Coronavirus

[1andrew1]

Originally Posted by Maggy

Seems to me if you don't want it don't have it.I'm going to listen to my doctor first and foremost.

Fortunately, I don't think anyone's suggesting people don't get vaccinated on this forum.

In principle, the EU's decision to source the vaccine as a block rather than have member states compete against each other makes sense.

The problem is the Commission screwed up the procurement by being to slow to act. They took too long to place orders, they didn't place enough orders and they had a scattergun approach to which vaccines to back so out of the too few orders they had a bunch of them didn't get to release.

That last point is the true success of the U.K effort. Really placing large orders early shouldn't have been that difficult a task but the thing the U.K clearly did well was pick the right vaccines to back.

[1andrew1]

Originally Posted by Damien

That last point is the true success of the U.K effort. Really placing large orders early shouldn't have been that difficult a task but the thing the U.K clearly did well was pick the right vaccines to back.

I think's it really an early orders thing - from that FT chart I posted a few pages earlier, the UK, EU and USA have all backed the same vaccines with the notable exception being that the EU did not back the Sanofi-GSK vaccine.

Originally Posted by 1andrew1

Fortunately, I don't think anyone's suggesting people don't get vaccinated on this forum.

To be truthful it's hard to work that out..with all the naysayers and armchair warriors who seem to think they are experts in the field posting definitive statements.

[jonbxx]

Originally Posted by Damien

In principle, the EU's decision to source the vaccine as a block rather than have member states compete against each other makes sense.

The problem is the Commission screwed up the procurement by being to slow to act. They took too long to place orders, they didn't place enough orders and they had a scattergun approach to which vaccines to back so out of the too few orders they had a bunch of them didn't get to release.

That last point is the true success of the U.K effort. Really placing large orders early shouldn't have been that difficult a task but the thing the U.K clearly did well was pick the right vaccines to back.

Agreed, the way that the EMA works with having a multilevel approval process (drug approval, market approval, country approval) just isn't nimble enough in an emergency situation. The 'big bloc' approach definitely drove the costs down but, in this case, money pretty much wasn't an issue.

I was having a look earlier on what vaccines were ordered and possibly why and there's no consistent theme to explain the difference between the decisions the UK and EU made (if we take any suggestion of vaccine nationalism out of the equation) The main vaccine types are;

mRNA - the biggest unknown in that these have never been really used as drugs but really simple and quick to test
Pfizer/BioNTech - UK 40m, EU 600m
Moderna - UK 17m, EU 160m
Curevac - UK 50m, EU 405m

Adenovirus - bit more tested/known technology
AZ/Oxford - UK 100m, EU 400m
Janssen - UK 30m, EU 400m

Inactivated virus/virus subunits - classic vaccine, safest bet but the longest lead time
GSK/Sanofi - UK 60m, EU 300m
Novavax - UK 60m, EU 200m
Valneva - UK 100m, EU 60m

There's no real big differences in the purchasing decisions. There are differences in the proportions of each vaccine contracted between the UK and EU but no fundamental differences in what was ordered - the UK and EU bet on the same horses. It seems that speed was the winner here rather than betting on the wrong things.

Originally Posted by jonbxx

Agreed, the way that the EMA works with having a multilevel approval process (drug approval, market approval, country approval) just isn't nimble enough in an emergency situation. The 'big bloc' approach definitely drove the costs down but, in this case, money pretty much wasn't an issue.

I was having a look earlier on what vaccines were ordered and possibly why and there's no consistent theme to explain the difference between the decisions the UK and EU made (if we take any suggestion of vaccine nationalism out of the equation) The main vaccine types are;

mRNA - the biggest unknown in that these have never been really used as drugs but really simple and quick to test
Pfizer/BioNTech - UK 40m, EU 600m
Moderna - UK 17m, EU 160m
Curevac - UK 50m, EU 405m

Adenovirus - bit more tested/known technology
AZ/Oxford - UK 100m, EU 400m
Janssen - UK 30m, EU 400m

Inactivated virus/virus subunits - classic vaccine, safest bet but the longest lead time
GSK/Sanofi - UK 60m, EU 300m
Novavax - UK 60m, EU 200m
Valneva - UK 100m, EU 60m

There's no real big differences in the purchasing decisions. There are differences in the proportions of each vaccine contracted between the UK and EU but no fundamental differences in what was ordered - the UK and EU bet on the same horses. It seems that speed was the winner here rather than betting on the wrong things.

The purchasing decisions in the UK and the EU were both fundamentally sound. There are a range of vaccine types from a range of companies with varying experience. The difference between the two lies in their non-healthcare related policy aims. The EU’s decision to act on behalf of member states, whatever else it was meant to achieve, was an attempt at a deliberate post-Brexit display of the superiority of the EU’s concept of pooled sovereignty. All would benefit from the strength of the biggest members, and the power of the whole would secure the lowest prices and the most favourable terms.

Meanwhile in the UK, where for whatever reason we have not been very good at curbing the spread of the virus or stopping it from killing a lot of people, the overriding policy aim has been getting hold of lots of vaccines quickly. That led HMG to veto Oxford University’s intention to give its vaccine formula to an American manufacturer due to concerns over whether it could then be banned from export back to the UK by the Trump administration, and its strong urging that they choose a company that could manufacture in the UK. It also led HMG to prioritise rapid conclusion of deals over price, although its involvement in the Oxford-AstraZeneca tie-up has allowed it to negotiate at-cost terms for the duration of the pandemic.

It seems unlikely that the EU would have been able to directly intervene in the production process in the way we have done, although ensuring domestic production is less of an issue as they already have several sites in EU member states dedicated to that. The bigger issue for the EU is that trying to devise a system by which states could act together has taken time, acting in an unfamiliar policy area has taken time, and trying to prove the power of the EU by negotiating hard on price, delivery terms, IP rights etc has taken time. The EU has been let down by its inefficient bureaucracy and by focusing on political symbolism rather than on an unfolding public health crisis.

Hence why, if you take vaccine nationalism out of the equation, you can’t understand the disparity of performance. It was an attempt to deal in European nationalism that has put them in this mess.

[1andrew1]

Originally Posted by jonbxx

There's no real big differences in the purchasing decisions. There are differences in the proportions of each vaccine contracted between the UK and EU but no fundamental differences in what was ordered - the UK and EU bet on the same horses. It seems that speed was the winner here rather than betting on the wrong things.

Agreed.

One aspect that may have influenced the UK purchasing pattern was manufacturing location as the UK is keen to build up its vaccine manufacturing base.

Four groups - BioNTech-Pfizer, Moderna, Johnson & Johnson and Sanofi-GlaxoSmithKline — wanted to supply the UK solely from overseas. The other four groups — Oxford-AstraZeneca, Valneva, Novavax and CureVac — accepted funding to help develop and manufacture their products in the UK.

[jfman]

Originally Posted by Maggy

To be truthful it's hard to work that out..with all the naysayers and armchair warriors who seem to think they are experts in the field posting definitive statements.

I’m not aware of anyone being a naysayer or “armchair warrior”. It’s healthy to be sceptical of political spin when there’s competing science floating around.

The pandemic is over a year old and likely to extend to the end of this year and for the developing world well into next year. South Africa, or anyone else, taking an extra few weeks to see emerging data from the UK will make little fundamental difference to the end result.

Every individual should take the first vaccine they are offered, it’s the only one they are likely to see before Autumn. However at a national or international level I’m reluctant to place our scientists on a pedestal to the extent I’d apply their knowledge to everyone else’s situation that will vary depending on variants, vaccine supply and the infrastructure to rapidly deploy.

[jonbxx]

Originally Posted by Chris

The purchasing decisions in the UK and the EU were both fundamentally sound. There are a range of vaccine types from a range of companies with varying experience. The difference between the two lies in their non-healthcare related policy aims. The EU’s decision to act on behalf of member states, whatever else it was meant to achieve, was an attempt at a deliberate post-Brexit display of the superiority of the EU’s concept of pooled sovereignty. All would benefit from the strength of the biggest members, and the power of the whole would secure the lowest prices and the most favourable terms.

Meanwhile in the UK, where for whatever reason we have not been very good at curbing the spread of the virus or stopping it from killing a lot of people, the overriding policy aim has been getting hold of lots of vaccines quickly. That led HMG to veto Oxford University’s intention to give its vaccine formula to an American manufacturer due to concerns over whether it could then be banned from export back to the UK by the Trump administration, and its strong urging that they choose a company that could manufacture in the UK. It also led HMG to prioritise rapid conclusion of deals over price, although its involvement in the Oxford-AstraZeneca tie-up has allowed it to negotiate at-cost terms for the duration of the pandemic.

It seems unlikely that the EU would have been able to directly intervene in the production process in the way we have done, although ensuring domestic production is less of an issue as they already have several sites in EU member states dedicated to that. The bigger issue for the EU is that trying to devise a system by which states could act together has taken time, acting in an unfamiliar policy area has taken time, and trying to prove the power of the EU by negotiating hard on price, delivery terms, IP rights etc has taken time. The EU has been let down by its inefficient bureaucracy and by focusing on political symbolism rather than on an unfolding public health crisis.

Hence why, if you take vaccine nationalism out of the equation, you can’t understand the disparity of performance. It was an attempt to deal in European nationalism that has put them in this mess.

Remember though that like the UK, the member states could have set up Emergency Use Authorisations under EU law but chose not to (or at least didn't early on, Hungary has one on the go for Sputnik V) This is from Art. 5(2) of Directive 2001/83;

Member States may temporarily authorise the distribution of an
unauthorised medicinal product in response to the suspected or
confirmed spread of pathogenic agents, toxins, chemical agents or
nuclear radiation any of which could cause harm.

There's big questions from the public at least in Germany on why governments didn't do this

Originally Posted by jonbxx

Remember though that like the UK, the member states could have set up Emergency Use Authorisations under EU law but chose not to (or at least didn't early on, Hungary has one on the go for Sputnik V) This is from Art. 5(2) of Directive 2001/83;



There's big questions from the public at least in Germany on why governments didn't do this

Member states didn’t even have to participate in the vaccine procurement programme but the fact that they all did simply lends weight to the argument that there was a political, symbolic motive running alongside the public health concerns. A number of EU states were already well advanced in their own plans and they abandoned them in order to go with the EU scheme.

The real significance of them locking themselves into this scheme isn’t in the drug approvals process however. It’s in the scheme’s stipulation that a member state is not allowed to negotiate separately with any manufacturer that the EU is negotiating with. That’s why the group led by Germany stopped its activity. Any one of them could approve any drug at any time, but there could have been no advantage to them in doing that. They couldn’t have got supplies of any Western vaccine any quicker within the rules of the programme they locked themselves in to.

Hungary went with Sputnik V but as that was being rolled out for use on the basis of phase 1 and 2 clinical trials, with phase 3 still ongoing, that was a risk. Serbia and others that have bought the Sinopharm vaccine have likewise taken a chance that the Chinese government isn’t hiding anything. That’s a big assumption on any day of the week.

[jonbxx]

Originally Posted by Chris

Member states didn’t even have to participate in the vaccine procurement programme but the fact that they all did simply lends weight to the argument that there was a political, symbolic motive running alongside the public health concerns. A number of EU states were already well advanced in their own plans and they abandoned them in order to go with the EU scheme.

The real significance of them locking themselves into this scheme isn’t in the drug approvals process however. It’s in the scheme’s stipulation that a member state is not allowed to negotiate separately with any manufacturer that the EU is negotiating with. That’s why the group led by Germany stopped its activity. Any one of them could approve any drug at any time, but there could have been no advantage to them in doing that. They couldn’t have got supplies of any Western vaccine any quicker within the rules of the programme they locked themselves in to.

Hungary went with Sputnik V but as that was being rolled out for use on the basis of phase 1 and 2 clinical trials, with phase 3 still ongoing, that was a risk. Serbia and others that have bought the Sinopharm vaccine have likewise taken a chance that the Chinese government isn’t hiding anything. That’s a big assumption on any day of the week.

That's a good question - was the EU joint procurement scheme mandatory for EU states for vaccines? I have seen evidence that the PPE joint procurement wasn't (Denmark, Bulgaria, France, Lithuania, Portugal and Finland opted out link)

Don't get me wrong, I reaffirm that the Joint Procurement Schemes are not a nimble tool and not suitable for emergency use, I am just curious, once everything has settled, where the mud will stick

------------------------------------------------------------------------------------------------------------------------------
Ah, here we go, member states signed up to the vaccine JPA in June 2020 at a meeting of the European Council (heads of state) - https://ec.europa.eu/commission/pres...en/QANDA_21_48

Originally Posted by jonbxx

That's a good question - was the EU joint procurement scheme mandatory for EU states for vaccines? I have seen evidence that the PPE joint procurement wasn't (Denmark, Bulgaria, France, Lithuania, Portugal and Finland opted out link)

Don't get me wrong, I reaffirm that the Joint Procurement Schemes are not a nimble tool and not suitable for emergency use, I am just curious, once everything has settled, where the mud will stick

------------------------------------------------------------------------------------------------------------------------------
Ah, here we go, member states signed up to the vaccine JPA in June 2020 at a meeting of the European Council (heads of state) - https://ec.europa.eu/commission/pres...en/QANDA_21_48

In some ways, asking whether it’s mandatory is to misunderstand the way the EU works. It wasn’t mandatory, it was entirely outside of the EU’s competence and certain member states were already well advanced with their own plans. But everyone fell into line anyway. There is enormous peer pressure at the European Council (the forum for heads of government). They tend to negotiate into the small hours and achieve a consensus, with any individual isolated prime minister normally falling into line rather than risking the loss of good will that comes from using a veto. The actual use of one is rare. In this case there was no veto as it was a voluntary scheme but nevertheless the pressure to take part will have been significant.

[Pierre]

How did their ventilator procurement program pan out? We never heard anything else on that.

Originally Posted by Pierre

How did their ventilator procurement program pan out? We never heard anything else on that.

https://www.politico.eu/article/comm...zech-republic/

The European Commission sent 30 ventilators from its rescEU stockpile Thursday to the Czech Republic as it struggles with the worst rate of coronavirus infections in Europe.

https://www.eureporter.co/frontpage/...member-states/

As of 11 January, Belgium, the Netherlands and Slovenia will become new host countries for rescEU medical supplies. In addition, a second medical reserve will be hosted by Germany – already a rescEU host country. In total, there are now nine countries hosting the common European stockpiles of medical equipment.

Supplies now include:

- More than 65 million medical masks and 15 million FFP2 and FFP3 masks;
- more than 280 million pairs of medical gloves;
- close to 20 million medical gowns and aprons, and;
- Several thousand oxygen concentrators and ventilators.

[jonbxx]

Originally Posted by Chris

In some ways, asking whether it’s mandatory is to misunderstand the way the EU works. It wasn’t mandatory, it was entirely outside of the EU’s competence and certain member states were already well advanced with their own plans. But everyone fell into line anyway. There is enormous peer pressure at the European Council (the forum for heads of government). They tend to negotiate into the small hours and achieve a consensus, with any individual isolated prime minister normally falling into line rather than risking the loss of good will that comes from using a veto. The actual use of one is rare. In this case there was no veto as it was a voluntary scheme but nevertheless the pressure to take part will have been significant.

So who failed here? It sounds like the heads of state are not representing their respective countries interests at the EU Council, and that's a problem...