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OPINION: European governments were cautious on AstraZeneca vaccines but they were neither stupid nor ‘political’

It is the best of decisions and the worst of decisions. Everyone can claim to be right. Everyone is partly wrong, writes John Lichfield on the pausing of the AstraZeneca vaccination campaign across Europe.

OPINION: European governments were cautious on AstraZeneca vaccines but they were neither stupid nor 'political'
Photo: Christophe Stache/AFP

The European Medicines Agency handed down its judgement on Thursday. The AstraZeneca vaccine is effective and safe to use. Most European countries which had suspended AZ vaccinations are expected to resume today or in the next couple of days.

But – despite what is being reported by some – the EMA did not dismiss out of hand concerns that AZ shots can lead to blood clotting disorders in perfectly healthy young people.

The agency said that there was indeed evidence of “a small number of cases of rare and unusual but very serious” clotting problems associated with AZ.  Nonetheless, on balance, the EMA said, it had come to a “clear scientific conclusion” that AZ shots were safe to use. The huge benefits far outweighed the tiny risks.

Fair enough. Balance and clarity have been in short supply in this sorry saga until now.

Unfortunately, there is no sign that will change soon.

Were European governments wrong to suspend their AZ roll-out at the start of the week? The pause will undoubtedly have dangerous side-effects on vaccine resistance, and specifically AZ resistance, in European countries.

On the other hand, ploughing ahead regardless of the evidence of rare clotting disorders emerging in several places – in Norway, in Germany, in Austria and in Italy –  might have had an even more calamitous effect on public opinion.

Let us, for once, be fair to governments. They were placed in a very difficult situation. France, for instance, where there were very few AZ side-effects, did not want to suspend an AstraZeneca programme which had just started to take wing.

President Emmanuel Macron was bounced into his decision by a domino-tumble of suspensions imposed by Germany, the Netherlands, Italy and others.

France is the most vaccine-sceptic country in the world. How could Macron say that there was no reason to stop briefly to think when all his neighbours were stopping briefly to think?

READ ALSO How worried should France be about its vaccine-sceptics?

Little of this was reflected in the coverage in the British media. With some honourable exceptions, the consensus view in the UK was that the EU was being “stupid” or seizing on flimsy reasons to attack the AstraZeneca vaccines because a) AZ was British or b) AZ had failed to supply the EU with all its promised doses.

In other words, it was all “political”. In truth, it was the opposite. Politicians in a score of European governments decided, rightly or wrongly, that their political interest – the belatedly accelerating vaccine programme – must briefly give way to medical and legal considerations.

Only Belgium stood up to this trend. The Belgian government said that it would be “irresponsible” to interrupt an AZ vax roll-out which WOULD save thousands of lives because very rare side-effects  MIGHT take a handful of young, healthy lives.

That was a courageous decision by Belgium but I don’t think that it makes the decision taken by the others irresponsible. We live in a time of instant experts and easy answers but sometimes there are no easy answers.

It has been widely asserted in the UK media, and by the UK government, that there is no obvious connection between the AZ vaccine and clotting disorders. It is also asserted that such “thromboses” have actually been less common among the AZ-vaccinated than in the population as a whole.

Neither of these things, it now turns out, are true.

A Norwegian study found on Thursday that there was a clear link between AZ vaccinations and three youngish Norwegians who suffered rare brain thromboses or strokes, one of whom died. On Tuesday, Germany’s health ministry of health said that there had been seven cases of “cerebral venous sinus thrombosis (CVST), including three deaths, among the 1.6m million Germans people who had received an AZ shot. That was three or four times higher than the normal rate.

Science magazine reported that in five countries 13 people aged 20 to 50 had suffered from widespread blood clots, low platelet counts, and internal bleeding. Seven had died. This was “more frequent than would be expected by chance”.

“It’s a very special picture” of symptoms, said Steinar Madsen, medical director of the Norwegian Medicines Agency. “Our leading haematologist said he had never seen anything quite like it.”

I am not trying to start – or re-start – a scare story.

I think vaccination is great. I think the AZ vaccine is wonderful. One week ago I had my first shot in a French doctor’s surgery. It was AstraZeneca. I have a history of blood clotting problems. I have no regrets that I took the shot. I’m looking forward to my second in June.

The EMA and Belgium are right. The need to vaccinate rapidly against Covid is so urgent that, on balance, a small risk of clotting problems is a risk worth taking.

But that’s not so simple a choice as much of the British media – BBC included – would have us believe. Life-death accountancy is not straightforward.

Is it worth risking the lives of few young people who are broadly unthreatened by Covid to protect the lives of tens of thousands of vulnerable older people?

European governments had little choice but to stop to review the evidence. The easiest way to fuel anti-vaccine feeling in France – and probably other EU countries –  is to create the impression that vaccination is a politico-industrial juggernaut which cares nothing  for potential or actual side-effects.

Yes, EU countries are sometimes more risk-averse than Britain.

Yes, the UK has, so far, got away with, even hugely benefitted, from a series of risky short-cuts on vaccines.

Yes, the EU should find a way to make these common health decisions in advance, not after the damage is done.

Yes, President Macron and others were wrong to make baseless accusation against the AZ vaccine in the past.

Yes, the blood-clot scare will cause greater AZ-scepticism in the EU for a while (and then the effect will, hopefully, fade).

But for Britain to shout down understandable caution as “stupid” or “political” or “an EU attack on our vaccine” is foolish and hazardous. 

John Lichfield is the former foreign editor of the UK’s Independent newspaper. He also worked in Brussels covering the EU and spent 20 years as the France correspondent for the newspaper. He now writes opinion & analysis articles for a number of publications including The Local.

Member comments

  1. You have to make exceptions for the gammons as most only “read” the British guttersnipe press and believe every word that they print. Brexit is a prime example of that.

    1. Boggy, glad to see you and Joanne are sticking up for the privileged youth of Europe, lucky to have a choice of vaccines (when the EU eventually gets its act together?)
      Can I suggest that when you both are offered a vaccine, you decline to have it and request that your dose be donated to an older less privileged person in Africa or some other poor country who have no chance in the for seeable future of getting a life saving drug. You would of course give up any other entitlement to a vaccine, as this would mean stealing another person’s. Only fair don’t you think.
      As for me, i’m a gammon, guttersnipe reading older person who will have any vaccine offered and be thank full for it.

      1. You are obviously a prime example of a gammon. It’s such a great pity the Fourth Reform Act was passed and gave people like you and women the right to vote. My great grandfather used to say that England took a step back when women were allowed into the Lower House and it was even worse with the Life Peerages Act of 58′.

        Just because I would prefer the J & J vaccine does not mean I will participate in getting vaccinated. I prefer to let you guinea pigs test it first.

        1. Thats quite alright – choosing not to have the vaccine is entirely your right. However, it is worth remembering that Smallpox was eradicated because enough people had the vaccine. The only reason measles is still in circulation is because too many people refused the MMR – that has put the rest of the population at risk. So if you choose not to have the covid vaccine yet, just don’t expect to have the same freedom to interact with others until after you have had the vaccine as your choices shouldn’t impact on the health of others, just as you shouldn’t be forced to have the vaccine if you dont want it (unless of course there is a very god medical reason why you cant have the vaccine like allergy, pregnancy, suppressed etc).

      2. I quite agree – people who have no medical reason should not be permitted a choice of vaccine – if they choose to refuse a vaccine – as is their right – then they should go the bottom of the queue after everyone else. There are some very limited numbers of people where there is s a medical reason not to have a specific vaccine (allergy to ingredients, immunosuppressed, high risk of clotting etc) and that should be catered for, but for everyone else – take what you are offered or wait until everyone else has had their vaccines first.

      3. I have to donate to a less priviledged older person in Africa? Can you explain this opinion exactly please, because to me this does not make sense. It is the same as telling a child ‘eat your bread because in Africa children do not have bread’.
        It is the same as ‘this vaccine is safe because the WHO or whoeverr says so. The drug companies do not make statements ‘our vaccine is 100% safe’, they make sure not to be reliable if something goes wrong. And nobody knows at this point in time or it is as safe as anyone wants you to believe. Short term? reasonable safe. Long term? ???? nobody knows.
        Today they say A, tomorrow B, astrazeneca is today so safe that the french goverment does not allow it for under 55, while a week or two ago it was no good in the elderly. Are they crazy? maybe…… maybe they know more than we do………. maybe not crazy. Get a flower pull off the leaves, crazy, not crazy, crazy, not crazy, crazy etc. Time will tell…….

  2. Just refuse AZ, than the goverment will soon give a choice of vaccins! They want everyone vaccinated, I do not think many younger healthy people who will not die from covid like this risk! Why would you want to take it? Pain in the arm, feeling a bit tired, yes no problem to help others. Risking a brain bleed or death? not really. And even without the blood problems, nobody knows long term side effects yet, so how much risk is acceptable for the healthy younger population. Pain in arm plus tiredness plus some vague other side effects plus 0% guarantee this is safe long term, is enough risk in itself. So who refuses AZ is not a granny killer or selfish in my books!
    Am I going to take it when it is my turn in May or so? To be honest I feel very reluctant right now! Today they say A, tomorrow B. I think J&J is a better option, but who knows?

      1. That’s like delaying your car insurance. It might pay off for you , it might not. You’re assuming you won’t get the disease in the interim. Good luck.

          1. Yes but you are extremely unlikely to end up in hospital or die from Covid – seems like a no brainier

          2. Astrazeneca apparently changed name: Vaxzevria (previously COVID-19 Vaccine AstraZeneca)
            Why? I guess because too many young died, now people refusing. They hope it is quickly forgotten, in the weeks to come they only mention Vaxzevria, and no association with Astrazeneca, until the same happens………oops. All feels a bit dodgy, like a cover up.

    1. Refusing the vaccine without a good medical reason to do so should absolutely not result in you getting a choice of other vaccines – it should put you to the bottom of the queue after absolutely everyone else. The only people who should have a “choice” in which vaccines in this circumstance are those who are medically at risk from a certain type due to allergy or preexisitng medical condition which makes a certain type of vaccine an issue for them. There are too many people waiting for vaccines for fussy people to be catered for. If you dont want the vaccine fair enough but then you shouldn’t expect another until after everyone else has had theirs. Just remember EMA, WHO and all of the recognised bodies have repeatedly stated these vaccines are safe (except in very limited circumstances for very specfiic types of people).

      1. wow, I prefer not to have an injectable stuck in my arm without knowing long term side effects. Have you read the patient leaphley from Astra zeneca? I have even called them. They are unable to explain when feeling naussia is just a commen side effect (more often than 1 in 10 or when you urgently need to call in medical care. The answer is ‘we do not suggest you take this vaccin nor do we say don’t take it. I refuse Astra zeneca, you obviously trust whtever they tell you. First it was useless in the old, now healthy young people dropped dead and voila, France says only for those over 55. They say that because the who or whoever told them it is perfectly safe. I prefer not to have AZ simply because most people react quite badly to it, some say that’s good, extra immunity, I think the reaction is too strong for most people and I think too this might trigger other responses, auto mmune problems later on. The fact that several healthy 20 to 50 year old dropped dead is something I find hard to accept as ‘the price to pay for sociery. Another point is the goverment want everyone vaccinated, if they want that they might give people choice and not threaten ‘if you do not take it now, your turn is last’. Well if they want it that way…… I wait. This strategy might be unwise because I am sort of a super spreader…….. by not changing my mask when I sneeze or cough, not poisoning myself with desinfected gel every time I enter a shop, by touching my mask, by being alife and breathing.

        1. I must comment on your statement that “ most people react quite badly to it “ that is the AZ jab. I live in the UK and know many, many people who have had the vaccine with no side effects other that a sore arm and/or feeling of tiredness.
          I agree in an ideal world we shouldn’t be injecting rapidly developed vaccines into people. However, I think you might have noticed that this not an ideal world and our chances of dying from Covid are massively higher than from a possibly resultant blood cot or any other possible side effect. But ultimately it is a personal decision and I respect people’s decision not to have a vaccine although I really do not understand it !
          Also a comment to the author of the article – the consensus in the UK is not that we think European decision making is stupid or political ( unless you take the “ gutter press “ seriously), we are just bemused by the lack of a clear plan and the constant smoke from various politicians trying to blame others for what has been a very poor vaccination programme from start to finish.

  3. Mr. Lichfield, how many people do you estimate will become seriously ill or die as a result of the suspension? I’II be surprised if that figure is lower than the estimated 40 (forty) in 17 million that caused the now discredited link between the vaccine and blood clotting; because there is no proven causal link. More damaging, is the further undermining of confidence to now take up the vaccine (look at earlier post as it’s now typical). You say you’re not trying to restart a scare story, then suggest that the UK has “so far, got away with, even hugely benefitted, from a series of risky short-cuts on vaccines.” A company wouldn’t usually consider mass producing a new vaccine until they were sure that it worked, that’s obvious. However, the UK initiative took the financial risk to mass-produce the AZ vaccine in advance of study results, just in case they were successful, which they were. The ‘risk’ was to the UK government. If this is what you meant, you should make it clear rather than leave it open to misinterpretation that the risk is applied to the vaccine itself. However, I’m pleased that you have received the AZ vaccine yourself. For clarity, to all readers, my understanding is that the WHO, the EU drug regulator, and the Medicines and Healthcare products Regulatory Agency (MHRA) approved the vaccine as safe to use for all adults.

  4. It would help if a greater number of available vaccines had been administered instead of being left in the fridge or freezer! The EU is woefully slow in organising an effective vaccination programme, the result of which, the alarming resurgence of incidence and death rates, euro-wide.

  5. France waited on the EMA authorisations before starting their vaccination programme so why didn’t they follow their advice before stopping it ?

  6. Why don’t the authorities just get on with vaccinating the ‘forgotten’ tranche, and stop this pointless arguing about who’s vaccine it is. All the while its not in somebodies arm its useless.

  7. The EU “governments” have been both “stupid” and “political” sir, and many Europeans will now pay for it with their lives. The worst article I have read during this whole pandemic.

  8. This vaccine has undergone rigorous trials in the face of a pandemic. It has been authorised by the WHO, the EMA and MHRA and after today’s latest trials, shortly by the FDA. Macro et al should hang their heads in shame.

  9. I read a very long and detailed analysis of the issue with vaccine production and supply, especially as it relates to the AstraZeneca vaccine and the exclusivity clause that the British government inserted into their contract for supply (which is behind a large part of the supply issues into Europe). One comment that was made in that very long chain of discussion that is relevant here is this: Most EU countries take responsibility for the welfare of their citizens, and that demands caution when side effects were reported from this vaccine (as the side effects were statistically higher than expected). The UK government appears to have thrown caution to the wind and is willing to take risks with its population in its drive to get everyone vaccinated.

    You can decide for yourself which approach you prefer…If you think the risk is acceptable…I suspect if you think it is, it will remain acceptable only so long as it is not you or your loved ones that fall victim to that risk…

    1. Hi Rob. I think in reply I would say the view that the UK government has thrown caution to the wind and doesn’t take care of its citizens welfare is inaccurate, indeed very harsh. It was the UK government that financed the development of this vaccine which holds huge distribution advantages over many of the others when it comes to a global vaccination program. Equally, they have pursued strong lock-down measures, even if a week late in the first wave. Surely their strong pro-active vaccination approach including the 12 week vaccination gap (so that more people get protection) fully supports just how much they are caring for public health.
      The debate about this vaccines safety may continue for some time. Of course I understand that potential side-effects should not be ignored – that would be insane. But as at this time there is no proven link with the vaccine; indeed I have read (but not fact-checked) that the risk of clots is lower than that from taking the contraceptive pill. However what is for sure is the risk of hospitalization and death, even amongst the 18-49 year age group, from Covid, is significantly higher without being vaccinated.
      Meanwhile the virus is again out of control leading to further EU lockdowns and further economic hardship which will bring its own repercussions. I noticed Merkel said “everything is based on one principal and that is trust”. I wonder how many trust Sputnik V, a still unauthorised, adenoviral vaccine that may now be sourced from our beloved, trusted Russian friends.
      Terrible times. I hope everyone can receive their jab asap, whichever one is offered.

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OPINION & ANALYSIS

TRAVEL: How to spot Italy’s ‘fake authentic’ tourist villages

Ever visited a picture-perfect Italian village that felt too idyllic to be real? There's a reason for that, says reporter Silvia Marchetti.

TRAVEL: How to spot Italy’s ‘fake authentic’ tourist villages

Italy’s many beautifully authentic, ancient villages are a major reason why foreigners flock here, fall in love with the lifestyle, and often settle down for good. 

But in some places, that ‘dolce vita’ feel can be so well-fabricated that it is just fake.

It might have happened to you that while visiting an apparently idyllic borgo, or village, you felt there was something totally off with it; be it the neat windows, the empty, shuttered houses, the lack of locals around. Maybe it was so picture-perfect it seemed unreal.

There are places that have been totally restyled and hence lost their soul, and are just mere tourist postcards that contribute to distorting the real image of Italy abroad. 

They appear to be medieval, but even if they do date back centuries they’ve been given such a thorough makeover that everything is tidy and shiny, giving you the impression of being on a movie set.

MAP: The ‘best’ Italian villages to visit this year

I’ve visited some of these villages, and what hit me was the attempt to recreate that ancient vibe just to fool visitors – while at the same time destroying what Italy’s authentic villages are all about.

Most have been elegantly restyled. This is positive given they might have otherwise ended up in the grave as ghost hamlets, but the extreme ‘maquillage’ has killed the original spirit of the place.

The ancient village of Castelfalfi, in Tuscany, dates back to pre-Roman, Etruscan times and is – was – a jewel. Following massive real estate investments it has turned into a luxury retreat for wealthy foreigners looking to bask under the Tuscan sun. 

Pretty as a picture – but where is everyone? Castelfalfi, Tuscany. Photo: Silvia Marchetti

During winter everything is shut, boutiques sell modern things and signs are written in English. The vast estate, formerly belonging to aristocrats, has been transformed into a huge golf club, and local residents are nowhere to be seen. There’s even a high-end restaurant in the castle tower for lavish meals. But no matter how beautiful it is, it gave me a feeling of sadness and emptiness.

I think places like this feed and recreate that stereotypical idea of a typical rural Italian setting, of elegant mansions with pools, ceramic boutiques and flower shops.

Nearby the village of Certaldo di Castro is another example of a fake old-style spot. It is indeed medieval and is famous for being the hometown of Italian poet Boccaccio: his museum-house is a must-see and the main highlight. You get to admire his room, bed, slippers and nightgown – that’s why I visited.

OPINION: Why Italy must put its forgotten ‘ghost towns’ up for sale – or risk losing them forever

But other than that, it seems like the whole village has been rebuilt solely on Boccaccio’s legacy – there are just a few bars, restaurants, and B&Bs. No real village buzz, no elders sitting on benches. Last time I went, and it was during Christmas, most places were closed and I ended up eating a panino. 

The reddish roads and brick tile roofs have been perfectly fixed as per medieval style, and the chapels are also stunning. But life seems to have been frozen in time when Bocaccio inhabited it.

Certaldo di Castro has impressive medieval history but no village life. Photo: Silvia Marchetti

I recently drove hundreds of miles to explore what has been named as one of Italy’s most beautiful towns, Greccio. I found a ghost town.

It was perfectly renovated, but all shutters were down and not one single resident could be spotted. There were just holidaymakers having picnics on benches.

The streets were super clean. The stone walls were covered in paintings by local artists, hailing peace and friendship among countries; images that have nothing to do with the town’s old roots, nor character.

I must say it was a real disappointment. It surely is one of those places that come to life on weekends or during summer, when people visit. It is not ‘vissuto‘, as Italians would say, meaning it is not ‘lived’.

In the Tiber valley, the Calcata hamlet is a top destination for Romans looking for a weekend escape. The village is aesthetically charming, shaped like a giant mushroom jutting out of a deep green chasm. It’s perched on a reddish-brown hilltop overlooking a pristine river, with cave houses, moss-covered cobbled alleys, tunnels and wall openings overlooking a thick jungle-like canyon. 

READ ALSO: Mass tourism is back in Italy – but the way we travel is changing

But the original residents no longer live there and it’s become a ghetto of hippies and artists who each weekend come to turn it into an Italian-style Halloween village. Witchy objects, pumpkins and puppets are everywhere, while souvenir shops and boutiques sell weird, spooky amulets. Benches and doors are painted in bright colors and restaurants prepare exotic dishes.

This has killed the original old vibe, and though I love the scenery, I dislike the ambiance and village decor, which has nothing to do with its history.

Calcata is very similar to Civita di Bagnoregio, also in the Lazio region, dubbed the ‘dying city’ as soil erosion could make it crumble any day. 

Civita is world-famous for its dramatic scenery: sitting on a rock surrounded by a precipice, one single narrow bridge connects it to the mainland. I visited it several times: ten years ago it was lively. 

READ ALSO: Ten must-see places within reach of Rome

Two years ago, it was Easter, and I found a dead city. Just three locals going up and down the bridge, and a colony of hungry cats. It’s just luxury expensive B&B’s, taverns, souvenir boutiques and spots for selfie addicts. Artists and VIPs use it as their lair, yet despite its breathtaking beauty there’s really not much left.

I stayed the night once and ended up taking the car and driving to the nearest town for a slice of pizza for dinner because I couldn’t find an open trattoria.

If you can’t find so much as a single tavern open, no matter which day you visit, and if you don’t overhear some chit-chat among local grannies or some gossip at the bar, then you’ve likely landed in a ‘fake-authentic’ Italian borgo: perfect but unreal.

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