EU’s Vaccination Programme: What Went Wrong?

Most of Europe’s battle against COVID-19 has taken place at the state level, or in federal countries beneath it. It was there that choices were taken on how people should be locked down, how money could be allocated, and how to handle monitoring and isolation conditions.

Early on, the reaction seemed to be more than just national; by the end of April 2020, 17 countries in the essentially border-free Schengen zone had told the EU’s executive that they had reintroduced restrictions.

When polled, Italians were more inclined than Europeans to see China as helpful in their time of need.

To combat centrifugal trends, Angela Merkel, Germany’s chancellor, and Emmanuel Macron, France’s president, pressed for the EU’s core institutions to be given significant new powers to keep its members together. A recession was seen as an excuse to centralize, as it was in 2012 when the euro crisis saw the European Central Bank (ECB) taking a more robust view of its powers, then in 2015 as an increase in immigration strengthened the EU-wide frontier force.

It is clear that certain European countries have elevated levels of vaccine reluctance among adults, and that some have ineffective public institutions. However, the fact that all members of the Bloc are performing poorly in comparison to peers elsewhere clearly indicates a joint procurement problem.

France’s President Macron told a Greek television programme on March 24th that Europe had “lacked ambition” in its vaccination activities from the beginning. He confessed to being sceptical of Donald Trump’s claims that a vaccine will be available in time for the November elections in the United States.

As a result, Europe had concentrated its efforts — “whatever it takes,” Mr Macron said, quoting a phrase from the Euro crisis — on rescuing its economy. Britain, which did a worse job than the rest of Europe in containing the first wave of the disease, and America, which never recovered from the first wave’s high incidence of new cases, went all-in on the vaccine.

The need for new skills has slowed things down. In Europe, state or municipal governments are in charge of health care. Aside from a centralised European Medicines Agency (EMA) that licences new drugs, the majority of health-related decisions are made at the national level. The EU can only “complement” their behaviour.

When it came to purchasing vaccines quickly and in vast numbers, allowing states to do their own thing seemed to be a challenge. The major ones, including those with vaccine manufacturing facilities within their boundaries, would be fine. In the spring of 2020, France, Germany, Italy, and the Netherlands signed a deal with AstraZeneca (AZN) for up to 400 million doses of vaccine, the Anglo-Swedish pharmaceutical firm that is funding the Oxford University-developed vaccine.

So what about the states with a lower population? What about the possibility that some would do much better than others? How will the EU be called a union if the Czechs had vaccinations but the Slovaks didn’t, or if a well-vaccinated country became concerned with tourists from a much less-vaccinated neighbour?

As a result, it was decided that procurement would be delegated to Brussels, with the original four-country AstraZeneca contract grandfathered in. It seemed fair, and the commission appreciated the added burden. However, unlike Paris, Berlin, and Rome, where officials are well-versed in purchasing everything from a new form of frigate to a railway line, Brussels has no experience handling large-scale procurement, particularly not at high speed in a changing landscape.

After the decision to centralise procurement was made, there was no follow-through.

Exhausted negotiators and EU officials were eager for a rest after discussing the outlines of the economic package in July. The occurrence of COVID-19 was limited, and experts disagreed about whether a second wave would occur. In an average month, 300 meetings of national diplomats are held to advance the union’s business. There will be ten in August 2020.

On August 19th, a summit was held to address Mali, the Eastern Mediterranean, and Belarus, but the pandemic was not on the agenda. There was no new information on vaccine procurement.

Regulations were also a concern. And, although the United States and the United Kingdom used fast-track permits, which reduced the suppliers’ liabilities until the vaccinations were ready, the EMA used slower procedures. This was painted to dispel public fears over a hurried job.

Europe’s divisions did not help. Any poorer European countries were put off by the cost of MRNA vaccines produced by BioNTech, a German biotechnology firm, in collaboration with Pfizer, an American pharmaceutical company. Other diplomats believed that France and Germany, the EU’s pharmaceutical powerhouses, were assisting their domestic industries; a large vaccine order went to Sanofi, a French drugmaker.

It wasn’t until January that the full scope of Europe’s vaccination disaster became clear (citing the chart on the left). The Sanofi vaccine had been severely hampered by trial findings in December, which had blown a massive hole in the expected supply. Then AstraZeneca revealed that it would only be able to provide a fraction of the doses it had promised, claiming that it had only made the “best practical attempts” to supply them on time. The commission’s lack of procurement experience came into full relief as AstraZeneca provided relatively more vaccines to Britain.

The EU has since come under criticism for fueling “vaccine nationalism,” attempting to limit exports to Britain, in part because it is seen as a bulwark against protectionism (Australia has also had EU-made vaccine withheld). As a general allegation, this is unjust: the EU permits large-scale export of COVID-19 vaccines. However, it has had to be more forthright about prioritising itself over others. On March 25th, European leaders tentatively agreed to tighten export controls.

These causes, together with a few others, have resulted in the EU’s sluggish vaccine rollout in contrast to other countries of similar growth. Nonetheless, the EU is catching up.

President of the European Commission Von der Leyan told the Guardian:

“I understand very well the impatience that, now that the vaccine is available, citizens want to be vaccinated as quickly as possible and finally be protected,” she said. “We’re catching up. Britain has inoculated 17m first doses. There are 27m in the EU.