A fight for protection: the highs and lows of vaccine nationalism

Image courtesy of U.S. Secretary of Defense via Wikimedia, ©2020, some rights reserved.

Prioritising the wellbeing of one’s own people and economy is an arguably logical focus for various governments around the world in the face of this global epidemic. But no matter how many of your own population have had a needle in their arm, the world will not be back to normal until everyone has access to this protection. There are calls to share resources and support one another in order to come out on the other side of this pandemic but what is really the best approach to protect us all from COVID-19 as quickly as possible? Is vaccine nationalism always all bad or can a competitive spirit be the vital edge as countries find themselves in a race against new variants?  

In recent weeks, with tensions rising and mounting political pressures, vaccine nationalism has come to the fore, as the world’s leaders grapple for the best plan of action to finally escape the grip of coronavirus. Successful vaccination programmes in Israel and the United States are joined by the United Kingdom, reporting 19,663,577 total vaccines delivered in England up until the 7th March 2021. The picture in the European Union is a stark contrast. The EU’s approach has come under heavy criticism as they have struggled with procurement, distribution and rather widespread public distrust of the medicine itself. Now, controversial decisions are being made. 

On Friday, Italy became the first EU country to block an export shipment of vaccinations – 250,000 doses of the Oxford/AstraZeneca jab destined for Australia – under a provision introduced by Brussels in response to delays in Europe’s vaccine programme. With the Anglo-Swedish company failing to meet the agreed provisions for the EU, Italy has rejected the onward movement of doses and it has the European Commission’s backing. This news follows the Commission’s blunder last month which left European Commission President Ursula von der Leyen apologising that she, ‘deeply regretted’ the attempt to trigger an emergency provision in the Brexit Withdrawal Agreement. In an effort to control vaccine exports, Article 16 of the Northern Ireland protocol was cited which would have introduced checks on the island of Ireland impacting the special border arrangement intended to preserve the Good Friday Peace Agreement. Provoking an outcry from Irish politicians, the Commission quickly backtracked, but are now supporting an approach of vaccine protectionism as member states look to retain vaccines produced in European countries for their own people. In so doing, they are disregarding manufacturers’ agreements with other governments such as the UK, US and Australia. The World Health Organisation (WHO) has previously warned that such export controls mark a ‘worrying trend’ that risks compromising global supply chains and this new approach also comes as a surprise following various reports of distrust amongst EU leaders with regard to the Oxford/AstraZeneca vaccine. In January, France’s President Emmanuel Macron, suggested that the AstraZeneca vaccine was ‘quasi-ineffective’ for over 65s - quite possibly the reason for limited uptake of this vaccine in France so far, with just 273,000 doses administered out of the 1.7m received by the end of last month. Despite leaders now changing their minds and looking to hold on to the AstraZeneca vaccine at any cost, it might be a challenge to change public perception of this government-denigrated vaccine quite so quickly and to expect citizens to attend their offered appointments.

Meanwhile in the UK, vaccine nationalism began to emerge in 2020 with vindication for staunch Brexiteers. At the end of last year, health secretary Matt Hancock claimed that the UK’s success in approving the Pfizer/BioNTech vaccine - without having to wait for the European Medicines Agency (EMA) to do so - was ‘because of Brexit’ and the leader of the House of Commons, Jacob Rees-Mogg informed the house that ‘Germany, France and other European countries haven’t managed to do the same thing […] Draw your own conclusions […] as I’m sure the British public will’. These claims began to develop a rhetoric of ‘British success’ and consequent European failure. This national pride connecting coronavirus to Brexit was somewhat quashed, however, by chief executive of the Medicines and Healthcare Products Regulatory Authority (MHRA) June Raine, who was quick to counter that the UK had in fact enacted the approval under European rules - which remained in place for Britain until 1 January 2021. This idea of being better off because of Brexit has, however, not come out of nowhere. The EU has certainly made its fair share of mistakes. 

Europe was much slower to act. The UK’s first vaccine was approved on 2nd December but the EU’s did not come through until 21st December. As we know, mere days in this pandemic prove deadly so this delay has had serious repercussions for Europeans. Discussions with the EMA were not scheduled as promptly as they might have been and the EU was looking for a cheaper deal and was not prepared to take on the legal risks associated with the fledgling vaccines in comparison to the UK government which passed regulations to reduce legal protection for those injured by a COVID-19 vaccine. Distribution is also a major stumbling block. With 27 varying health systems across Europe, the success varies considerably. Some countries such as Malta and Denmark have vaccinated a healthy proportion of their population whilst Germany – often a trailblazer within the EU – now trails behind, having administered just 721,000 doses from the 2.1m of AstraZeneca that the country has received so far. 

So is vaccine nationalism always a bad thing? The controversy surrounding procurement and the demand for quick-thinking and risk-taking has stressed the importance of homegrown science. In the US, various emergent vaccine developments were funded which had the potential to succeed but could have just as easily failed miserably. Now with the Moderna vaccine being given out alongside the Pfizer vaccine and the Johnson & Johnson single-dose vaccine soon to facilitate inoculations in rural areas, US President Joe Biden anticipates enough vaccines for all American adults by the end of May. Despite the EU now looking to the US for possible help with doses, it would be understandable for Biden to put America first. 

This vaccine protectionism might not be as selfish and terrible as it sounds. There is a need for continued development and research into vaccines - whether we are set to fight another strain of coronavirus such as the disquieting Brazil P1 variant, or in preparation for another pandemic in the future. It is the responsibility of each country to fund and organise their own resources to protect their citizens. The £158m government funding towards the UK’s Vaccine Manufacturing Innovation Centre in Oxfordshire was a clear step taken by Prime Minister Boris Johnson’s government to protect its people and work to support its own vaccine rollout (and for any needed in the future). With European countries leaving scientists and laboratories unused as they wait for laggard guidance from the EU, it raises the question – how many more vaccines might be discovered and produced (for eventual global use) if every country were to engage their top scientists and begin to build more factories to manufacture vaccines themselves? No one is safe until everyone is safe (vaccinated). It behoves world-leading countries to set the tone and share resources with less economically and socially developed countries for the good of us all.