Europe’s Been Cautious About Vaccines. Now It’s Paying the Price.
Here’s why vaccination rates in most European countries are only about a third of what they are in the U.S.
Even as the number of daily deaths from Covid-19 in the United States has fallen to levels we haven’t seen in months, continental Europe is now in the middle of a third wave of Covid infections, with a number of countries, including France, imposing new shutdowns in order to try to control the virus. This may be, in part, because Europe’s rollout of Covid vaccines has also been far slower than that of the U.S. and the U.K, and now it’s facing a new issue: Dramatically increased skepticism among many Europeans about the AstraZeneca vaccine.
This is a serious problem, given that the AstraZeneca vaccine is widely used in Europe, as opposed to the U.S. where it has yet to be approved. And it’s partly a self-inflicted problem. A couple of weeks ago, after a small number of reports of people getting blood clots after taking the AZ vaccine, a dozen European countries, including Germany, France, and Italy, suspended the use of the shot. There had only been around 30 reports of clotting out of roughly 20 million shots given, but policymakers decided, somewhat mysteriously, that the smart thing to do was to stop vaccinating people until the European Medicines Agency (EMA), which had already approved the vaccine, declared that it was safe and effective.
This decision was likely informed by the fact that Europeans are, on the whole, more skeptical of vaccines than Americans are. (France, in particular, is a hotbed of anti-vax sentiment.) The bet these governments made was that pausing vaccinations and allowing the EMA to do a review of the data would dispel people’s anxieties about the vaccine and instill more confidence in the process.
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Unsurprisingly, this did not work. The EMA said last week that the AstraZeneca vaccine was safe and effective, and that it is “not associated with an increase in the overall risk of thromboembolic events or blood clots.” But while European countries have resumed giving the shot, Europeans’ doubts about whether the vaccine is safe have risen sharply, raising serious questions about how likely it is that people will be willing to take it.
A new YouGov survey of attitudes toward the vaccine in the four largest countries on the continent — France, Spain, Germany, and Italy — finds that in all four countries, more people now say the vaccine is unsafe than safe, with a majority of people in France, Spain, and Germany declaring it unsafe. More strikingly, the percentage of people surveyed who think the vaccine is not safe has risen by 27 points in Italy and Germany, by 18 points in France, where people were already skeptical of the vaccine, and by 15 points in Spain.
Much of this increase is undoubtedly due to the media coverage of the supposed clotting problem, but the impact of that coverage was amplified, rather than diminished, by the governments’ decision to stop giving the vaccine. Far from assuaging people’s concerns, this move was practically designed to aggravate them. After all, if the vaccine were truly safe, why would a government decide to stop using it in the middle of a still-ongoing pandemic? And since the EMA had already approved the vaccine, the reaffirmation of its safety after a few days' study of the data was hardly going to convince anyone who was already wavering. In their attempt to placate anti-vax concerns, European governments effectively gave them more credence.
(There was news on Tuesday about AstraZeneca supposedly relying on “outdated data” when it made public comments Monday about its recent U.S. clinical trial. But that appears to be more a matter of how AZ reported results than a statement about the vaccine’s efficacy. The U.S. trial also showed no increased risk of blood clots.)
Beyond that, there was a deeper problem with the decision to halt the use of the vaccine on the basis of such a small number of reports of “adverse events” — it failed to take into account the costs of delaying vaccination. Every day you don’t vaccinate people means that people who otherwise would have remained healthy are going to end up in the hospital with Covid-related illnesses, and some of those people will die. The cost European countries paid for halting the use of the vaccine was more people in the hospital and more deaths. This is an unreasonable trade-off, given the small number of blood-clotting cases that had been reported.
In their attempt to placate anti-vax concerns, European governments effectively gave them more credence.
It is similar to the trade-offs Europe has been willing to make from the start when it comes to Covid vaccines. While countries like Israel, the U.S., and the U.K. threw lots of money at drugmakers, did not haggle over price, and granted liability waivers, all in an effort to speed up the process of getting their hands on vaccines, the European Union took a more deliberate, cost-conscious path. It haggled over price, with its chief vaccine negotiator saying in February, “Pricing has been important from the beginning.” And it haggled over liability waivers. This meant that negotiations with drugmakers took longer than they otherwise would have and that Europe was not at the front of the line when it came to distribution. There were other issues as well; some of the bets Europe placed didn’t pan out, and because it wasn’t flinging money at drugmakers, it wasn’t able to control their supply of vaccines as easily as the U.S. has. The result has been that vaccination rates in most European countries are only a little more than a third of what they are in the U.S.
Bargaining with drugmakers to hold down prices, and refusing to bear potential liability costs, may seem like economically sensible moves, but in this case, they were pennywise and pound-foolish. Even if you set aside the human costs of delaying vaccination—which we shouldn’t do—the economic costs inflicted by each extra day of the pandemic are so large that delaying your acquisition of vaccines by even a couple of weeks in order to save a few dollars a dose simply isn’t worth it. Indeed, given the effectiveness of all of these vaccines, and the costs of shutdowns, and reduced economic activity due to the pandemic, these shots would be a bargain at many times the price the U.S. is currently paying. Worrying about the difference between paying $4 a dose or $2 a dose for the AZ vaccine was an extraordinarily foolish thing to do.
At every step in the process of acquiring and now distributing vaccines, European countries have acted out of an abundance of caution, because consciously or not, they have underestimated the benefits of vaccination. They have put too much emphasis on visible costs — the people with blood clots, the dollars going out the door — and not enough emphasis on the invisible ones, the people who got sick and died because they did not get vaccinated in time, and the economic activity that isn’t happening because of the pandemic. Invisible costs may be harder to identify, but in this case, they’re far, far more pricey than the visible ones.