AstraZeneca’s vaccine was banned in the Netherlands after four months, first temporarily and later permanently, after reports of rare and sometimes fatal thrombosis. Other vaccines appeared to be safer and slightly more effective. Several countries, including Belgium, gradually switched to the Pfizer and Moderna vaccines in 2021.
In our country, two people almost certainly died from the side effect, the Federal Agency for Medicines and Health Products (FAGG) announced in January 2022. In the United Kingdom, where the vaccine was developed, the side effect is believed to have cost 81 lives.
About the author
Maarten Keulemans is science editor at de Volkskrantspecializing in microlife, climate, archeology and genetic engineering.
Nevertheless, AstraZeneca’s decision to withdraw the corona vaccine from the world market is motivated by commercial interests, the pharmaceutical company itself emphasizes. There is no longer a market for Vaxzevria due to “a surplus of available adapted vaccines”, AstraZeneca said in a statement.
Beacon
Despite the gray veil, the vaccine mainly saved lives in the early phase: no fewer than 6.5 million lives after deploying a total of more than three billion doses, AstraZeneca quotes an earlier calculation. The company says it is ‘proud’ of the vaccine. Professor of Epidemiology Frits Rosendaal (LUMC) understands this: ‘Now we have alternatives, in 2020 we did not have them to a sufficient extent. This vaccine has also saved lives, we must not forget that.’
When corona emerged in 2020, AstraZeneca’s vaccine served as a beacon of hope for a while. At the University of Oxford, vaccinologist Andrew Pollard’s research group coincidentally already tested a vaccine against another coronavirus, the MERS virus, which suddenly gave the British a big lead. “All we had to do was exchange the spike protein,” Pollard said in the trade magazine at the time The BMJ.
When Pollard also joined forces with the established Swedish-British AstraZeneca, the optimism was complete: this was the vaccine that would defeat corona. “Probably the leading candidate,” WHO director Soumya Swaminathan said in June 2020, just after the first corona wave.
Errors in intent
But soon the problems started. During trials it was not clear exactly how well the vaccine protected, due to errors in the study design. And when the vaccine was ready, AstraZeneca suddenly announced that it would not be able to deliver even half of the promised 80 million doses to Europe. A failure that led to great irritation at the European Commission because of the company’s perceived blunt style.
While viewed from a distance, the vaccine still had major advantages. With its price of 1.78 euros per dose in Europe, it was much cheaper than the vaccines from Pfizer (12 euros) and Moderna (15 euros). It does not need to be cooled in complicated freezers and is therefore suitable for administration by a doctor or nursing home. And in independent measurements, the vaccine appeared to protect against hospitalization for 90 percent, even more than the manufacturer itself had expected.
Until, in April, the side effect ‘vaccine-induced immune thrombotic thrombocytopenia’ (VITT) suddenly appeared, an unusual condition in which people have fewer platelets in the blood, but dangerous clots in all kinds of unusual places, including the brain. After 34 million injections, 169 suspected thrombosis cases came to light in Europe, 18 of which were fatal.
Antibodies
What happens, Rosendaal explains, is that the vaccine induces antibodies in some people against a protein involved in blood clotting, ‘platelet factor 4’. As a result, clotting ‘suddenly starts like crazy’, says Rosendaal. ‘Platelets are affected, but also hyperactive. They’re all going to stick together.’
A condition that people who were vaccinated with Vaxzevria at the time no longer have to worry about, he emphasizes. ‘On those rare occasions when it happens, it happens immediately. Within a few days or at most weeks.’ The side effect is estimated to affect approximately one in thirty thousand people.
It turned out disastrously for AstraZeneca. In the Netherlands there was a temporary vaccination stop, which promptly led to deep divisions among experts: the temporary stop must have cost the lives of thirteen additional people due to corona, it turned out afterwards. Moreover, the name Vaxzevria became contaminated: by mid-2021, there were hardly any Western countries that still used it.
Economic decision
The vaccine also fell behind technically. The vaccine still provided very good protection against the first real mutated coronavirus, the ‘British variant’, but when the variants started to succeed each other at an increasingly rapid pace, Pfizer and Moderna proved to be better able to respond to this.
“I am not a business economist, but I understand AstraZeneca’s decision,” says Rosendaal. ‘If another drug is better, at some point you just have to stop. That doesn’t happen too often,” he praises the company’s decision.
That’s not the end of the matter yet. There are still ongoing lawsuits against the company in the US and Great Britain, among others, from patients who believe that AstraZeneca could have done more to prevent their suffering. The company only acknowledged the rare side effect VITT in black and white a few weeks ago for the first time, three years after it came to light.
Naturally, those affected are happy with the decision to withdraw Vaxzevria. “This means that no one can suffer from this horrible side effect anymore,” the British newspaper said TheTelegraph 47-year-old Jamie Scott, who suffered brain damage and became incapacitated after a shot of Vaxzevria.
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