A New York Times Op Ed today entitled “How Did Boris Johnson Get Covid Vaccines So Right?” by British journalist Samuel Earle lavishly praises the United Kingdom’s vaccine effort, but the real outcome from this program is yet to be determined.
The United Kingdom has one of the worst records of any developed nation in their handling of the COVID-19 pandemic. Early on in the pandemic, Prime Minister Boris Johnson resisted imposing a lockdown or other control measures.
Britain was late and limited in imposing most controls until the end of 2020. At that point high infection rates and a variant of the virus doubled the death toll and made Britain a pariah in the world community with one of the worst death rates in the world. Stringent lockdowns were then instituted and deaths finally dropped.
Britain has now suffered more than 120,000 deaths from COVID — more than any other country in Europe. Sadly, 20,000 of these deaths were estimated to have been avoided if lockdowns had been instituted earlier.
But despite listing all these catastrophes, the new OpEd focuses particularly on the recent “success” of the U.K.’s vaccination effort. The author points to what he describes as a “surprisingly successful vaccine rollout” that has caused “rising hopes.”
The author’s definition of success, however, is based simply on numbers as he points out that, “as of late February, Britain had vaccinated over 20 million people — more than a quarter of the population.” He points out that, “Only Israel, the Seychelles and the United Arab Emirates have moved faster” with vaccinations.
But there is a false economy at play here. Britain was able to vaccinate these people because they made several decisions that still appear to be scientifically unfounded if not unsound. Unlike the other countries in the comparison, Britain made the decision to give people only a single dose of vaccine. While there is evidence that, particularly with the RNA vaccines, a single dose can give 70% efficacy against infection with SARS-CoV-2, but potentially higher protection against serious illness, a single dose does appear to have limitations.
One particular limitation appears to be that one dose is less efficacious against variant viruses. This is of particular importance in the United Kingdom where most of the infections are now caused by a particular viral variant identified as B.1.1.7. While two doses of the Pfizer vaccine now appear to offer fairly strong protection against this variant, the lower antibody immune response seen with a single dose may not be as effective.
The other cornerstone of Britain’s vaccine program has been the early approval of their home-grown AstraZeneca vaccine. This vaccine is also given in a single dose despite the fact that the data on its efficacy in two doses have been difficult to interpret and it appears to provide less protection than any other currently approved vaccine.
Mr. Earle lambasts the European Union which is lagging in their vaccine program, and says this gives support to those who favored Brexit. Clearly the E.U. has had problems with their vaccine roll-out, but their decision not to license the AZ vaccine in several countries has been based on science, not expediency or politics. The E.U. zone is now using the highly effective RNA vaccines and will likely soon approve the Janssen vaccine which has defined efficacy with a single dose (unlike AstraZeneca).
Given the fact that most of the U.K.’s vaccinated population has had only a single dose of vaccine, they may be susceptible to infection from their variant virus. Thus, the real success of the U.K.’s vaccine program can only be evaluated after lockdowns are ended in the U.K. and individuals are allowed to again be exposed to infection.
If at that point their U.K. vaccine program protects the population, the accelerated way in which they vaccinated will be viewed as smart. However, there is also the possibility that infections will rise again after lockdowns are stopped, and the partially immunized U.K. population will serve as a reservoir to grow more aggressive, mutant COVID-19 viruses. If that is the case, Britain may be viewed as a failed clinical trial of a poorly conceived vaccine program.
Pandemic Pondering 