Brexit: vaccine wars

18/03/2021

Go back to the beginning of 2016, before even the referendum was announced, and think through how you would have responded if asked to predict what the general situation would be vis-à-vis the European Union.

I for one, did not expect a referendum in 2016 – I didn't think Cameron would be so rash as to commit the nation to such a contest at such short notice, when he had so little time to prepare his case. And, whenever he did hold a referendum, I expected the "out" campaign to lose – on the premise that Cameron would come up with something substantial by way of his renegotiation.

Predicting an early referendum with "leave" winning, multiple changes of prime minister, delayed negotiations, and then a botched Brexit, would have been difficult enough to predict. But then throw in the Covid-19 pandemic and I vouch that you would have needed supernatural powers to be even close to guessing where we would stand.

But we now have to add a further element to the mix, the ongoing vaccine saga which, rightly or wrongly, is pitching the EU against the UK, and stoking up nationalist sentiment in the baser elements of (largely) English society.

This is tied up with the suspension by some EU Member States of the use of the AstraZeneca vaccine, following a number of reports of blood clots in recently vaccinated people.

This has brought any number of armchair experts into play, including the vile Rod Liddle who is currently declaring that, "If you ever needed a reason for Brexit, the EU's coronavirus vaccine stupidity is it".

Writing in The Sun, this "expert" tells us that we might have read that "a bunch of European countries have suspended use of the AstraZeneca vaccine because some people who had them later developed clots. And some died from them". The number, says Liddle, is about 37 out of 17 million.

"This", he intones, "proves to me a few things. First, that politicians just do not understand statistics and risk. Especially French and Slovenian politicians. Second, that the EU is still riven with a hatred and enormous envy of the UK right now". He adds:

Envy at the speed and efficiency with which we have rolled out our vaccination programme, compared to the hopeless mess in which the European Union finds itself. Never was there a better advert for Brexit. The same dimbo, embittered, EU politicians who railed against the UK "hoarding" the vaccine are now suggesting it's dangerous.

Liddle continues on this theme, asserting: "If they were a bit brighter they would understand there is no meaningful risk from the vaccine. Blood clots are common".

According to all the data already compiled, he then tells us, "the number of clots discovered among people who have had the jab is LOWER than you would expect on average in the population, without a jab".

And this, to Liddle, "is the only point that matters". There's no meaningful link between the injection and blood clots, he asserts, then concluding: "That's why - a little late in the day, as ever - those EU countries are now poised to admit they were utterly and totally wrong".

However, it will come as no surprise to find that the situation is a little more nuanced than Liddle would have us believe. As regards German experience, the Paul-Ehrlich-Institut explains why the use of the vaccine was suspended:

A specific form of severe cerebral venous thrombosis associated with platelet deficiency (thrombocytopenia) and bleeding has been identified in seven cases (as of 15 March 2021) in temporal association with vaccination with COVID-19 Vaccine AstraZeneca.

(1) It is a very serious disease that is also difficult to treat. Of the seven affected individuals, three individuals had died.
(2) The affected individuals had ages ranging from about 20 to 50 years.
(3) Six of the affected persons had a particular form of cerebral venous thrombosis, called sinus vein thrombosis. All six individuals were younger to middle-aged women. Another case with cerebral haemorrhage in platelet deficiency and thrombosis was medically very comparable. All cases occurred between four and 16 days after vaccination with COVID-19 Vaccine AstraZeneca. This presented as a comparable pattern.
(4) The number of these cases after vaccination with COVID-19 AstraZeneca is statistically significantly higher than the number of cerebral venous thromboses that normally occur in the unvaccinated population. For this purpose, an observed-versus-expected analysis was performed, comparing the number of cases expected without vaccination in a 14-day time window with the number of cases reported after approximately 1.6 million AstraZeneca vaccinations in Germany. About one case would have been expected, and seven cases had been reported.
(5) The younger to middle-aged population affected by the severe cerebral venous thrombosis with platelet deficiency is not the population at high risk for a severe or even fatal COVID-19 course.
(6) In addition to the experts from the Paul-Ehrlich-Institut, other experts in thrombosis, haematology, and an adenovirus specialist were consulted with the details of the reported cases. All experts agreed unanimously that a pattern could be discerned here and that a connection between the reported above-mentioned diseases and the vaccination with COVID-19 Vaccine AstraZeneca was not implausible.

The summary report continues for several pages, augmented by a report in Science magazine, recording the tension between public health workers and vaccine safety officials.

The latter group say they did not take the decision lightly, and that symptoms in at least 13 patients, all between ages 20 and 50 and previously healthy, in at least five countries are more frequent than would be expected by chance. "It's a very special picture", says Steinar Madsen, medical director of the Norwegian Medicines Agency. "Our leading haematologist said he had never seen anything quite like it".

Karl Lauterbach, a German politician and epidemiologist, says he would have let the vaccinations continue while the safety concerns are investigated. But Clemens Wendtner, a haematology and infectious disease specialist at the Munich Clinic, Schwabing, says officials had little choice given the severity of the reactions.

In communicating about vaccine or drug safety, he says, "there is nothing worse than trying to sweep things under the rug". If the investigations show there was no connection to the vaccine, he says, "then we can be even more certain that the vaccine is safe".

Of course, such people are nothing as compared to "experts" such as Rod Liddle, who so gallantly informs the British public about "dimbo, embittered, EU politicians".

Yet, these same EU politicians are struggling to balance reported risks – and perceptions of risk, which in many instances are just as important – with the availability of vaccine supplies, against the background of a "third wave" of Covid-19 forming in Member States, as the mainly B117 strain (the so-called "Kent" strain) takes hold.

This has led von der Leyen to consider whether EU-based vaccine producers should be allowed to continue exporting doses to the UK, which does not reciprocate.

The Commission President is concerned that 41 million vaccine doses have been exported from the EU to 33 countries in six weeks, with more than ten million going to the UK. That is more than the total administered in the UK during February, and more than a third of the total.

On the other hand, there is no record of UK-produced vaccines being exported to EU Member States, leading von der Leyen to consider whether to impose export controls on products manufactured in Europe, stopping them being sent to the UK.

With a shortage of supplies also being predicted in the UK, this has the Telegraph running a story which has VDL accused of "acting like a dictator".

David Jones, the deputy chairman of the ERG, says: "This is the kind of conduct you expect from racketeers, not respectable international organisations such as the EU" – probably the only time an ERG member has called the EU "respectable".

But, while not even its best friends will accuse the EU Member States, or the commission, of acting with stellar efficiency in handling the vaccine rollout, there really is no call for this sort of thing.

Covid-19 is a pandemic and it is in the interests of the UK to see that the vaccine programme in the EU – as well as the wider world – is successful. There is little point in the UK completing its programme if Europe and elsewhere end up as incubators for new strains which reinfect the British population.

As Johnson keeps referring to our "friends" and "partners" in Europe, it is about time this language was given effect. There were, in my view, good reasons for leaving the EU, but we are now out. Neither the EU nor its members are our enemies. We can, therefore, do without the bellicose rhetoric.

Beating the virus should be our priority – not scoring points in a battle that has already been won.

Also published on Turbulent Times.