Pfizer or Sputnik? Race to vaccinate prompts calls for choice

Supplies are so tight in most of the world that choice remains impossible.
Supplies are so tight in most of the world that choice remains impossible.PHOTO: AFP

NEW YORK (BLOOMBERG) - Few people care who made their flu shot or their childhood immunisations against a range of deadly diseases. Covid-19 changed that, turning vaccine makers into household names and prompting calls for choice.

Doses remain scarce for now, amid a global scramble inflamed by a dispute between the European Union and British drugmaker AstraZeneca. Most of the more than 90 million people who have received a shot consider themselves lucky for any protection against the pandemic.

But vaccines are proliferating, with positive trial data from Johnson & Johnson and Novavax placing their candidates next in line for approval.

Health officials will have to figure out how to allocate all these different vaccines. Many people who have been boning up on efficacy rates, dosing schedules or side effects want to decide for themselves.

If the options are a shot from a Western drugmaker that has been vetted by an independent regulator or one from a Russian or Chinese lab with lesser transparency, that desire is even greater.

"We demand the government to provide people the freedom of choice," said Mr Gergely Arato, a member of the opposition Democratic Coalition party in Hungary.

Hungary broke ranks with other EU members to approve Russia's Sputnik V and a vaccine from China's Sinopharm alongside the three shots cleared by Europe's drug regulator - from Pfizer, Moderna and AstraZeneca.

While Prime Minister Viktor Orban is technically offering choice, his promotion of the Chinese and Russian shots is endangering people's "willingness to get vaccinated", Mr Arato said at a press conference this month.

In the United States, where the only two shots authorised so far - from Pfizer and Moderna - use similar technology and demonstrated virtually identical test results, choice may matter less for now. Elsewhere, however, some health authorities have begun catering to people's concerns about vaccine differences.

Dubai, Hong Kong

In Dubai, residents older than 60 or with pre-existing conditions can access the shot Pfizer developed with BioNTech, or the one from Sinopharm.

In Hong Kong, officials ordered enough doses of vaccines from Pfizer-BioNTech, Sinovac Biotech and AstraZeneca - along with plans to secure a fourth option - to cover the 7.5 million residents.

The Pfizer shot will be available at community vaccination centres, with the Sinovac and AstraZeneca options offered at private hospitals and clinics, and people will be given the choice of which they want to receive. That's important in Hong Kong, where some people are wary of taking a Chinese-made vaccine.

"If residents don't want to take a certain vaccine, they can choose to get the shots at another time and another location," Chief Executive Carrie Lam said in December.

Supplies are so tight in most of the world that choice remains impossible. Those getting shots often have no idea which one they will receive until they walk through the door of a vaccination centre or doctor's office.

But that could change if vaccines from the likes of J&J, Novavax and CureVac NV come on stream in the coming weeks, and as pharma giants like Sanofi and Novartis AG lend their heft to the production effort.

EU approval

Even if they do not offer choice, health officials have to decide who gets what.

At the Cleveland Clinic, Dr Cassandra Calabrese has been telling patients to take whatever vaccine they get offered, even though some have been asking her which one she would recommend.

"Things may be different as more are approved," she said in an e-mail.

The EU, criticised for its slow roll-out of the Pfizer-BioNTech and Moderna vaccines, expanded its offerings on Friday by approving AstraZeneca's shot.

In a sign of the growing tide of people wanting to choose, the approval came after days of pitched debate about the shot's efficacy, with Germany's immunisation commission recommending against its use in seniors.

In Britain, where infections and fatalities are much higher than in Hong Kong, health authorities are prioritising the quick inoculation of as many people as possible. The second dose of two-shot vaccines is being delayed in an effort to get first injections into as many arms as possible.

Other countries are considering similar steps.

Distribution is based on "supply and logistics, such as availability of very cold freezers", a British Department of Health spokesman said by e-mail. The Pfizer-BioNTech and Moderna shots must be kept frozen for long-term storage, while refrigeration suffices for the AstraZeneca vaccine.

Efficacy rates

Although Britain has set a priority list for vaccine recipients - starting with the oldest, most vulnerable people - it doesn't allocate the different shots based on a person's profile, the agency added.

So one 80-year-old patient might receive the AstraZeneca shot while someone else with the same age and health conditions might get the Pfizer one.

Some Britons are expressing a preference on the grounds of patriotism rather than what they might have read about different efficacy rates or side effects.

Never mind that the US company's vaccine was 95 per cent effective in large trials, compared with an average of 70 per cent for AstraZeneca's shot.

"They're saying they want to wait for the British one," Dr Jimmy Whitworth, a professor of public health at the London School of Hygiene and Tropical Medicine, said in a phone interview.

"I think that it's purely a nationalistic viewpoint."