Is Europe Getting Its COVID Vaccine Rollout Wrong?

Just days after the Brexit transition period ended at the end of 2020, as the United Kingdom was plunged into an undetermined period of strict national lockdowns, Prime Minister Boris Johnson was keen to deliver some good news - he revealed the U.K. is beating Europe in the global vaccine race.

He said at the time that the nation's ambitious vaccine program had seen more people vaccinated in the U.K. "than in the rest of Europe combined" and that Britain was now in a "sprint in a race against the virus" to vaccinate people quicker than COVID is spreading. People around the world are now being vaccinated against COVID-19 thanks to the approval and rollout of Pfizer, AstraZeneca and Moderna jabs. But World Health Organization (WHO) statistics show more than 10,000 people are dying across the globe each day too.

More than four million people have been vaccinated against COVID in the U.K., a total number of 4,062,501 have received the first dose, with 452,301 people receiving both doses of the injection between December 8 and January 17.

This is more than double the number of vaccinations, per person per day than any European country, the U.K. Department of Health says. Figures show the European Union (EU) has handed out a total of 5.5 million doses of the vaccine compared to the four million in the U.K. alone.

Johnson has set a target of offering vaccines to 15 million people by the middle of February. The most vulnerable people are being given vaccines first, starting with those aged 80 and over and elderly care home residents. People aged 70 and over, as well as those listed as clinically extremely vulnerable, are being invited to have a COVID vaccine from this week. So is Britain getting it right? Is Europe getting it wrong? Or is there something more complicated going on?

According to a tracker developed by Our World In Data—a research partnership between the University of Oxford and the British non-profit Global Change Data Lab—Israel, the United Arab Emirates (UAE), and Bahrain have vaccinated a higher proportion of their populations than the rest of the world.

The U.K. is currently in fourth place in the vaccine race, just ahead of the United States on COVID vaccine doses administered per 100 people, but it is leaps ahead of its nearest European rival, Denmark.

Britain has administered 6.65 jabs per 100 of its population, according to Our World In Data statistics. The U.K. is followed by Denmark, Malta, Slovenia and Italy, which have given 2.94, 2.65, 2.02 and 1.91 jabs per 100 of their populations, respectively.

Germany just about makes it into the top 10 of EU member countries, so far injecting 1.37 doses per 100 of the population, but France is lagging behind the pack at just 0.65 doses per 100 of the population given out. Italy, Ireland and Spain had administered between one and 1.6 doses per 100 of their populations as of January 14.

After the U.K., just 12 countries among the EU27 have an inoculation rate of one per 100 people or more. Meanwhile, deaths continue to rise, with almost 5,000 recorded across Europe on January 17. So what is going on?

Every country on Earth is at the mercy of vaccine production, with Britain's chief medical officers saying supply shortages are "a reality that cannot be wished away".

AstraZeneca vaccine administered in Bournemouth, England
Staff give AstraZeneca injections to patients at a COVID vaccination center in Bournemouth, England Finnbar Webster/Getty

Denmark, like the U.K., has opted to use all of its first supply of the vaccine to give the first dose to as many people as possible, while other countries have opted to save half of their vaccination supply to ensure that there is enough for all inoculated patients to receive their second dose.

In a joint letter outlining the decision to administer one dose to a greater number of people, rather than hoard enough doses for a smaller number to receive both, the U.K. medical chiefs said: "We are confident that based on publicly available data as well as data available to the Joint Committee on Vaccination and Immunisation (JCVI), the statutory independent body, that the first dose of either Pfizer or AstraZeneca vaccine provides substantial protection within two-three weeks of vaccination for clinical disease, and in particular severe COVID disease.

"In terms of protecting priority groups, a model where we can vaccinate twice the number of people in the next two to three months is obviously much more preferable in public health terms than one where we vaccinate half the number but with only slightly greater protection."

Danish Prime Minister Mette Frederiksen agrees with the policy. He has said the country's goal is ultimately to get to 100,000 vaccinations per day. In an interview with broadcaster TV2 in December, Frederiksen said: "The vaccine should be distributed the very second it touches Danish soil."

France, among Europe's hardest-hit countries in the pandemic, has vaccinated just 0.65 percent of its population. The French government has been criticized for its slow pace, with Health Minister Olivier Véran vowing to extend and speed up its vaccination rollout. France started administering the Pfizer/BioNTech vaccine at the end of December, beginning with staff and residents in care homes and those considered at risk of developing severe symptoms of the virus, but only delivered 516 vaccines during the first week. The delay is being put down, in part, to widespread vaccination skepticism.

A December Ipsos Global Advisor survey* found that just 40 percent of French respondents were willing to have the vaccine compared to 80 percent in China, 77 percent in the U.K., and 69 percent in the U.S.

Analysts dubbed France the most anti-vax country in the world, leaving President Emmanuel Macron privately fuming. In his New Year address, Macron had pledged there would be no "unjustifiable delays" in the rollout of the vaccination, but the Journal du Dimanche newspaper quoted him as saying the pace of the rollout was that of "a family stroll" that was not "worthy of the moment nor of the French."

In Germany, the COVID vaccine rollout was branded a "planning disaster" by the newspaper Der Spiegel, which compared the "supposedly well-prepared Europeans" waiting for a vaccine developed in their own country to the "supposedly incompetent Trump administration" which expects to have immunized around 100 million Americans with two doses by March. Critics argue that the EU did not purchase enough of the Pfizer vaccine, the first to be approved and created in labs in Berlin. Others say Germany is issuing fewer vaccinations than it could with the supplies it has.

Health Minister Jens Spahn said the country is getting more doses of the COVID vaccine than many other European countries, with 64 million doses of the BioNTech/Pfizer vaccine and 50 million doses of the Moderna vaccine, the second jab approved for use in the EU.

The difference is that doctors in Germany say half the doses must be held back for the second jab after three weeks to boost the vaccination to a 95 percent efficiency rate and avoid the risk that the virus could mutate and adapt to the vaccine. This means opting to administer as many first doses as possible has gone a long way to secure the U.K. its lead over other European countries, combined with a campaign to tackle misinformation about taking the vaccine.

The U.K. was among the first countries to devise a communications strategy to beat anti-vaccination sentiment which involved government departments spreading positive messages and working with social media companies to take down damaging content. Having high-profile figures, including the Queen and David Attenborough, reveal they have received their doses also helped.

The first advantage was speed, with the U.K. drugs regulator the Medicines and Healthcare products Regulatory Agency (MHRA), becoming the first in Europe to approve the Pfizer/BioNTech vaccine on December 2 — weeks ahead of the European Medicines Agency.

The MHRA has since approved the Oxford/AstraZeneca and Moderna vaccines after allowing the agency to give temporary authorization to a vaccine that meets safety and efficacy standards but has yet to finish the licensing process.

Chart showing COVID vaccine doses across Europe
The U.K. has administered more doses per 100 people than any EU member state Our World In Data

A clear delivery plan, setting out who was going to get the vaccine first, was established through priority recommendations made by the JCVI to target the groups that account for 88 percent of the U.K.'s coronavirus deaths first. In the EU, while the European Commission produces recommendations for which groups to vaccinate first, it is up to individual countries to determine how and when the jabs are given.

The U.K. is also set up to administer vaccines widely and quickly. The government has committed to ensuring that every person has a vaccination center within 10 miles of their home. The military has been drafted in to transport doses across the country, while more than 200,000 people have signed up as volunteer stewards and first-aiders to help speed up the process.

People in the U.K. can now get a vaccine at their GP, their local pharmacy, or at one of ten mass vaccination centers set up in already existing large venues, such as sports stadiums or concert halls. Soon, supermarkets and high street pharmacies including Boots will begin administering jabs. This idea has reportedly been considered in other EU countries, such as Spain, but critics argue the involvement of private providers could undermine public health care systems.

It may be that EU countries waiting for more supplies of the vaccine in order to ensure every citizen has their first and second doses will soon catch up to the U.K. in terms of numbers being immunized. Global health experts warn that wealthy countries focusing on "winning the race" to vaccinate their populations first are missing the point - unless every population is given equal access to a vaccine, the pandemic will continue to thrive.

WHO Director-General, Tedros Adhanom Ghebreyesus, this week said the prospects for fairly distributing the various jabs were at serious risk because of a "me-first approach" taken by some countries, which has left "the world's poorest and most vulnerable at risk" as countries prioritize themselves over the greater good. He said: "It is self-defeating. Ultimately these actions will only prolong the pandemic."

*Study Methodology & Notes

The Ipsos Global Attitudes on a COVID-19 Vaccine survey was conducted online between December 17 and 20, 2020, with a sample of 13,542 adults aged 18 to 74 in Canada, South Africa, and the U.S., and aged 16 to 74 in Australia, Brazil, China, France, Germany, Italy, Japan, Mexico, Russia, South Korea, Spain, and the U.K.

The sample consisted of approximately 1,000 individuals in each of Brazil, Canada, China, France, Germany, Italy, Japan, South Korea, Spain, the U.K., and the U.S., and approximately 500 individuals in Mexico, Russia, and South Africa.