One Country Has Jumped Ahead on Vaccinations
January 27, 2021 7:40 PM Subscribe
Israel is nine miles wide. Apples to meatloaf.
posted by parmanparman at 9:02 PM on January 27, 2021 [3 favorites]
posted by parmanparman at 9:02 PM on January 27, 2021 [3 favorites]
This isn’t right
Yep. A good example of shooting yourself in the foot with apartheid because herd immunity DGAF about religion.
posted by adept256 at 10:53 PM on January 27, 2021 [9 favorites]
Yep. A good example of shooting yourself in the foot with apartheid because herd immunity DGAF about religion.
posted by adept256 at 10:53 PM on January 27, 2021 [9 favorites]
Similarly UAE will have vaccinated 50% of it's population by March.
posted by PenDevil at 1:36 AM on January 28, 2021
posted by PenDevil at 1:36 AM on January 28, 2021
Israel’s vaccination drive also doesn’t include Palestinians in the West Bank and the Gaza Strip, as Israeli and Palestinian authorities each accuse the other of shirking their responsibility for these populations.
This was the first thing I thought of. And then, that if you insist on having an apartheid system, you have to get all members of the ruling population vaccinated. It's depressing.
Israel is nine miles wide. Apples to meatloaf.
The article adresses that. Yes, size is a factor, but America is supposed to be the best at doing scale. Before the pandemic, WHO thought the USA was the best prepared country in the world, for dealing with a pandemic. Well it isn't. The facilities are there, and the science is there, but the physical and digital infrastructure that connects the different elements isn't there.
posted by mumimor at 1:37 AM on January 28, 2021 [10 favorites]
This was the first thing I thought of. And then, that if you insist on having an apartheid system, you have to get all members of the ruling population vaccinated. It's depressing.
Israel is nine miles wide. Apples to meatloaf.
The article adresses that. Yes, size is a factor, but America is supposed to be the best at doing scale. Before the pandemic, WHO thought the USA was the best prepared country in the world, for dealing with a pandemic. Well it isn't. The facilities are there, and the science is there, but the physical and digital infrastructure that connects the different elements isn't there.
posted by mumimor at 1:37 AM on January 28, 2021 [10 favorites]
Arab Israelis living in Israel are of course being vaccinated.
Palestinians living in areas A and B are of course not being vaccinated by the Israeli government and would never have expected to be since those areas are administered by the PA.
Who is accountable for vaccinating Palestinians in East Jerusalem and area C is complicated. International law says by default the military authority so that would be the Israeli government. However the Oslo accords says medical care and public health is exclusively a PA competency for Palestinians in any area. On the other hand, in practice, Palestinians in those areas (and especially in Jerusalem) do in practice rely on Israeli medical infrastructure to some degree and one might raise the question of how realistic it would be for the PA to provide any vaccines there.
Israel is vaccinating Palestinians in East Jerusalem, but not area C.
Of course international law on occupied territory never envisioned the current situation where substantial territory is under some form of military control but also has an international treaty laying out who is responsible for what in that territory, the underlying assumption is that this is a temporary status. Relying on Oslo is also tricky because it was *also* intended to be a transitional agreement and a bridge to a full two-state solution.
Anyway, I think relying on the text of international law for one's morality is disgusting. I understand it's very tempting for Americans since they rely on micro-interpretation of comma positioning for their politics but there's something absurd about it.
posted by atrazine at 2:08 AM on January 28, 2021 [23 favorites]
Palestinians living in areas A and B are of course not being vaccinated by the Israeli government and would never have expected to be since those areas are administered by the PA.
Who is accountable for vaccinating Palestinians in East Jerusalem and area C is complicated. International law says by default the military authority so that would be the Israeli government. However the Oslo accords says medical care and public health is exclusively a PA competency for Palestinians in any area. On the other hand, in practice, Palestinians in those areas (and especially in Jerusalem) do in practice rely on Israeli medical infrastructure to some degree and one might raise the question of how realistic it would be for the PA to provide any vaccines there.
Israel is vaccinating Palestinians in East Jerusalem, but not area C.
Of course international law on occupied territory never envisioned the current situation where substantial territory is under some form of military control but also has an international treaty laying out who is responsible for what in that territory, the underlying assumption is that this is a temporary status. Relying on Oslo is also tricky because it was *also* intended to be a transitional agreement and a bridge to a full two-state solution.
Anyway, I think relying on the text of international law for one's morality is disgusting. I understand it's very tempting for Americans since they rely on micro-interpretation of comma positioning for their politics but there's something absurd about it.
posted by atrazine at 2:08 AM on January 28, 2021 [23 favorites]
Does anyone else feel like omitting absolute numbers is journalistic malpractice? Israel has vaccinated ~4M people, UAE ~2M, the USA ~23M. (Source: Our World in Data, make sure to click "total vaccinations".)
If we want to criticize a modern nation for failure in contrast to nations with 1/20th their size, the country to look at is Germany, which has vaccinated ~2M. (AFAIK this is largely due to sharing doses with the EU, but still.)
The article claims "the story of Israel’s success is arguably more about distribution than procurement" but that seems false unless we think procuring hundreds of millions of doses (US pop: 330M, EU pop: 450M) is equivalent to procuring five or ten million. Tell me if I'm wrong but I think those are qualitatively different.
posted by daveliepmann at 2:23 AM on January 28, 2021 [5 favorites]
If we want to criticize a modern nation for failure in contrast to nations with 1/20th their size, the country to look at is Germany, which has vaccinated ~2M. (AFAIK this is largely due to sharing doses with the EU, but still.)
The article claims "the story of Israel’s success is arguably more about distribution than procurement" but that seems false unless we think procuring hundreds of millions of doses (US pop: 330M, EU pop: 450M) is equivalent to procuring five or ten million. Tell me if I'm wrong but I think those are qualitatively different.
posted by daveliepmann at 2:23 AM on January 28, 2021 [5 favorites]
Israel is nine miles wide. Apples to meatloaf.
The correct way to analyse this is to separate factors which are scale dependent and once which are not.
In physics we think differently about intensive vs extensive properties. An intensive property like temperature does not depend on bulk. If two objects have the same temperature that doesn't change if you make it bigger.
Extensive properties do depend on size, two objects with the same temperature but different sizes do not have the same amount of heat energy.
We can think about country size and capability in a similar way. Some properties are scale invariant because both their numerator and denominator scales with population size. Whether a country can have a public healthcare system is scale invariant. Yes a country like the US has more patients but also more doctors, more nurses, more hospitals, and a bigger tax base.
Population density and differences between population densities are scale invariant but often talked about as if they were scale variant.
Scale variant properties tend to be associated with co-ordination issues or with the size of a country relative to others. The more tightly something needs to be co-ordinated, the tighter interfaces have to be and the harder it is for a bigger country to do. One example is legislature sizes. The Netherlands has 150 people in its primary legislative chamber and because it is a small country is able to select them without local constituencies. The US has 17x more people but only about 3x more representatives. The UK which has a constituency based system like the US (and on which the US system was partially modelled) has one MP for every 92k people, the US House has 750k. Either you have so many people per rep that you increase social distance between them and constituents or you increase the size of the chamber to such a size that it becomes impossible for members to know more than a very small fraction of their peers which impedes collegiality and efficiency.
The question then: which aspects of a vaccine programme are extensive / scale variant and which are intensive / scale invariant?
Distribution and administration are clearly scale invariant and should not in fact be more difficult in larger countries. The level of coordination required is very low and can easily be carried out across well defined interfaces. Yes you need more distribution warehouses and more vaccination centres in larger countries but you also have more money and more land on which to put them as well as more people to run them. It's not like one dude needs to hold all the details in their head, right?
Vaccine supply on the other hand is scale variant because vaccines are manufactured globally for a global market. If everyone was buying vaccines strictly proportionally to their population size, this would be reduced to scale invariant issue but smaller countries may be able to:
a) Reach decisions more quickly. See also the way in which the EC delayed some very important decisions on vaccine purchases because of extended internal discussions over terms and allegedly over allocation of orders to various national champions.
b) Make deals for relatively small proportions of total vaccine output which are high proportions of their needs.
The Israelis seem to have done both and were able to propose a deal where they got a very large amount of vaccine early in exchange for serving as a sort of phase IV test bed to settle issues like the effect on transmission and the related question of herd immunity. So, couldn't a medium sized country like the UK which also has a highly centralised healthcare system have done the same? Probably not because the UK is too large a fraction of the global vaccine demand for this to be possible. Vaccinating the UK, let alone the US, at this rate would require 100% of global supply which other countries would never tolerate.
Certainly even on the issue of distribution there have been vast differences. All EU countries have received the same vaccine allocations to date so differences in their performance are purely distribution related. The contrast between Denmark (3.73% vaccinated) and The Netherlands (1.1%) despite many similarities of culture, size, and government style are evidence of that.
posted by atrazine at 2:51 AM on January 28, 2021 [19 favorites]
The correct way to analyse this is to separate factors which are scale dependent and once which are not.
In physics we think differently about intensive vs extensive properties. An intensive property like temperature does not depend on bulk. If two objects have the same temperature that doesn't change if you make it bigger.
Extensive properties do depend on size, two objects with the same temperature but different sizes do not have the same amount of heat energy.
We can think about country size and capability in a similar way. Some properties are scale invariant because both their numerator and denominator scales with population size. Whether a country can have a public healthcare system is scale invariant. Yes a country like the US has more patients but also more doctors, more nurses, more hospitals, and a bigger tax base.
Population density and differences between population densities are scale invariant but often talked about as if they were scale variant.
Scale variant properties tend to be associated with co-ordination issues or with the size of a country relative to others. The more tightly something needs to be co-ordinated, the tighter interfaces have to be and the harder it is for a bigger country to do. One example is legislature sizes. The Netherlands has 150 people in its primary legislative chamber and because it is a small country is able to select them without local constituencies. The US has 17x more people but only about 3x more representatives. The UK which has a constituency based system like the US (and on which the US system was partially modelled) has one MP for every 92k people, the US House has 750k. Either you have so many people per rep that you increase social distance between them and constituents or you increase the size of the chamber to such a size that it becomes impossible for members to know more than a very small fraction of their peers which impedes collegiality and efficiency.
The question then: which aspects of a vaccine programme are extensive / scale variant and which are intensive / scale invariant?
Distribution and administration are clearly scale invariant and should not in fact be more difficult in larger countries. The level of coordination required is very low and can easily be carried out across well defined interfaces. Yes you need more distribution warehouses and more vaccination centres in larger countries but you also have more money and more land on which to put them as well as more people to run them. It's not like one dude needs to hold all the details in their head, right?
Vaccine supply on the other hand is scale variant because vaccines are manufactured globally for a global market. If everyone was buying vaccines strictly proportionally to their population size, this would be reduced to scale invariant issue but smaller countries may be able to:
a) Reach decisions more quickly. See also the way in which the EC delayed some very important decisions on vaccine purchases because of extended internal discussions over terms and allegedly over allocation of orders to various national champions.
b) Make deals for relatively small proportions of total vaccine output which are high proportions of their needs.
The Israelis seem to have done both and were able to propose a deal where they got a very large amount of vaccine early in exchange for serving as a sort of phase IV test bed to settle issues like the effect on transmission and the related question of herd immunity. So, couldn't a medium sized country like the UK which also has a highly centralised healthcare system have done the same? Probably not because the UK is too large a fraction of the global vaccine demand for this to be possible. Vaccinating the UK, let alone the US, at this rate would require 100% of global supply which other countries would never tolerate.
Certainly even on the issue of distribution there have been vast differences. All EU countries have received the same vaccine allocations to date so differences in their performance are purely distribution related. The contrast between Denmark (3.73% vaccinated) and The Netherlands (1.1%) despite many similarities of culture, size, and government style are evidence of that.
posted by atrazine at 2:51 AM on January 28, 2021 [19 favorites]
Does anyone else feel like omitting absolute numbers is journalistic malpractice?
The total number of doses administered isn't unimportant, but the really significant figure when it comes to immunity is the percentage of population vaccinated. Israel has not only done dramatically better than any other country, but did it earlier: the UAE is catching up, but probably not in time for the article to cover it. And, with all due respect to the USA, I am prepared to bet a cake that its vaccination rate will still be below Israel's at this time next year.
posted by Joe in Australia at 2:56 AM on January 28, 2021 [3 favorites]
The total number of doses administered isn't unimportant, but the really significant figure when it comes to immunity is the percentage of population vaccinated. Israel has not only done dramatically better than any other country, but did it earlier: the UAE is catching up, but probably not in time for the article to cover it. And, with all due respect to the USA, I am prepared to bet a cake that its vaccination rate will still be below Israel's at this time next year.
posted by Joe in Australia at 2:56 AM on January 28, 2021 [3 favorites]
It seems there are a lot of shady back room deals going on. The article hints at it, but makes no real claims about Netanyahu. In Europe, AstraZeneca suddenly sent millions of doses of vaccine that were reserved for the EU to the UK instead. Maybe. We don't know yet what happened, but there is a row.
The EU isn't built for something like this, in principle, health care belongs almost entirely to the nation-states, and in some countries the regions have the responsibility, not the state. That might change after this, because with a pandemic, you can't have one country failing completely -- The Netherlands are a better example than Germany -- if you want open borders. Which is what applies to Israel/Palestine as well. When people travel across the border every day for work, you have to have the same level of immunity to protect everyone.
The EU has not speeded up approvals of the vaccine, while the US, the UK and Israel have, so there is a delay built in there.
posted by mumimor at 2:58 AM on January 28, 2021 [1 favorite]
The EU isn't built for something like this, in principle, health care belongs almost entirely to the nation-states, and in some countries the regions have the responsibility, not the state. That might change after this, because with a pandemic, you can't have one country failing completely -- The Netherlands are a better example than Germany -- if you want open borders. Which is what applies to Israel/Palestine as well. When people travel across the border every day for work, you have to have the same level of immunity to protect everyone.
The EU has not speeded up approvals of the vaccine, while the US, the UK and Israel have, so there is a delay built in there.
posted by mumimor at 2:58 AM on January 28, 2021 [1 favorite]
In Europe, AstraZeneca suddenly sent millions of doses of vaccine that were reserved for the EU to the UK instead. Maybe. We don't know yet what happened, but there is a row.
Maybe is right.
No-one has any idea what is going on because there are no uninterested parties who have access to information. The EC is desperately trying to protect its position from furious national governments, national governments are dealing with furious populations and elected representatives. AZ is trying to protect their own reputation. Everyone is motivated to confuse the issue and push their perspective.
As far as I can tell from public information, the following seems to have happened:
-AZ signed a contract with the UK in May for delivery of a certain number of doses and for pre-payment to start work on getting production up and running.
-AZ was in talks with several EU member states for a similar deal, after the EC insisted on handling it a deal was not signed until August.
The contracts are not public but it appears that in both cases, the nature of ordering biological products that are completely unproven means that there were no hard guarantees of dates and quantities, only commitments to produce as much as possible as early as possible up to the order size. The core of the dispute appears to be over two issues:
-Do the production lines in each place primarily serve that location (and therefore the EU and UK respectively bear the risk of shortages from their respective production lines) or was the order with AZ as a whole and it is up to AZ to allocate?
-Does either the nature of the earlier order or the differences in contract language driven by the difference in lead time require AZ to prioritise UK supply from its total factory base?
Production was to take place at four sites, two in the UK, two in EU. Exact details of which plant would serve which area not disclosed. AZ says each plant was primarily for the area it served but could send excess to the other area. EC position is that at the very least this was not clear in contract they think they have.
Production scale-up started earlier at the UK sites.
Both orders have been substantially delayed, which for some reason has not really been covered in the press, it is not only the EU order. This is as a result of lower than expected startup yields. The UK was originally going to have most of its vaccines ready to go by September, then the end of 2020 and will now receive 2m a week starting this week. It appears that all sites have had trouble scaling and therefore everyone is getting their vaccines later than anticipated. The difference of course is that the UK scale-up pains happened well before the vaccine was approved (although the fact that only in late January are they reaching production targets seems to indicate that the scaling problems were not fully resolved even by that point) and probably more importantly happened while nobody else was vaccinating on a large scale either which took the heat off.
The EC claims that a substantial number of vaccines from European sites "may have been used to supply the UK" and that therefore at least the same number should come back the other way. AZ has not commented to say that this was untrue which makes me think it might be but the upper limit of how many doses this could possibly be is simply not very high and much, much lower than the Q1 production shortfall.
Some possibilities:
-AZ is telling the complete truth, there have been scale-up issues despite best efforts and this has delayed everyone's orders. Unfortunately the EC delay is more material than the UK one because of the timing difference.
-AZ is mostly telling the truth but some quantity of vaccine was supplied to the UK from the EU sites early in the process. This is not necessarily a breach of their contracts (since we do not know this) and the UK did sign contracts earlier but the EC may still be extremely unhappy and may rightly say that if indeed the intention was that the plants in each area would produce for that area up until the point when the ordered quantity was produced, then they are entitled to have their doses back from UK factories. The problem with this from the EC point of view is that taking this line essentially commits them to the territorial perspective - it may well be that a few million such doses were moved but as the UK has only vaccinated 7m people total and many of them with Pfizer vaccines, they'd likely get at most 3m doses additional this way but by their own logic would not be entitled to any additional supply from the UK production lines.
The EC point of view is that AZ has a contract with them for a certain quantity of vaccines and how they supply them is really their business. If they have four plants and two of them are producing on target and those two happen to be in the UK, then that should not matter. Everyone should have the same production cut, regardless of where the factories are. I have some sympathy with this, that is after all how normal purchasing contracts would work. The problem is that I don't think the EC has a consistent position here. Would they feel that way if this was the other way around?
There is the further problem with that position which is that the UK was originally meant to have its full allocation of vaccines by now. If we ignore the territorial perspective then you could make the argument that all of the production from the EU sites should also be diverted to the UK until the original date is met. Obviously that would be ridiculous.
I have to say it is a bit rich they are insisting on absolute fairness of allocation regardless of when the orders were made and production started because the subtext is (fairness between the UK and EU), I don't see the EC planning to divert their supplies to South Africa in the interests of fairness. Let's be clear - if this had happened the other way around, the world's smuggest people would now be explaining that this was the price the UK paid for absolute national sovereignty and they would be right. Fairness is for sharing within the club, not a universal principle. If it is the case that ordering first and spending money on scale-up earlier does not confer any right to get vaccines earlier then why did the EC order months before approval and why does it have a claim on those vaccines above that of someone who ordered after them? I understand they want their vaccines but high-minded language about fairness is ridiculous here. Let's be clear: fair would mean vaccinating the world's most vulnerable people first and explaining to your 55 year old CDU voter that he will have to wait for his vaccine until we've vaccinated all the elderly people of the world. If that's not what you're proposing then you need to be honest about the pure power relations here - everyone wants vaccines and is manoeuvring to get them by any means necessary.
The language coming out of the EC right now is basically Trump style blustering coming from more elegant mouths. If you want a preview of what the complete breakdown of a rules based system into climate barbarism under the stress of global warming is going to look like, here it is.
posted by atrazine at 4:43 AM on January 28, 2021 [19 favorites]
Maybe is right.
No-one has any idea what is going on because there are no uninterested parties who have access to information. The EC is desperately trying to protect its position from furious national governments, national governments are dealing with furious populations and elected representatives. AZ is trying to protect their own reputation. Everyone is motivated to confuse the issue and push their perspective.
As far as I can tell from public information, the following seems to have happened:
-AZ signed a contract with the UK in May for delivery of a certain number of doses and for pre-payment to start work on getting production up and running.
-AZ was in talks with several EU member states for a similar deal, after the EC insisted on handling it a deal was not signed until August.
The contracts are not public but it appears that in both cases, the nature of ordering biological products that are completely unproven means that there were no hard guarantees of dates and quantities, only commitments to produce as much as possible as early as possible up to the order size. The core of the dispute appears to be over two issues:
-Do the production lines in each place primarily serve that location (and therefore the EU and UK respectively bear the risk of shortages from their respective production lines) or was the order with AZ as a whole and it is up to AZ to allocate?
-Does either the nature of the earlier order or the differences in contract language driven by the difference in lead time require AZ to prioritise UK supply from its total factory base?
Production was to take place at four sites, two in the UK, two in EU. Exact details of which plant would serve which area not disclosed. AZ says each plant was primarily for the area it served but could send excess to the other area. EC position is that at the very least this was not clear in contract they think they have.
Production scale-up started earlier at the UK sites.
Both orders have been substantially delayed, which for some reason has not really been covered in the press, it is not only the EU order. This is as a result of lower than expected startup yields. The UK was originally going to have most of its vaccines ready to go by September, then the end of 2020 and will now receive 2m a week starting this week. It appears that all sites have had trouble scaling and therefore everyone is getting their vaccines later than anticipated. The difference of course is that the UK scale-up pains happened well before the vaccine was approved (although the fact that only in late January are they reaching production targets seems to indicate that the scaling problems were not fully resolved even by that point) and probably more importantly happened while nobody else was vaccinating on a large scale either which took the heat off.
The EC claims that a substantial number of vaccines from European sites "may have been used to supply the UK" and that therefore at least the same number should come back the other way. AZ has not commented to say that this was untrue which makes me think it might be but the upper limit of how many doses this could possibly be is simply not very high and much, much lower than the Q1 production shortfall.
Some possibilities:
-AZ is telling the complete truth, there have been scale-up issues despite best efforts and this has delayed everyone's orders. Unfortunately the EC delay is more material than the UK one because of the timing difference.
-AZ is mostly telling the truth but some quantity of vaccine was supplied to the UK from the EU sites early in the process. This is not necessarily a breach of their contracts (since we do not know this) and the UK did sign contracts earlier but the EC may still be extremely unhappy and may rightly say that if indeed the intention was that the plants in each area would produce for that area up until the point when the ordered quantity was produced, then they are entitled to have their doses back from UK factories. The problem with this from the EC point of view is that taking this line essentially commits them to the territorial perspective - it may well be that a few million such doses were moved but as the UK has only vaccinated 7m people total and many of them with Pfizer vaccines, they'd likely get at most 3m doses additional this way but by their own logic would not be entitled to any additional supply from the UK production lines.
The EC point of view is that AZ has a contract with them for a certain quantity of vaccines and how they supply them is really their business. If they have four plants and two of them are producing on target and those two happen to be in the UK, then that should not matter. Everyone should have the same production cut, regardless of where the factories are. I have some sympathy with this, that is after all how normal purchasing contracts would work. The problem is that I don't think the EC has a consistent position here. Would they feel that way if this was the other way around?
There is the further problem with that position which is that the UK was originally meant to have its full allocation of vaccines by now. If we ignore the territorial perspective then you could make the argument that all of the production from the EU sites should also be diverted to the UK until the original date is met. Obviously that would be ridiculous.
I have to say it is a bit rich they are insisting on absolute fairness of allocation regardless of when the orders were made and production started because the subtext is (fairness between the UK and EU), I don't see the EC planning to divert their supplies to South Africa in the interests of fairness. Let's be clear - if this had happened the other way around, the world's smuggest people would now be explaining that this was the price the UK paid for absolute national sovereignty and they would be right. Fairness is for sharing within the club, not a universal principle. If it is the case that ordering first and spending money on scale-up earlier does not confer any right to get vaccines earlier then why did the EC order months before approval and why does it have a claim on those vaccines above that of someone who ordered after them? I understand they want their vaccines but high-minded language about fairness is ridiculous here. Let's be clear: fair would mean vaccinating the world's most vulnerable people first and explaining to your 55 year old CDU voter that he will have to wait for his vaccine until we've vaccinated all the elderly people of the world. If that's not what you're proposing then you need to be honest about the pure power relations here - everyone wants vaccines and is manoeuvring to get them by any means necessary.
The language coming out of the EC right now is basically Trump style blustering coming from more elegant mouths. If you want a preview of what the complete breakdown of a rules based system into climate barbarism under the stress of global warming is going to look like, here it is.
posted by atrazine at 4:43 AM on January 28, 2021 [19 favorites]
Equally important, with regards to Israel, is the study they published this week talking about the effectiveness of the Pzifer vaccine.(as summarised by John Campbell here) - they looked at 128,000 Israelis in the 2 weeks after they had got their second vaccine - and observed that 20 of the these people got Covid 19 during that time - 0.015 % - all mild cases. During the same period the infection rate for non-vaccinated citizens was 0.65% - and from a comparison between these 2 figures, we get very large scale verification of the figures from the trial indicating that that the vaccine is about 95% effective.
posted by rongorongo at 4:48 AM on January 28, 2021 [12 favorites]
posted by rongorongo at 4:48 AM on January 28, 2021 [12 favorites]
Right or wrong... not touching that. What it is, though, is another in a long line of squandered opportunities to build some kind of good will.
posted by kleinsteradikaleminderheit at 5:09 AM on January 28, 2021 [4 favorites]
posted by kleinsteradikaleminderheit at 5:09 AM on January 28, 2021 [4 favorites]
Fairness on a global scale is not going to happen. I hate that, but it can't be.
To me, it makes sense that the countries who bungled up the management of the pandemic in the beginning, and thus have huge infection rates, will be willing to pay whatever it takes to get the vaccine fast. The commission is trying to keep at least some control of this within the union and that will lead to a more fair outcome, though not a fair outcome.
I don't know what is with a "55 year old CDU voter"? As I mentioned above, Germany is not even near the worst country in terms of infection rates and vaccine roll-out. And anyway, Germany is one of the countries where the regions are in charge of health care, and obviously Germans know that. If you go to the Johns Hopkins map, you can see how France has one big red dot, while Germany has several smaller dots, of different sizes. So when the Bavarian PM makes noises, the voters, whatever age they have, know that he is trying to wash his hands off of his own responsibility, or bargain for some advantage with Berlin. Some voters will applaud that spectacle, others won't. Just like everywhere else in the world.
Everyone wants the vaccine to get out there as fast as possible, and there is a lot of stress and anxiety about it. That has to lead to squabbling and mistakes and even fights. It's part of the whole that is the pandemic.
Anyway, in spite of the obvious issues, It's good to see how a country is rolling out the vaccine, and inspiring. Hopefully, it will happen in the rest of the world soon.
posted by mumimor at 5:15 AM on January 28, 2021 [3 favorites]
To me, it makes sense that the countries who bungled up the management of the pandemic in the beginning, and thus have huge infection rates, will be willing to pay whatever it takes to get the vaccine fast. The commission is trying to keep at least some control of this within the union and that will lead to a more fair outcome, though not a fair outcome.
I don't know what is with a "55 year old CDU voter"? As I mentioned above, Germany is not even near the worst country in terms of infection rates and vaccine roll-out. And anyway, Germany is one of the countries where the regions are in charge of health care, and obviously Germans know that. If you go to the Johns Hopkins map, you can see how France has one big red dot, while Germany has several smaller dots, of different sizes. So when the Bavarian PM makes noises, the voters, whatever age they have, know that he is trying to wash his hands off of his own responsibility, or bargain for some advantage with Berlin. Some voters will applaud that spectacle, others won't. Just like everywhere else in the world.
Everyone wants the vaccine to get out there as fast as possible, and there is a lot of stress and anxiety about it. That has to lead to squabbling and mistakes and even fights. It's part of the whole that is the pandemic.
Anyway, in spite of the obvious issues, It's good to see how a country is rolling out the vaccine, and inspiring. Hopefully, it will happen in the rest of the world soon.
posted by mumimor at 5:15 AM on January 28, 2021 [3 favorites]
Anyway, I think relying on the text of international law for one's morality is disgusting.
Indeed, especially in this case, where defenses of "but-but the OSLO ACCORDS" are extremely disingenuous given that the Israeli government publicly announced their intent to violate the accords several times since the vaccine rollout began.
What's even worse is that this is maybe Israel's 3rd-most awful violation of civil and/or human rights just this week, including an extremely chilling ruling from their Supreme Court that combines theocratic white nationalism with an increasingly anti-diaspora Jews sentiment that has become all too common there.
posted by Glegrinof the Pig-Man at 5:46 AM on January 28, 2021 [8 favorites]
Indeed, especially in this case, where defenses of "but-but the OSLO ACCORDS" are extremely disingenuous given that the Israeli government publicly announced their intent to violate the accords several times since the vaccine rollout began.
What's even worse is that this is maybe Israel's 3rd-most awful violation of civil and/or human rights just this week, including an extremely chilling ruling from their Supreme Court that combines theocratic white nationalism with an increasingly anti-diaspora Jews sentiment that has become all too common there.
posted by Glegrinof the Pig-Man at 5:46 AM on January 28, 2021 [8 favorites]
What's even worse is that this is maybe Israel's 3rd-most awful violation of civil and/or human rights just this week, including an extremely chilling ruling from their Supreme Court that combines theocratic white nationalism with an increasingly anti-diaspora Jews sentiment that has become all too common there.
My, the Israeli Supreme Court really has expanded its scope.
posted by atrazine at 5:58 AM on January 28, 2021
My, the Israeli Supreme Court really has expanded its scope.
posted by atrazine at 5:58 AM on January 28, 2021
The consequence of having your gaming tabs and your news tabs open right next to each other. Sent the new link to the mods.
posted by Glegrinof the Pig-Man at 6:10 AM on January 28, 2021
posted by Glegrinof the Pig-Man at 6:10 AM on January 28, 2021
Mod note: Updated the link. General caution, please don't turn this into a proxy thread about Israel/Palestine generally. Please keep the focus on vaccination stuff. Thanks.
posted by LobsterMitten (staff) at 6:23 AM on January 28, 2021 [2 favorites]
posted by LobsterMitten (staff) at 6:23 AM on January 28, 2021 [2 favorites]
Maybe its been posted somewhere, but there was an article maybe in the Financial Times that showed Israel had aggressively brokered a deal with Pfizer that in exchange for earlier and deeper access to vaccine doses, they would offer up very complete data on health outcomes to Pfizer. There was a quid pro quo that got them to the front of the line. But this is also why we are so quickly getting the (So far incredibly positive!) data on all kinds of effectiveness.
Something like 14 direct calls between the Pfizer CEO and the Israeli PM
posted by JPD at 6:28 AM on January 28, 2021 [4 favorites]
Something like 14 direct calls between the Pfizer CEO and the Israeli PM
posted by JPD at 6:28 AM on January 28, 2021 [4 favorites]
Vaccination Under Occupation
“Israel is responsible for the millions of lives of those under occupation—it is as simple as that,” said Michael Sfard, a leading Israeli human rights lawyer. Article 56 of the Fourth Geneva Convention—one of the pillars of international humanitarian law—stipulates that an occupying power is responsible for “ensuring and maintaining” public health in the occupied territories, which includes “the adoption and application of the prophylactic and preventative measures necessary to combat the spread of contagious diseases and epidemics.” But that doesn’t mean the Israeli government must directly vaccinate Palestinians in the West Bank and Gaza or provide them the same care as it does for Israeli citizens living within the Green Line. “The relationship between a state and its citizens is not the same as the relationship between an occupying power and its subjects,” Sfard told me. “[The] laws of occupation allow the occupying power to use local authorities and institutions in order to maintain the services the population needs.”posted by Glegrinof the Pig-Man at 7:46 AM on January 28, 2021 [8 favorites]
In the case of the West Bank, the most significant local institution is the PA, which reportedly expects to begin its own vaccination initiative in February or March. And while Israel is not necessarily expected to implement the inoculation program in the West Bank itself, under international law, Israel is responsible for its overall success. Article 55 of the Fourth Geneva Convention requires an occupying power to ensure medical supplies are provided “if the resources of the occupied territory are inadequate.” Israel is expected not only to enable the Palestinian Authority to vaccinate the Palestinian population in the West Bank and Gaza, but also to step in when necessary. “If the PA fails, or if the PA is unable to perform those tasks,” Sfard said, “then this would be a violation by Israel” of international law.
Israel’s provision of vaccines solely to settlers in the occupied West Bank contravenes other aspects of international law. On December 30th, Health Minister Edelstein tweeted a photo of himself visiting an Israeli health clinic in the West Bank settlement of Kiryat Arba, stating, “Settlements in Judea and Samaria are the backbone of the State of Israel. We are currently vaccinating the backbone of the country.” But while the settlers in Kiryat Arba, located on the outskirts of Hebron, are being vaccinated, their Palestinian neighbors are not. “That is a clear manifestation of apartheid,” Sfard told me. “While Israel may have differing programs in Israel and the occupied territories, it cannot make a distinction between residents of the occupied territories based on nationality.” Differential treatment of populations in occupied territories is not just a violation of international law; it also violates Israeli legal precedent. During the 1991 Gulf War, when Iraqi scud missiles hit Israeli cities, Israel’s High Court ruled that Israel had to provide gas masks to all Palestinians in the West Bank, due to fears of a chemical attack. If settlers are getting vaccinated, their Palestinian neighbors need to as well, Sfard explained.
the physical and digital infrastructure that connects the different elements isn't there.
That's certainly nothing to be ignored, but a combination of societal ignorance and political incompetence/malevolence seems to have done a lot of the damage in the US case. It doesn't matter so much if the infrastructure exists if it's actively being undermined.
posted by aspersioncast at 8:04 AM on January 28, 2021
That's certainly nothing to be ignored, but a combination of societal ignorance and political incompetence/malevolence seems to have done a lot of the damage in the US case. It doesn't matter so much if the infrastructure exists if it's actively being undermined.
posted by aspersioncast at 8:04 AM on January 28, 2021
This basically confirms what the article says about the problems in the us: Hours of scrolling, endless refreshing: US tech woes make scheduling vaccine a nightmare
posted by mumimor at 8:38 AM on January 28, 2021
Earlier this month, the New York-based photographer Hee Jin Kang woke up at 3am and went online to register her elderly parents for the coronavirus vaccine.Compare with the guy from the FPP article:
She created accounts on five different websites, including portals for state-run vaccination programs as well as hospitals, pharmacies and primary care locations. After hours of clicking through and refreshing various landing pages, she secured time slots for both parents.
“It’s just crazy,” she said. “There is no centralized system. I just couldn’t stop thinking, if you are not tech literate this would just be impossible – they make you jump through so many hoops.”
Cohen told me he got his shots by tuning into regular updates on the news about which demographic group was eligible to be vaccinated next. He logged into his account on his HMO site when he learned it was his turn, chose a vaccination center based on his location, and scheduled an appointment. “Thirty seconds after confirming, I got a text on my cell with all the info, including date, time, place and already a second appointment for [the] next shot, exactly three weeks apart,” he told me. It all took “less than two minutes.” There are alternative options if you don’t use the internet or prefer to get your vaccination at a hospital rather than through your HMO.Here it will work like in Israel when we get to people under 65. The elderly are just vaccinated. At least my mother was. They had teams going out to nursing homes. Now they are at elderly who still live in their own residences, maybe they call in advance to them.
posted by mumimor at 8:38 AM on January 28, 2021
It is kind of bananas how prescient World Wad Z was about how the world would handle a pandemic.
posted by furnace.heart at 10:00 AM on January 28, 2021 [3 favorites]
posted by furnace.heart at 10:00 AM on January 28, 2021 [3 favorites]
And Canada has fully* vaccinated 0.13 M, despite having famously pre-ordered more vaccine doses per capita than any other country. This is entirely due to the vaccine manufacturing and shipment schedule. Can we not attribute to competence, nefariousness, or whatever a statistic that is almost entirely out of the individual country's control?
*meaning, both doses received.
posted by heatherlogan at 1:38 PM on January 28, 2021 [3 favorites]
*meaning, both doses received.
posted by heatherlogan at 1:38 PM on January 28, 2021 [3 favorites]
Just looking at a debate about the EU-AstraZeneca thing on the TV, and it looks a lot like the AstraZeneca is "blackmailing" the EU. I'm not sure blackmailing is the right term, rather they are pressuring all the countries to the max, and the US, the UK and Israel have given in to the pressure for understandable reasons.
posted by mumimor at 2:15 PM on January 28, 2021
posted by mumimor at 2:15 PM on January 28, 2021
I don't think the EC has a consistent position here. Would they feel that way if this was the other way around?
If the EU got all the vaccines it ordered and every other country got far less than they purchased? Since that's an imaginary scenario it's not really fair to criticize the EC for being inconsistent, wouldn't you say?
posted by romanb at 2:21 PM on January 28, 2021
If the EU got all the vaccines it ordered and every other country got far less than they purchased? Since that's an imaginary scenario it's not really fair to criticize the EC for being inconsistent, wouldn't you say?
posted by romanb at 2:21 PM on January 28, 2021
It seems there are a lot of shady back room deals going on. The article hints at it, but makes no real claims about Netanyahu.
The article is pretty clear about Israel's access to the vaccine. Firstly, there is the agreement between Pfizer and Israel [PDF] under which Israel agrees to share its coronavirus medical data and analyses. I don't know why any of it should have been redacted, but the redactions principally apply to dispute resolution, liability and indemnification. Under the agreement, Israel agrees to send Pfizer weekly, "at a minimum",
posted by Joe in Australia at 3:13 PM on January 28, 2021 [6 favorites]
The article is pretty clear about Israel's access to the vaccine. Firstly, there is the agreement between Pfizer and Israel [PDF] under which Israel agrees to share its coronavirus medical data and analyses. I don't know why any of it should have been redacted, but the redactions principally apply to dispute resolution, liability and indemnification. Under the agreement, Israel agrees to send Pfizer weekly, "at a minimum",
[...] current counts of the following:Also, Israel's Ministry of Health and Pfizer will cooperate on
• Confirmed COVID-19 cases/week
• Confirmed COVID-19 hospitalizations/week
• Confirmed COVID-19 severe/ critical cases /week
• Confirmed COVID-19 ventilator use/week
• Confirmed COVID-19 deaths/week
• Symptomatic cases/week
• Weekly numbers of vaccinees, as total and by age and other demographic subgroups.
• Number of cases per week by age groups, and other demographic factors.
• Additional subgroup analyses and vaccine effectiveness analyses, as agreed by the PartiesThat last paragraph IMO shows Pfizer's interest in this: it's going to use Israeli data to demonstrate that the cost of its vaccine is less than the medical cost of COVID-19 infections. That's a commercial argument, not a medical or moral one. Pfizer does have to cover its costs, but we shouldn't imagine that they're not profit-driven. This ties into the other reason they're supplying Israel with the vaccine: Israel's paying substantially more for its doses than other countries. The article links to a report in The Times of Israel, which says:
• Direct medical costs averted based on modeled impact of national vaccination program on outpatient visits, hospitalizations, ICU admissions, etc.
The price tag per person for coronavirus vaccines that Israel has purchased from the Pfizer-BioNtech and Moderna pharmaceutical companies is $47, [i.e., $23.50 per dose - JiA] the Kan public broadcaster reported on Monday evening.Anyway, I'm disappointed to see people uncritically repeating conspiracy theories. I'm especially disappointed to see people repeating what amounts to a modern blood libel: the idea that Israel is somehow at fault for failing to vaccinate Palestinians outside its own health systems, particularly when it does not and never could have had the ability to acquire the extra vaccines to do so.
[...]
Vaccine prices reported by the Washington Post and the BBC in December indicate Israel is paying significantly more for the Pfizer vaccine than either the US or the European Union.
The Washington Post reported at the time that the US was paying Pfizer/BioNTech $19.50 per dose while the EU 27-country bloc was paying $14.76. It cited Moderna vaccine prices as $15 per dose for the US and $18 per dose for the EU.
The figures were based on EU prices that were tweeted — and then deleted — by a Belgian government official as well as calculations from Bernstein Research, an analysis and investment firm.
The BBC reported a day earlier that Pfizer was marketing its vaccines to countries at a price range of $10.65 to $21 per dose, while Moderna’s range was $25 to $37 per dose.
posted by Joe in Australia at 3:13 PM on January 28, 2021 [6 favorites]
Here in the US Mrs. free cell had to go get a TDAP booster recently . Scheduled online, went to Target. 5 total minutes in the store, 90 seconds total interaction with the provider. So we can do it. I blame Trump 100%. His administration fucked this up worse than Hurricane Katrina.
posted by freecellwizard at 3:21 PM on January 28, 2021 [3 favorites]
posted by freecellwizard at 3:21 PM on January 28, 2021 [3 favorites]
At least here, it is very controversial to share personal medical data with commercial organisations. We have an ongoing case about something totally unrelated to COVID right now. When countries, like Israel or Denmark, have very detailed information about citizens, it is paramount that the citizens can trust the authorities to handle these data safely.
You know the old(-ish) saying: if you are not paying, you are the product.
I noted above that countries who botched the first phases of the pandemic are more likely to make risky deals on the vaccine. (I didn't use those words then, but now I do). I can also see how the populations in those countries will be more accepting of those deals. I think the majority here wants approved vaccines at fair prices and without handing over personal information. But that's just us.
posted by mumimor at 3:26 PM on January 28, 2021
You know the old(-ish) saying: if you are not paying, you are the product.
I noted above that countries who botched the first phases of the pandemic are more likely to make risky deals on the vaccine. (I didn't use those words then, but now I do). I can also see how the populations in those countries will be more accepting of those deals. I think the majority here wants approved vaccines at fair prices and without handing over personal information. But that's just us.
posted by mumimor at 3:26 PM on January 28, 2021
The idea that Israel should vaccinate people living outside of their borders is insane. Now if they could just publicly define their borders, we can figure out who all that entails ;)
Hearing from family members inside Israel, there has been a lot of bragging that "we got the vaccine from Pfizer for free," although that does not seem to be the case and as Joe mentions is sort of your typical conspiracy theory used by outsiders.
Also the idea that Israelis in 2021 come into contact regularly with Palestinians who are not Israeli citizens is not that valid unless you live/work in a settlement that hires from the local Palestinian population. You'd think they might want to vaccinate those workers, but time will tell. There are illegal workers daily in Israel who come from Palestine as well, but as far as I know those numbers are vastly lower than they were 10 years ago.
posted by chaz at 4:29 PM on January 28, 2021
Hearing from family members inside Israel, there has been a lot of bragging that "we got the vaccine from Pfizer for free," although that does not seem to be the case and as Joe mentions is sort of your typical conspiracy theory used by outsiders.
Also the idea that Israelis in 2021 come into contact regularly with Palestinians who are not Israeli citizens is not that valid unless you live/work in a settlement that hires from the local Palestinian population. You'd think they might want to vaccinate those workers, but time will tell. There are illegal workers daily in Israel who come from Palestine as well, but as far as I know those numbers are vastly lower than they were 10 years ago.
posted by chaz at 4:29 PM on January 28, 2021
Interesting piece by David Allen Green on what "best efforts" clause means in this context based on a contract that is public.
Essentially the issue is this: if you have only one client, the meaning is super obvious. You do your best and supply what you can. What do you do if there is a shortfall in production and you have multiple commitments though? Now you need a way of deciding who will bear the shortfall.
This does not appear to have been covered in the contract with the EC.
Options:
1) A declared priority list (for instance in order of date the contract was signed), the contract explicitly says where you are in the queue and shortfalls in production accrue from the bottom up
2) Strict proportionality, shortfalls are allocated pro-rata to all buyers (but then why sign an early contract at all?)
3) Territorial allocation, everyone bears the risk of shortfalls at "their" factories
4) Some mix of these that accords priority to earlier orders and/or territorial allocation but not absolutely.
Any one of these, documented and understood, would have been perfectly fine although I think that some form of the latter would probably have been best. The problem appears to be that this was not included in the EC contract in any form. I suspect that option 3 was included in the UK contract based on what has been said publicly.
If that is the case, then AZ and the EC basically screwed up the contract negotiations. If AZ knew it already had an option 3 contract with the UK, that should have been reflected in the EC contract as well. For instance AZ now says it can only supply from the UK factories once those orders have been filled. If that had been in the EC contract, everyone would have understood where we are. The EC should really have insisted on more detail on how supplies would be prioritised if there was a shortfall, they knew they had other contracts so this was an oversight on their part.
Had AZ's UK production not had essentially the same problems, the UK order would have been complete in Q3/Q4 2020 and the UK factories would be free by their contract with the UK government to supply EU demands as well. As a result of scale up problems across all their factories, both orders are now late but the delay in UK production happened earlier so was less noticed.
AZ has put themselves in a bad place here where their commitments conflict and without a pre-agreed way of resolving them. I think it would be really hard for them to argue that any vaccines they did produce in Europe and subsequently ship to the UK would be compatible with the best efforts language in the EC contract even if for all we know they were required under the UK contract. The contracts have a completely separate existence and obviously you cannot cancel out a requirement under one contract by language in another. So if they have done this, the EC would have a very reasonable case for insisting that they came back the other way from UK factory production which is now up and running. This however would likely breach the contract between AZ and the UK since they are also behind on meeting their UK order.
The EC has also screwed this up badly. What was the point of taking extra time to negotiate the contract if you didn't even consider how to handle this? They're now in a very bad position and while national governments are publicly supportive because they know a unified front is the best way to maintain leverage and get what extra vaccines they can, behind the scenes they are furious. The EC can now take a few different positions:
First, they can demand any vaccines that left the EU are replaced for Q1 delivery. A layman's reading of "best efforts" would seem to require this. The problem is that the UK has only administered 7m vaccines total, many of them Pfizer and many of the AZ ones made in the UK (since production in Belgium has been scaled up last, it is unlikely many would have been available to ship) so there is just no way that this could ever be more than a few million doses max. If the EC pushes too hard on this lever they risk essentially post facto legitimising strict territorial allocation and then where are they? They get, say 500k doses, back at the cost of establishing a principle that leaves them with little way of arguing that they should get more from UK production.
Second, they can demand that production setbacks are shared proportionally between all customers or just between them and the UK. They will certainly not go for the former which might leave them with even less but are pushing for the second. This is what I would push for if I was them but they are then faced with the problem of whether the contract language supports that.
The UK government has no interest in getting involved but may have little choice. If the EC decides that as a result of their contract dispute with AZ, they won't allow AZ to export any more (if there was any) vaccine to the UK, then that is fair enough. If the EC decides that no vaccine can leave the EU (including Pfizer vaccine bound for the UK) then regardless of not being a party to the AZ/EC contract the UK government will have to do something.
It's worth noting that the UK very carefully trailed the idea yesterday that they would not absolutely rule out allocating some of their doses to allies after the highest priorities in the UK were done and that the EC has only said that they are creating a visibility tool and a set of rules that would allow export restrictions. Both sides very carefully making it clear that there is work that can be done here. The EC is very unlikely to decide tomorrow to restrict Pfizer shipments to the UK because that would absolutely rule out any AZ vaccine allocation from UK factories by the inevitable retaliation. Nobody wants this so some kind of deal between governments is probably inevitable.
Interesting to see today's EMA decision on not using the AZ vaccine for over 65s. Since the UK is still vaccinating its groups 1-4 and over 65s are in group 5, this might form the basis for an agreement by the UK to allow AZ to send some of its allocation to the EU once the UK has finished group 5. Obviously the UK government will not allow vaccine it ordered to go elsewhere to vaccinate 60 yr olds when it still hasn't vaccinated 69 yr olds. I do wonder what AZ and the EC will have to offer the UK to make this deal though.
-There's obviously the full Trump naked power play tactic of threatening to cut off supplies of the Pfizer vaccine. I doubt they will do this as it is likely to lead to an escalation and if that threat became public it would become politically impossible to compromise.
-AZ could offer a discount to the UK in return for delaying part of their order and send it to the EU instead but vaccines are already cheap TBH and economically you want to vaccinate at the highest possible rate so you can relax restrictions.
-The EU could trade some of its Moderna allocation which it is getting earlier than the UK because they ordered earlier (according to Stella Kyriakides getting vaccine earlier because you placed your order first is the logic of the butcher shop so I'm sure they will be happy to do this...). Maybe a bigger share of the J&J vaccine and earlier? Not sure who's ordered what here.
-Fundamentally the EC has limited tools to get extra vaccine from AZ and their most powerful tool is a massive blunderbuss aimed at their closest trading partner who isn't even a party to that contract.
posted by atrazine at 3:16 AM on January 29, 2021 [3 favorites]
Essentially the issue is this: if you have only one client, the meaning is super obvious. You do your best and supply what you can. What do you do if there is a shortfall in production and you have multiple commitments though? Now you need a way of deciding who will bear the shortfall.
This does not appear to have been covered in the contract with the EC.
Options:
1) A declared priority list (for instance in order of date the contract was signed), the contract explicitly says where you are in the queue and shortfalls in production accrue from the bottom up
2) Strict proportionality, shortfalls are allocated pro-rata to all buyers (but then why sign an early contract at all?)
3) Territorial allocation, everyone bears the risk of shortfalls at "their" factories
4) Some mix of these that accords priority to earlier orders and/or territorial allocation but not absolutely.
Any one of these, documented and understood, would have been perfectly fine although I think that some form of the latter would probably have been best. The problem appears to be that this was not included in the EC contract in any form. I suspect that option 3 was included in the UK contract based on what has been said publicly.
If that is the case, then AZ and the EC basically screwed up the contract negotiations. If AZ knew it already had an option 3 contract with the UK, that should have been reflected in the EC contract as well. For instance AZ now says it can only supply from the UK factories once those orders have been filled. If that had been in the EC contract, everyone would have understood where we are. The EC should really have insisted on more detail on how supplies would be prioritised if there was a shortfall, they knew they had other contracts so this was an oversight on their part.
Had AZ's UK production not had essentially the same problems, the UK order would have been complete in Q3/Q4 2020 and the UK factories would be free by their contract with the UK government to supply EU demands as well. As a result of scale up problems across all their factories, both orders are now late but the delay in UK production happened earlier so was less noticed.
AZ has put themselves in a bad place here where their commitments conflict and without a pre-agreed way of resolving them. I think it would be really hard for them to argue that any vaccines they did produce in Europe and subsequently ship to the UK would be compatible with the best efforts language in the EC contract even if for all we know they were required under the UK contract. The contracts have a completely separate existence and obviously you cannot cancel out a requirement under one contract by language in another. So if they have done this, the EC would have a very reasonable case for insisting that they came back the other way from UK factory production which is now up and running. This however would likely breach the contract between AZ and the UK since they are also behind on meeting their UK order.
The EC has also screwed this up badly. What was the point of taking extra time to negotiate the contract if you didn't even consider how to handle this? They're now in a very bad position and while national governments are publicly supportive because they know a unified front is the best way to maintain leverage and get what extra vaccines they can, behind the scenes they are furious. The EC can now take a few different positions:
First, they can demand any vaccines that left the EU are replaced for Q1 delivery. A layman's reading of "best efforts" would seem to require this. The problem is that the UK has only administered 7m vaccines total, many of them Pfizer and many of the AZ ones made in the UK (since production in Belgium has been scaled up last, it is unlikely many would have been available to ship) so there is just no way that this could ever be more than a few million doses max. If the EC pushes too hard on this lever they risk essentially post facto legitimising strict territorial allocation and then where are they? They get, say 500k doses, back at the cost of establishing a principle that leaves them with little way of arguing that they should get more from UK production.
Second, they can demand that production setbacks are shared proportionally between all customers or just between them and the UK. They will certainly not go for the former which might leave them with even less but are pushing for the second. This is what I would push for if I was them but they are then faced with the problem of whether the contract language supports that.
The UK government has no interest in getting involved but may have little choice. If the EC decides that as a result of their contract dispute with AZ, they won't allow AZ to export any more (if there was any) vaccine to the UK, then that is fair enough. If the EC decides that no vaccine can leave the EU (including Pfizer vaccine bound for the UK) then regardless of not being a party to the AZ/EC contract the UK government will have to do something.
It's worth noting that the UK very carefully trailed the idea yesterday that they would not absolutely rule out allocating some of their doses to allies after the highest priorities in the UK were done and that the EC has only said that they are creating a visibility tool and a set of rules that would allow export restrictions. Both sides very carefully making it clear that there is work that can be done here. The EC is very unlikely to decide tomorrow to restrict Pfizer shipments to the UK because that would absolutely rule out any AZ vaccine allocation from UK factories by the inevitable retaliation. Nobody wants this so some kind of deal between governments is probably inevitable.
Interesting to see today's EMA decision on not using the AZ vaccine for over 65s. Since the UK is still vaccinating its groups 1-4 and over 65s are in group 5, this might form the basis for an agreement by the UK to allow AZ to send some of its allocation to the EU once the UK has finished group 5. Obviously the UK government will not allow vaccine it ordered to go elsewhere to vaccinate 60 yr olds when it still hasn't vaccinated 69 yr olds. I do wonder what AZ and the EC will have to offer the UK to make this deal though.
-There's obviously the full Trump naked power play tactic of threatening to cut off supplies of the Pfizer vaccine. I doubt they will do this as it is likely to lead to an escalation and if that threat became public it would become politically impossible to compromise.
-AZ could offer a discount to the UK in return for delaying part of their order and send it to the EU instead but vaccines are already cheap TBH and economically you want to vaccinate at the highest possible rate so you can relax restrictions.
-The EU could trade some of its Moderna allocation which it is getting earlier than the UK because they ordered earlier (according to Stella Kyriakides getting vaccine earlier because you placed your order first is the logic of the butcher shop so I'm sure they will be happy to do this...). Maybe a bigger share of the J&J vaccine and earlier? Not sure who's ordered what here.
-Fundamentally the EC has limited tools to get extra vaccine from AZ and their most powerful tool is a massive blunderbuss aimed at their closest trading partner who isn't even a party to that contract.
posted by atrazine at 3:16 AM on January 29, 2021 [3 favorites]
Stop vaccinations after health workers and vulnerable, WHO says
I don't see much chance of wealthy countries adopting WHO's suggestion, though. When it comes to the crunch most of us in wealthy countries are selfish, and we're playing a global game of Prisoners' Dilemma: we'd rather have a good chance of personal survival in a world wracked by plague than direct our resources towards achieving globally fair health outcome, while watching other countries defect.
posted by Joe in Australia at 3:16 AM on January 30, 2021 [3 favorites]
The World Health Organization is urging its member states to halt coronavirus vaccinations after their health workers and vulnerable groups have been inoculated, to ensure a “fair” vaccine rollout around the world.This probably is morally the correct thing to do, and the strategically correct thing to do if you believe people's lives are equal without regard to wealth or nationality. Interestingly, it's pretty much the same demand that was made of iIsrael.
WHO spokesperson Margaret Harris said it was “morally” and “economically” the right thing to do.
“We’re asking countries, once you’ve got those groups, please ensure that the supply you’ve got access to is provided for others,” she told BBC Breakfast. “While that is morally clearly the right thing to do, it’s also economically the right thing to do.
“There have been a number of very interesting analyses showing that just vaccinating your own country and then sitting there and saying ‘we’re fine’ will not work economically. That phrase ‘no man is an island’ applies economically as well.”
“We in the world, we’re so connected and unless we get all societies working effectively once again, every society will be financially effected,” she added.
Research suggested earlier this week that the world’s 84 poorest countries will not achieve mass immunisation from coronavirus until at least 2024 and some may never get there, due to a lack of vaccine doses.
I don't see much chance of wealthy countries adopting WHO's suggestion, though. When it comes to the crunch most of us in wealthy countries are selfish, and we're playing a global game of Prisoners' Dilemma: we'd rather have a good chance of personal survival in a world wracked by plague than direct our resources towards achieving globally fair health outcome, while watching other countries defect.
posted by Joe in Australia at 3:16 AM on January 30, 2021 [3 favorites]
On the topic of the AstraZeneca vaccine production disaster: Here's a Der Spiegel interview with a professor for contract law in the pharmaceutical industry (German language link).
posted by romanb at 11:25 AM on February 3, 2021 [1 favorite]
posted by romanb at 11:25 AM on February 3, 2021 [1 favorite]
Followup on vaccine results by Ha'aretz:
94 Percent Drop in Symptomatic COVID Cases Seen Among Vaccinated, Biggest Israeli Study Shows
So, good news. Another story says:
In Shift, Vast Majority of New COVID Cases in Israel Below Age 39
Not such good news! The total numbers are going down, but they should be going downmore. Ha'aretz says that younger people aren't taking up the vaccine as quickly as they should, particularly among Arab and Haredi Israelis. It has been reported elsewhere that the government is looking at the tools it has to enforce compliance.
posted by Joe in Australia at 3:08 AM on February 15, 2021 [1 favorite]
94 Percent Drop in Symptomatic COVID Cases Seen Among Vaccinated, Biggest Israeli Study Shows
The Pfizer coronavirus vaccine has produced a 94 percent drop in symptomatic coronavirus cases, a study published Sunday by the Clalit health maintenance organization's research institute says.
The study analyzed 1.2 million Clalit members, including 600,000 who had received the Pfizer vaccine and 600,000 who had not. The inoculated group produced 94 percent fewer symptomatic COVID-19 cases, and 92 percent fewer cases of serious illness.
[…]
While the study reinforced that the vaccine is highly effective in preventing symptomatic infection a week or more after the second dose, it also showed that it was highly effective in preventing serious illness, which clinical trials were unable to prove, since there were too few cases of serious illness among the participants for the data to be statistically significant.
So, good news. Another story says:
In Shift, Vast Majority of New COVID Cases in Israel Below Age 39
Seventy-five percent of new COVID-19 cases in Israel are under the age of 39, a new report by Israel's Coronavirus Information Center published on Sunday shows.
Additionally, the report revealed that as much as 15 percent of patients in a serious condition are age 39 or younger, a figure which has steadily increased since December.
Not such good news! The total numbers are going down, but they should be going down
posted by Joe in Australia at 3:08 AM on February 15, 2021 [1 favorite]
Update on the Palestine Authority vaccination program at Wafa [Google Translate]
A bit of a mixed bag, but if you can believe the Minister of Health they've already vaccinated some people and will shortly be in a position to vaccinate around 20% of their population. It's not clear to me whether they're sharing vaccines with Gaza.
posted by Joe in Australia at 12:01 AM on February 26, 2021
A bit of a mixed bag, but if you can believe the Minister of Health they've already vaccinated some people and will shortly be in a position to vaccinate around 20% of their population. It's not clear to me whether they're sharing vaccines with Gaza.
posted by Joe in Australia at 12:01 AM on February 26, 2021
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I have many things I could say on this but I think I’ll just say “This isn’t right” and leave it at that.
posted by Big Al 8000 at 7:47 PM on January 27, 2021 [61 favorites]