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Britain is going through its darkest days in the pandemic. The delayed effect of a highly contagious virus variant has pushed daily deaths to double digits. Hospitals are struggling to cope with a higher caseload than at the peak of the first wave last year. Yet the encouraging early pace of its vaccine rollout is one of the weaknesses.
From purchasing protective gear to the testing and traceability program, from its lockdown deadlines to its handling of school exams, much of the government’s response to Covid-19 has been late, or just plain inept. . There are reasons why per capita deaths in the UK are in the top five worldwide. But on vaccinations, with nearly 5 million people, or 7.5% of the population already receiving a first shot, the UK is ahead of any major economy. It lags behind Israel, the United Arab Emirates and Bahrain in terms of vaccinations per capita.
The success reflects, in part, that the NHS and public health bodies are at the heart of the initiative. The health service has a long history of immunization programs and has built a strong immunization culture. Uptake of annual influenza vaccines is higher than in many counterparts. While volunteers and private groups are involved, the government has not – as in areas such as tracking and traceability – outsourced the effort or tried to build a new operation, but has relied on a trusted institution. The contrast with the United States, where the lack of a national healthcare system has led to a fragmented approach, is stark.
While Britain isn’t unique here, the vaccination effort also benefits from early – risky – decisions to invest in development and pre-order millions of doses. Kate Bingham, the venture capital firm and chair of the UK Vaccine Task Force, has come under fire for hiring expensive public relations advisers. But she deserves to be commended for her wise investment in a portfolio of seven vaccines. These decisions helped developers, including the Oxford / AstraZeneca jab, start making doses before they even knew if they worked. They were aided by a flexible response from UK regulators, who agreed to assess data on an ongoing basis and issue rapid emergency approvals for three vaccines. Despite American and European criticism, they insist the standards have not been relaxed.
Big caveats remain. Great variations in progress exist between regions. The Financial Times analysis found that hundreds of thousands of people in England will struggle to reach their nearest vaccination center without access to a car, heightening concerns over a ‘postcode lottery’. Red tape slowed the recruitment of retired doctors to help, and community pharmacies could have been introduced earlier.
More importantly, the high numbers given at a first dose are in part a function of the controversial decision to delay the second doses by 12 weeks or more. Oxford / AstraZeneca said they were comfortable with the strategy and tested a range of intervals between doses. The makers of the BioNTech / Pfizer jab are suspicious. While the data is not definitive, an Israeli study has suggested that a single dose of the BioNTech vaccine may be less effective than the UK government’s assumptions and test results indicate.
To speak positively about an initiative at an early stage is a temptation of fate. Supply shortages can develop; the split-dose strategy may work against you. Worse yet, a vaccine-resistant variant could emerge, forcing Britain – and others – to start all over again. Even without a hitch, a successful immunization program should not eclipse the glaring mistakes of the past year once a public inquiry into government management is held. Yet, for months, the British have been deprived of good news about the virus. Here, for now, they have it.
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