarket had a vacant slot, sometime needing to go as far afield as Reading or Wantage to find one. Gradually the restrictions were eased, but Christmas was a write-off. We got used to wearing face covering in public, using hand-cleanser as we entered any building and maintaining a 2-meter distance. Arrows on walkways showed us which side to walk on.
And we did twice-weekly lateral flow tests with the free test-kits we ordered online and dutifully reported the results to the NHS.
Then, in February 2021, we got the long-awaited phone call inviting us to get the new COVID vaccine and on Saturday, 6 February, 2021, everything changed. We had the first of our two vaccinations at a mass-vaccination centre in a social centre in a village some 5 miles away. It felt like a weight had been lifted from our shoulders; we had gotten through the pandemic! In 10-14 days, we would be protected against the more severe form of COVID-19. Medical science, in the form of the Oxford/AstraZeneca vaccine, had delivered humanity from the worst of the pandemic and made it possible to begin to restore normal life.
Last year, after having had just about every booster going in spring and autumn, we both caught COVID-19 on a trip to France - it was a mild, flue like infection that lasted about a week - nothing worse than a 'bit of a cold'. Without the protection of the vaccines, the outcome could have been very different.
And soon we are going to Czechia to visit our son, free from any worries or restrictions on travel; Czechia that 4 years ago, our son could only enter in a sealed, specially quarantined coach. What has made the difference is the vaccines, manufactured by pharmaceutical companies using techniques developed by the Oxford scientists in association with AstraZeneca (AZ).
And now, the European Union has decided to withdraw authorization for the AZ. Michael Head, Senior Research Fellow in Global Health, University of Southampton, explains why in an article in The Conversation, reprinted here under a Creative Commons license, reformatted for stylistic consistency: AstraZeneca’s COVID vaccine withdrawn – right to the end it was the victim of misinformation
AstraZeneca’s COVID vaccine withdrawn – right to the end it was the victim of misinformation
Michael Head, University of Southampton The Oxford-AstraZeneca vaccine was a critical part of the COVID-19 pandemic response. However, on May 7 2024, the European Commission announced the vaccine is no longer authorized for use.
This EU announcement was preceded by an application from AstraZeneca on March 27 2024 to withdraw the EU marketing authorisation. This development has been covered in various media outlets as primarily related to the known “adverse events”, namely a very small risk of blood clots. However, other factors are far more likely to be driving this decision.
The first AstraZeneca vaccine dose, outside of clinical trials, was administered on January 4 2021. In that year, about 2.5 billion doses were administered, and an estimated 6.3 million lives saved.
It was a key product at the peak of the pandemic. This includes during the emergence of the delta variant in India, across the first half of 2021 where, amid significant global supply issues, the AstraZeneca vaccine was one of the few tools available during that humanitarian crisis.
Professor Sarah Gilbert led the Oxford University team that produced the AZ vaccine.
The potential adverse events related to blood clots were publicly reported in February 2021, with, for example, the UK government and the drugs regulator (the MHRA) then publishing a statement about its continued use on March 18 2021.
Amid speculation and investigation, the European Medicines Agency and the World Health Organization both highlighted how the benefits of the vaccine greatly outweighed any possible risks.
This was a time when COVID levels were extremely high, and getting higher, with around 4 million confirmed new cases globally per week.
It is well established that COVID itself caused a significantly increased risk of these related blood clots and also thrombocytopenia (low platelet count). An August 2021, analysis of 30 million vaccinated people in the UK showed that the risks of thrombocytopenic events were much higher following a COVID infection, compared with any COVID-related vaccine.
From that study, the British Heart Foundation describe how for every 10 million people who are vaccinated with AstraZeneca, there are 66 extra cases of blood clots in the veins and seven extra cases of a rare type of blood clot in the brain. By comparisons, infection with COVID is estimated to cause 12,614 extra cases of blood clots in the veins and 20 cases of rare blood clots in the brain.
To put this into some perspective, these vaccine-associated blood clot rates are much lower than many widely prescribed medicines. For example, the combined contraception pill, prescribed widely to women, has blood clot-related risks of around one in 1,000. With women taking postmenopausal hormone therapy, around one in 300 per year are likely to develop a blood clot.
Poor public profile
The AstraZeneca vaccine did suffer from a poor public profile, arguably much of it undeserved. There was some poor quality reporting in Germany in January 2021, with claims that the vaccine was only “8% effective in the elderly”. This claim was widely repeated, but it turns out that 8% figure referred to the percentage of people aged over 65 years in the study and not the efficacy measure.
The antivaccine lobby had a field day with fuelling the “infodemic”, including other false claims such as fabricated links between the vaccine and female infertility. As with the blood clots, COVID infection is known to increase the risks of infertility, but there is no link between infertility and the vaccine.
For individuals and families likely to have been injured by any medicine, including any of the COVID vaccines, compensation schemes are available. Many claimants report difficulties and frustrations with accessing the compensation. This is an area where the government-led schemes should be more transparent, and also where the misinformation from the anti-vaccine lobby hinders those groups they are claiming to support.
So, why would AstraZeneca withdraw this high-profile product? One reason for the withdrawal is likely to be that other COVID vaccines, such as Pfizer and Moderna, are essentially better products.
AstraZeneca is very good, but the mRNA versions have better effectiveness and safety levels.
The initial concerns around the difficulties of the specialist refrigeration needed to transport and store the Pfizer and Moderna vaccines have been overcome, including in low-income countries. The mRNA vaccines are also easier to update when new variants emerge.
With those factors, orders for the AstraZeneca vaccine are probably much lower now than they were in previous years. It is being overlooked in favour of better-performing vaccines.
For the Oxford AstraZeneca vaccine, perhaps it’s time has indeed passed. But it has been a safe and effective vaccine and a key part of the pandemic response for most countries around the world.
Correction. The sentence that read: It is well established that COVID itself caused a significantly increased risk of these related blood clots (thrombocytopenia). Now says: It is well established that COVID itself caused a significantly increased risk of these related blood clots and also thrombocytopenia (low platelet count).
Michael Head, Senior Research Fellow in Global Health, University of Southampton
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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