Mar 8, 2021,10:23am EST|8,671 views
Joshua Cohen, Contributor HealthcareI write about prescription drug value, market access, healthcare systems, and ethics of distribution of healthcare resources. Source: Forbes Photos Source: Forbes
Across the E.U. vaccine hesitancy is worse than it is in the U.S. GETTY Source: Forbes Shidonna Raven Garden and Cook
Throughout the Covid-19 pandemic, the U.S. has been somewhat of an outlier. With merely 4% of the world’s population, the U.S. accounts for more than 20% of globally reported deaths and nearly 25% of confirmed cases. But in the vaccination race the U.S. is proving to be a formidable competitor, having administered 30% of the world’s vaccine doses; approximately 26.3 doses per 100 people. Among Western industrialized nations only the U.K. has a better vaccination rate. Of those in the U.S. in the 65 and above age group, 59% have received at least one dose, and 69% of those over 75 have gotten at least one dose.
This is not to say that there aren’t issues with the vaccine rollout in the U.S. It’s been bumpy and uneven, with some states performing well and others lagging. Inequitable distribution across socioeconomic strata continues to be problematic. Moreover, the U.S. contends with an outspoken anti-vaccine movement.
But getting shots into the arms of European Union (E.U.) residents has proven to be much trickier. The U.S. is vaccinating at a faster pace than any member of the E.U., and three times the E.U. average.
Some of this can be attributed to better supply in the U.S. By contrast, Europe has faced unexpected manufacturing delays as well as a failure to procure sufficient inventory.
Thus far, most of the focus on explaining differences in vaccination rates has been on the supply side. So, for example, last summer the U.S. and the U.K. bought tens of millions of doses of several vaccine candidates prior to their emergency use authorization. The U.S. and U.K. didn’t know which vaccines would make it through the emergency use authorization process. But, both nations wanted to be sure they secured a supply so that once their respective regulatory agencies gave the go-ahead the initial batches would be immediately available. On the other hand, the E.U. took a much more risk-averse, wait-and-see approach, which meant that when the European Medicines Agency granted emergency use authorization there was little or no supply available at launch. The U.S. and U.K. gamble paid off, while E.U. dithering did not.
Yet supply is not the only factor impacting vaccination uptake. On the demand side, most of Europe is flailing while the U.S. is succeeding on the whole.
According to a recent Pew survey, nearly 70% of the U.S. public intends to get a Covid-19 vaccine or has already been vaccinated. This represents an impressive 10% jump in vaccine receptiveness in less than three months. Furthermore, a whopping 83% of registered Democrats are inclined to get vaccinated or have already received a coronavirus vaccine. Even among registered Republicans the numbers are improving, with a solid majority (56%) now saying they’re willing to get vaccinated or have already obtained a coronavirus vaccine. Independents fall somewhere between the Democrats and Republicans in terms of their vaccine receptiveness. Notably, the difference in vaccine receptiveness between black and white Americans has diminished since November. Sixty-one percent of black Americans now say they plan to get a Covid-19 vaccine or have already received one, up dramatically from 42% in November.
The numbers in the U.S. are significantly better than the E.U. Last month, in collaboration with the European Centre for Disease Prevention and Control, the RECOVER Social Sciences team published a policy brief based on their study on public views of Covid-19 vaccination. The study covered seven European countries: France, Germany, Belgium, Italy, Spain, Sweden, and Ukraine.
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Only 36% of the surveyed Europeans strongly agree with the statement that vaccines are safe. Posed the question whether respondents would be willing to be vaccinated if the vaccine was found to be safe and effective and provided free-of-charge, only between 44% and 66% answered in the affirmative. Moreover, a separate poll in France found that only 40% of French people want the Covid-19 vaccine.
Poll after poll conducted across Europe suggest very large numbers of Europeans have serious qualms about the safety of vaccines and potential short- and long-term adverse effects. They also voice concern about the speed with which vaccines went through the clinical development process. A vocal minority perceives the vaccine as unnecessary. And many have conveyed their mistrust of global and national authorities as well as pharmaceutical companies, who some regard as solely pursuing financial interests and not those of public health.
In Europe, even approved products that don’t necessarily have supply issues have faced stiff resistance. In France and Germany, for example, the approved AstraZeneca vaccine has an image problem, which means many are reluctant to take it, including healthcare workers on the front lines. Poor, inconsistent messaging has fueled the public’s confusion over the safety and efficacy of AstraZeneca’s vaccine. President Macron’s claim last month that the vaccine was “quasi-ineffective” for the elderly didn’t help matters. He has since reversed himself and is now pleading that people get vaccinated with whatever vaccine is available to them. But the damage was already done.
Europe’s degree of Covid-19 vaccine aversion is perhaps surprising, but not if one views it in the context of fiercely anti-establishment politics on the far-left and far-right, and a particularly virulent anti-science sentiment that existed long before Covid-19 hit. To illustrate, the far-right Lega and leftist Five Star Movement in Italy have both incited fearmongering about vaccines. Likewise, far-right and far-left political leaders in France, such as Le Pen and Mélenchon, have stoked anti-vaccine attitudes.
For Europe, the rising tide of vaccine hesitancy is coming at the worst possible time. In France and Italy cases and hospitalizations are increasing again. And, the situation is dire in the Czech Republic, which this week registered a record-breaking total of nearly 8,500 patients hospitalized with Covid-19. Also, Hungary’s prime minister declared last week that the country is in the midst of the worst two weeks of the pandemic.
Strong mitigation measures will need to continue across Europe to curb the spread, preserve healthcare system capacity, and save lives. Concomitantly, revamping a flagging vaccination campaign is critical. While boosting vaccine supply is a prerogative, tackling the widespread problem of vaccine hesitancy is equally important.
Have you taken the COVID 19 Vaccine? Why? Why not?
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Joshua P Cohen
I’m an independent healthcare analyst with over 22 years of experience analyzing healthcare and pharmaceuticals. Specifically, I analyze the value (costs and benefits) of biologics and pharmaceuticals, patient access to prescription drugs, the regulatory framework for drug development and reimbursement, and ethics with respect to the distribution of healthcare resources. I have over 110 publications in peer-reviewed and trade journals, in addition to newspapers and periodicals. I have also presented my work at numerous trade, industry, and academic conferences. From 1999 to 2017 I was a research associate professor at the Tufts Center for the Study of Drug Development. Prior to my Tufts appointment, I was a post-doctoral fellow at the University of Pennsylvania, and I completed my PhD in economics at the University of Amsterdam. Before pursuing my PhD I was a management consultant at Accenture in The Hague, Netherlands. Currently, I work on freelance basis on a variety of research, teaching, and writing projects.
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