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The rollout of COVID vaccinations in Europe isn't going as smoothly as officials hoped, with critics saying governments didn't prepare sufficiently for the inevitable procurement and logistical challenges in what amounts to the biggest mass inoculation campaign ever seen.
A series of logistical missteps marred the first week of the European Union's vaccine strategy, say critics, prompting public frustration with the pace of inoculations. French President Emanuel Macron has castigated his own ministers for the painfully slow start of France's inoculation effort, which saw only 400 people receive their initial Pfizer-Biontech jab in the first week the program started.
Critics say European governments should learn from Israel, which has moved fast with its mass vaccination program and already has administered first jabs to 17% of the country's population of nine million. Israeli officials say centralized hubs have allowed for the quick distribution of vaccines, and the support of the Israeli army has also been crucial. They also say inbuilt competition between health care providers within the public medical system has also helped to quicken vaccinations.
Meanwhile in Europe, staffing shortages are partly being blamed for the slowness in Europe as well as other management difficulties. But mayors and opposition politicians are demanding rapid acceleration.
"It's a state scandal," said Jean Rottner, president of the Grand Est region of eastern France. "Getting vaccinated is becoming more complicated than buying a car," he said on France 2 television.
In Germany, one of the scientists who developed the Pfizer vaccine, Ugur Sahin, Biontech's chief executive, said the rollout was "not looking rosy" in Europe and, aside from the sluggish start in several European states, he raised the possibility of a medium-term shortfall in stockpiles of the vaccine. He questioned the reasoning behind the EU's ordering just 300 million doses of the vaccine - enough for around a third of the bloc's 450 million people - and declining to order more.
In an interview with Germany's Der Spiegel magazine, Sahin said that the U.S. will be better supplied because the Trump administration "didn't just buy our vaccine, but also those from other companies, like Moderna." He added, "The process in Europe certainly didn't proceed as quickly and straightforwardly as with other countries. In part because the European Union isn't directly authorized, and member states also have a say."
Brussels also made large purchases from other vaccine developers, but they are behind on development.
"There was an assumption that many other companies would produce vaccines. There was apparently an attitude of: We'll get enough, it won't be that bad, we have everything under control. That surprised me," Sahin said.
The European Medicines Agency approved the Moderna COVID-19 vaccine Wednesday, paving the way for it, too, to be rolled out across the EU.
EU officials across Europe acknowledge they are in a race against time, partly thanks to the emergence of a more contagious mutant strain of the coronavirus, which was flagged initially last month by British authorities and is accelerating transmission rates from 50 to 74%.
Britain
The more easily transmitted strain is driving infections in Britain, where Prime Minister Boris Johnson has walked back bullish predictions he made before Christmas that the country's mass inoculation campaign will allow the country to be returned to normal life by Easter.
"We really are confident that things will be very, very much better" by April, he said at a recent press conference. But this week he tempered his claims, telling the BBC, "We've got to be realistic. We've got to be realistic about the pace of which this new variant has spread."
And he added: "We've got to be humble in the face of this virus." Johnson has ordered a national lockdown to try to curb the spread of the virus.
The British government is aiming to vaccinate two million people a week. But some medical experts are doubtful that rate can be achieved in the near term. And England's chief medical officer, Chris Whitty, undercut this week the government's optimistic forecasts by saying vaccine shortages will be a problem for months.
"Vaccine shortage is a reality that cannot be wished away," he said in a letter to doctors.
In Britain, 1.3 million people have received the first of their two doses of the Pfizer vaccine, far more than other European countries have managed. To try to get more people vaccinated with at least a first dose, offering lower levels of protection but allowing more people to get some protection, the government has decided to delay when a second dose should be administered.
The developers recommend the second dose is administered from three to four weeks after the first. But the British government is delaying the second dose for another eight weeks. They plan to do that with both the Pfizer vaccine and another developed by the University of Oxford and AstraZeneca, which has yet to receive regulatory approval by the EU.
But Pfizer has indicated it isn't happy with the change, arguing that such a long delay was never tested in clinical trials. And American officials are also highly skeptical, saying the switch amounts to a gamble. In a statement Monday, the U.S. Food and Drug Administration said such a change is "premature and not rooted solidly in the available evidence."
The dosage change has also got pushback from British doctors. "We have real and grave concerns about these sudden changes to the Pfizer vaccine regime," the Doctors' Association UK, a non-profit medical advocacy group, said in a statement. "It undermines the consent process, as well as completely failing to follow the science."
In Germany and Italy, logistical challenges are being blamed for a slow pace in inoculations. Germany has managed 317,000 jabs, or 0.4% of its people. "Some things can and will improve," Chancellor Angela Merkel's spokesman Steffen Seibert promised this week.
Italy vaccinated over 100,000 the past week.
In Spain, a shortage of medical personnel and of freezers for the vaccine, which has to be stored and transported at -70C, have combined to restrain the vaccination program. Spain has received 718,535 Pfizer doses but had only managed to administer 82,334 by Monday, according to the country's health minister, Salvador Illa. He promised vaccination levels will reach "cruising speed" soon.
Patience wears thin
EU officials caution that public expectations are in some ways too high and people need to be more patient, though they acknowledge people are desperate for an end to lockdowns and a return to normal life. But critics say the EU was too slow in authorizing the Pfizer vaccine.
Hungarian Prime Minister Viktor Orban this week criticized the EU's vaccine acquisition strategy, saying he is "not happy with the pace."
He told Hungarian radio "there were manufacturers whose products were available sooner in Canada, the UK." Orban said he has discussed with Moscow about switching to Russia's Sputnik V vaccine, but due to its limited production capacity it won't work as an alternative.