Adam Boulton Diary – Will you get vaccinated?

So, are you going to have the jab? As a late baby boomer, I’ve grown up in the glow of enthusiasm for vaccination fuelled by Jonas Salk’s great triumph over polio in the 1950s. The worst I’ve suffered has been successive school doctors sticking the needle in with the words “I wish I had a pound for every time your father has done this” – by complete coincidence all had been trained in anaesthesia by him as medical students at Barts.

Now that the UK authorities have approved the Pfizer-BioNTech for use here, getting enough of the population immunized may not be as tricky as the anti-vaxxers on social media hope. A large survey by the London School of Tropical Medicine this summer found only 14% would definitely not have a properly approved Covid vaccination; 13% didn’t know. More recently, last month IpsosMori found  that 37% committed “definitely” to have one, and the vast majority are simply hanging back with an open mind.

This week, I spoke to anti-lockdown demonstrators who had an unused “1984” face mask hanging from their rear-view mirror. They went on to tell me that they certainly wouldn’t be having a vaccination. It will be a practical inconvenience for self-styled lovers of liberty, if they reject the most obvious key to their freedom.

The Prime Minister has assured the public “there will be no compulsory vaccination”. But Nadhim Zahawi, the newly appointed, if somewhat low-profile minister for Covid-19 vaccine rollout, was wise to point out that market forces may decide what we do anyway. Already some countries refuse entry to travellers who cannot produce the right vaccine certificates. Some airlines could follow suit with their own rules. Air France, for example, insists on disposable masks rather than cloth ones. Many companies actively encourage and assist their staff to have annual flu jabs. Since mass inoculations can help protect contacts from contagion as much as the person injected, there will be sound health and safety pressures on managements to make workplaces “covid proof”. Employment lawyers do not fancy their chances before a tribunal of a worker who refuses vaccination on anything other than health grounds.

Most of us seem likely to end up getting vaccinated against Covid, in the course of next year at the latest. This pandemic has been epoch defining. So is such rapid discovery of apparently effective vaccines to curb the outbreak. Can a Nobel Prize be far away for Ugur Sahin and Ozlem Tureci, the Turkish-German couple at BioNTech who discovered the vaccine now marketed by Pfizer?

A more interesting question, perhaps, is which vaccine will end up being shot into our bodies? National governments are already jostling for credit and championing their own locally developed products. Vaccines have become the latest battleground for international rivalries and influence peddling, inevitably linked to profit motives.

Pfizer/BioNTech and Moderna’s mRNA vaccines are the United States’ favoured candidates. American media outlets were quick to seize on any question marks over the testing of the more conventional competitor being developed in tandem by the British-based AstraZeneca and University of Oxford. Russia, China and India have also joined the great vaccine game.

Although the outbreak is still spiking in Russia, President Putin says, “Russian vaccines exist. They work and they are safe and efficient.” Russia is already offering contracts for Sputnik V to other countries, many of them similar autocracies with strong man leaderships. Meanwhile GCHQ accuses Russian sources of promulgating anti-vaxxer lies on social media alleging “a gigantic pharma rip-off” by the West.

To little surprise, the People’s Democratic Republic of North Korea has been caught trying to hack into the Covid data bases of pharmaceutical companies including Johnson and Johnson, AstraZeneca and Novavax. Officially, Kim Jong-Un claims his country is Covid-free.

China sees the virus which originated in Wuhan as a fresh opportunity to extend its influence. As with the Belt and Road initiative, the Peoples’ Republic is offering help in exchange for long term indebtedness. Countries targeted include Indonesia, Pakistan, Turkey, Egypt, Saudi Arabia and Malaysia, where local populations have been used to test Chinese prototype vaccines. According to the Mexican government, China is offering $1bn dollar loans to purchase its products.

The leading Chinese candidate vaccine, developed by Sinovac, is currently one of the most expensive. It is on sale privately for $60 dollars a dose. The details of many contracts have not been made public. Moderna’s vaccine comes in at about $35 dollars a dose and the US government is paying $19.50 each for one hundred million Pfizer/BioNTech doses. To be effective the America vaccines require two doses for each person.

President Trump tried to buy up exclusive America first rights to the Curevac vaccine being developed in Germany for $1 billion. He was unsuccessful, and Curevac has not yet announced a breakthrough. On Tuesday, the head of the Food and Drug Administration (FDA) was summoned to the White House. But the FDA is still not expected to give regulatory approval to any vaccine until the middle of the month. The EU is likely to take until the end of the year, both will be weeks behind the UK’s Medicine and Healthcare products Regulatory Agency (MHRA).

Responding to boasts from the American and British governments about the Pfizer/BioNTech breakthroughs, both the German Health Minister and Ambassador to London retorted that it was a “European” triumph.

Unlike the UK and major European nations, Trump has kept the United States out of the UN and Bill Gates supported Covax programme which aims to provide poorer countries with two billion vaccines at $3 a dose by the end of next year. President elect Joe Biden plans to re-join the World Health Organisation but has not yet committed to Covax.

AstraZeneca hopes to provide the “Oxford Vaccine” for $3. The pharmaceutical company had little alternative but to adopt a non-profit approach given the amount of public funding invested both domestically and from the United Nation’s GAVI. Dr David Nabarro, the World Health Organisation’s Covid envoy, thinks it is more likely that the Oxford vaccine will become the global standard. It is cheaper, has a much longer shelf life and easier to handle and distribute, requiring only normal refrigeration compared to -70 degrees for the American vaccines.

National stereotypes seem to be reflected in the developments on either side of the Atlantic. The “American” solutions are expensive, complex, and highly engineered. The “British” vaccine is more straightforward and cheaper and while it may only be 60+% effective preventing the virus, the fact that nobody who had it during the trial fell seriously ill with Covid has perhaps been under appreciated.

There is a Brexit twist of course. The Pfizer/BioNTech doses destined for this country are manufactured in Brussels. Super refrigerated lorries will have to come through British ports this winter whether or not there is a Trade Deal with the EU.

On the bright side, these arguments between countries of the vaccines herald the return of politics as normal. As the Prime Minister warned, the vaccine breakthroughs are “not the end of the national struggle…it is very important people don’t get their hopes up too soon.” First, the nation’s health will have to weather the temptations to socialise presented by the Christmas holidays. Effective distribution of any vaccine will be essential. Logistics have not so far been a British triumph during this pandemic.

In the first half of the year, however, vaccines which could presage a return to life near normal should be widely available. My guess is that most of us will be as keen to be inoculated against Covid-19, as we have been against Polio and the flu.