The regulators have been blamed for taking too long to approve vaccines,

suppliers have missed delivery targets and more recently, 13 EU nations

suspended the use of the AstraZeneca shot over fears about possible side effects.

It is a messy picture, further complicated by the unique nature of European politics.

So, what's going wrong with the EU's vaccine rollout?

The European Union, a group of 27 advanced economies,

is lagging in terms of how many people have been vaccinated so far against coronavirus.

While Israel, the UAE and the U.S. are quite advanced in their vaccination drives,

the EU is only slightly above the global average inoculation rate so far,

despite extensive resources and advanced vaccine production capacities.

There are a few reasons behind these numbers,

starting with: how much was invested in research at the start.

If we look at the differences between how did the U.S. approach this

and how did Europe approach this, we see two quite different strategies.

The U.S. government said 'we are going to push money into the research and development,

we are going to subsidize and reduce the risk for companies,

we are going to push money in manufacturing, we are going to pay companies early on,

you scale up production even if we don't know if your product is going to be successful'.

Europe took a very different approach. They didn't put as much money into R&D.

Some, but not at the scale of the U.S. 

and instead they put all  of the emphasis at the end.

By the end of 2020, the U.S. government had committed almost $13 billion

to develop, manufacture and distribute vaccines.

In comparison, the EU has only invested about $1.2 billion in vaccine research

and another $3.4 billion in expanding production capacity.

And although this total doesn't include contributions from individual member countries,

it contrasts starkly with the efforts made across the Atlantic.

This brings us to the next step in putting together a vaccination program:

negotiating contracts with the vaccine manufacturers.

The European Commission, the executive arm of the EU,

assumed the responsibility for this task on behalf of the bloc.

By negotiating as one, smaller countries within the bloc

could leverage the body's power to secure access to the future vaccines and negotiate lower prices.

However, the Commission struck deals with the pharma firms later than the U.S. and the U.K.

While these countries inked  their first deals in May 2020, 

the EU only closed its first  vaccine agreements in August.

This three-month delay has been viewed as one of the reasons

why it took EU member states longer to receive Covid-19 shots.

Then there is the issue of vaccine approval.

The first pharmaceutical venture to announce positive results from its Covid shot

was a joint effort between American drug giant Pfizer and German firm BioNTech.

The U.K. greenlit their shot on December 2. 

In the U.S., the FDA approved the same vaccine on December 11,

while the European Medicines Agency only announced they had reached the same decision on December 21.

MHRA had adopted a rolling approval model, so they were obviously looking at data

at every stage of the process, from the early-phase lab-based studies

right through to the phase 3 trials. EMA was actually adopting a similar model,

but their systems are just a little bit less responsive and I think potentially more complex.

I think it's really important to emphasize that the rigor of both systems is really strong.

Even as other vaccines entered the market in the following weeks and months,

that didn't end the challenges for European nations.

In fact, the region has been receiving significantly fewer doses than it initially expected

from one supplier in particular: AstraZeneca.

The EU was initially expecting 90 million doses of AstraZeneca's vaccine in the first quarter of 2021.

However, the Anglo-Swedish pharmaceutical giant said it could only deliver 40 million doses

and then further revised this number down to just 30 million doses.

AstraZeneca has pinned the blame for the delay on low yields in European plants.

Like you, of course I am disappointed that lower-than-expected output

in our dedicated European supply chain has affected our ability to deliver,

but I want to assure you that we are working up production and doing everything that we can.

But then things got worse.

In addition to adjusting its first-quarter targets, the firm also said it could not deliver

the 180 million vaccines that the EU was expecting in the second quarter.

Instead, it will provide less than half.

We also know that AstraZeneca has unfortunately under-produced and under-delivered.

And this painfully, of course, reduced the speed of the vaccination campaign.

These delivery issues infuriated many officials in Brussels,

who are keen to ensure that the region gets as many vaccines as possible.

As a result, the Commission introduced restrictions on the export of Covid-19 vaccines at the end of January 2021.

Do you think that the EU is indeed practicing vaccine nationalism?

I think the EU is definitely prioritizing its population first

but no different from other high-income countries or regions.

The United States is doing the same, the U.K. is doing the same,

so in that sense, it is no different. I think where the nuance is a bit,

that we have to be careful with the notion that the EU is stockpiling vaccines,

they are rolling out the vaccines that they get.

Between the start of February and late March, the EU exported 43 million vaccines to 33 countries.

The U.K., which recently left the bloc in a messy breakup,

was the biggest recipient, receiving just under 11 million doses.

The European Union has indeed, we have to say, been exporting

quite a substantial amount of vaccines. These export bans are not particularly helpful

and because European strategy is quite focused on European production of vaccines,

we should move beyond this logic.

Beyond the delivery issues, the EU's vaccine program has also been clouded

by decisions to suspend the use of the AstraZeneca vaccine temporarily.

In mid-March, 13 out of the 27 EU nations halted injections of the AstraZeneca shot

after a number of blood clot cases were observed in people who had received this shot.

Our position is that the benefits continue to outweigh the risks.

The European Medicines Agency maintained that member states should continue using this jab,

even while reviewing the data from the incidents. But these nations opted for the most cautious approach.

This is actually a sign that the alert system is working.

These countries and Europe as a whole have a well-established mechanism

for reporting adverse events and it's not uncommon when you have got

millions of people being vaccinated that there will be events and they need to be studied.

On the other hand, it causes harm. So the pause is scientifically justified in terms of

'let's have time to look at the data and the cases', but the problem is that Europe as whole

and some countries in particular are facing another wave of Covid.

People are dying from this disease every single day. And if you only have a few days' delay in rollout

of a particular vaccine that is available, it means people will not receive it

and then at a population level you will have fewer people protected.

While most EU countries later resumed using the AstraZeneca shot after it was

deemed safe by Europe's drugs regulator, mistrust in the vaccine was growing.

A recent poll showed that German, French, Italian and Spanish citizens were

already less confident about AstraZeneca's vaccine compared with other shots.

But the same poll showed these citizens became even more skeptical about its safety following the suspensions.

And what about those countries in the bloc which continued to use the vaccine?

In Belgium, health authorities believed it would be “irresponsible” to halt its use

while the blood clot cases were being reviewed.

The additional challenge facing the EU is that while the Commission is responsible

for negotiating contracts and overseeing exports of vaccines,

most of the responsibility for health policy remains with the individual countries.

It's a big organization and often it is not easy to get everybody on the same page

but nevertheless, the negotiation tried to spread the risk between different options

because at the time nobody really knew which one, or which ones, would be able

to reach the market, being safe and effective.

And therefore there was a significant risk involved in choosing the different options.

But we also need to be aware that health has not been a part of the core tasks of the EU.

Do you think that perhaps countries would have been better if they had done this alone?

I think it is very unlikely, this is a very competitive situation,

to try and negotiate the vaccines, so eventually some of the bigger countries

might be better off because they have more bargaining power but then

the smaller countries would probably be in a more difficult situation.

There have also been issues at the national level, such as bureaucratic red tape

slowing down the initial distribution of vaccines in France.

But there are some brighter prospects ahead for the EU's vaccine rollout.

The EU expects to receive 55 million doses of Johnson&Johnson's single-shot vaccine,

200 million from Pfizer/BioNTech, 35 million from Moderna

and 70 million from AstraZeneca between April and June.

And this means the EU is well placed to achieve its target of

vaccinating 70% of the adult population by the end of summer.

This target is critical for the health of the bloc's citizens, and will also bring economic benefits.

The European Central Bank has projected a 4% increase in GDP this year

for the 19 countries that share the euro. However this forecast is heavily dependent

on a successful vaccine rollout, and it still doesn't lift economic activity to pre-pandemic levels.

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