How AstraZeneca went from pandemic hero to villain
“What we have with AstraZeneca is a company that is not straightforward, that cannot be relied upon,” Philippe Lamberts, a Belgian member of the European Parliament, said in a radio interview with the BBC on Wednesday.
“They’ve made one mistake after the other,” said Jeffrey Lazarus, head of the health systems research group at the Barcelona Institute for Global Health.
The AstraZeneca vaccine is administered to a patient at a pharmacy in London.
Leap of faith
AstraZeneca entered the Covid-19 crisis with little vaccine experience. In recent years, it generated a large portion of its revenue by producing popular cancer drugs, such as Tagrisso, which is used to treat lung cancer.
But when the pandemic hit, the company decided to enter the race to develop a game-changing shot.
“I don’t think they ever had any intention to be a vaccine company,” said Andrew Berens, a pharmaceuticals analyst at SVB Leerink. “I think that the reason they embarked on this — and they’ve been pretty apparent about it — is they wanted to help humanity and fight the scourge of Covid.”
AstraZeneca generated more goodwill by pledging to supply its vaccine at no profit during the pandemic, and by partnering with the Serum Institute of India, which agreed to produce more than 1 billion doses for low and middle income countries.
“They came into an area they’re not known for and they did really well,” Lazarus said.
Misstep after misstep
Almost immediately, however, problems started cropping up. Before AstraZeneca’s shot received emergency use approval, the company faced questions about data from large-scale trials presented in November.
Volunteers received different doses due to a manufacturing error, creating confusion about its actual effectiveness. AstraZeneca did not mention that a mistake caused the dosing discrepancy in its initial announcement, generating concerns about a lack of transparency.
“I hate to criticize fellow academics, or anyone for that matter, but releasing information like this is like asking us to try and read the tea leaves,” Dr. Saad Omer, a vaccine specialist at the Yale School of Medicine, said at the time.
A nurse prepares a dose of the AstraZeneca vaccine at the Edouard Herriot hospital on Feb. 6 in Lyon, France.
Lazarus called such issues “easily avoidable,” since they were tied to trial design.
AstraZeneca has said that its clinical data supports efficacy in the over-65 age group. In an interview in January, CEO Pascal Soriot said that Oxford scientists running the trials did not want to recruit older people until they had “accumulated a lot of safety data” for those aged 18 to 55.
Had the vaccine rollout been smooth, such stumbles may have been forgotten. But continued shortages of shots in Europe, which is now facing a third wave of coronavirus infections, have triggered a political crisis in the bloc. EU leaders are meeting Thursday to decide whether to adopt European Commission proposals for even stricter controls on the export of vaccines made in the bloc, including AstraZeneca’s.
“We have the option of prohibiting a planned export,” European Commission President Ursula von der Leyen said in a recent interview with German publishing group Funke Mediengruppe. “That is the message to AstraZeneca: You first fulfill your contract with Europe before you start delivering to other countries.”
European countries have expressed frustration that the United Kingdom appears to have been prioritized for delivery while it faces shortfalls, and that, unlike others, they have been sending tens of millions of doses abroad.
A spokesperson for AstraZeneca rejected reports that the doses were part of a “stockpile,” saying that the vaccine was made outside the European Union and that it had been brought to the factory to be filled into vials before distribution within Europe and export to low and middle income countries.
EU Commission Vice President Valdis Dombrovskis said he could not comment on the origin or potential use of the doses reportedly discovered in Italy, but noted that the drugmaker is “very far away from their contractual commitments.”
Some politicians, and media outlets, may be looking for a scapegoat as vaccination programs stumble.
Yet Simona Guagliardo, an analyst with the European Policy Center, said AstraZeneca’s delivery delays have “certainly played a role in slowing down the rollout across Europe.”
“What appears clearly is AstraZeneca may have overpromised in terms of distribution compared to the effective production capacity,” Guagliardo said.
Tough path forward
According to Prashant Yadav, a medical supply chain expert and senior fellow at the Center for Global Development, AstraZeneca seems to have spread itself too thin, with a far-reaching supply chain that’s more likely to run into hiccups than those powering vaccines by Pfizer and Moderna. AstraZeneca touts having built more than a dozen regional supply chains to produce its vaccine, with more than 20 partners in over 15 countries.
It’s also more difficult to predict how much vaccine can be produced from batches of AstraZeneca’s product due to the type of components it contains, Yadav added, though that variability perhaps could have been anticipated when drawing up contracts. AstraZeneca did not provide comment for this story, but it has cited “lower-than-expected output from the production process” as a major complication in Europe.
“As our teams learn from each other and improve their knowledge, the yield is increasing,” Soriot said in February. “Manufacturing of a vaccine is a very complex biological process.”
But other concerns — like the alleged misrepresentation of data in its recent US trials — have undoubtedly damaged the company’s reputation, especially in comparison to other drugmakers that have produced safe and effective vaccines but generated fewer negative headlines.
Ronn Torossian, CEO of 5W Public Relations, noted that AstraZeneca’s slip-ups come at a time when distrust of authorities and the benefits of vaccination remain high, raising the stakes.
“The public’s already skeptical,” he said. “I think it’s a very, very difficult thing for AstraZeneca to solve at this juncture.”
Berens of SVB Leerink thinks the company will be able to move past these problems — especially since making vaccines isn’t a business it relies on to make money.
But Berens does wonder: If AstraZeneca could go back in time, would it choose to get involved in resource-heavy vaccine production again? On that count, he’s not so sure.
— Chris Liakos contributed reporting.
