It doesn’t happen often that a pharmaceutical giant is applauded, and certainly not at a festival. AstraZeneca received this honor in March 2021. On the grounds of the Dutch Lowlands, festival goers loudly chanted “Astra! Zeneca! Astra! Zeneca!” After all, the Covid shots from the British-Swedish vaccine maker would herald the road to freedom.

Those cries of joy have long since faded away. On Wednesday, AstraZeneca finally pulled the plug on its Covid vaccine. A day earlier, the European Medicines Authority EMA had withdrawn its approval. It is the final end to what then Prime Minister Boris Johnson described as a “triumph for British science”.

Second rate

The vaccine, developed by the University of Oxford, used a known technology based on a cold virus. This caused less fear than the brand new mRNA technology used by competitors Pfizer and Moderna.

It also did not have to be kept extremely cold, which was necessary with the mRNA vaccines. And also: Oxford and AstraZeneca offered their vaccine at cost, making it seven to eight times cheaper than the mRNA vaccines. The European Commission ordered 300 million doses and wanted to make AstraZeneca the workhorse to contain the pandemic.

But AstraZeneca never lived up to the sky-high expectations. The company initially faced major delivery problems. Moreover, it had not done its homework properly. Because it had included too few seniors in the clinical trials, the EMA could not say whether the vaccine was effective for the elderly. That’s why many countries initially did not give it to people over 55. It never even received approval in the United States. Moreover, the EMA estimated the effectiveness at only 60 percent. That gave the impression that Vaxzevria (the brand name) was a second-rate vaccine.

But the biggest setback was yet to come. In March 2021, many countries noted a rare but serious side effect. In the United Kingdom alone, 81 people died from a thrombosis linked to Vaxzevria. In Belgium, three deaths were attributed to the vaccine, one of which was related to thrombosis.

Because this side effect mainly occurred in young women, many countries imposed a minimum age for a shot. Other countries, such as Denmark and Norway, quickly decided to stop using the vaccine. Many countries forwarded their doses to poorer countries.

Smaller market

Yet the merits of the vaccine are much greater than the setbacks indicate. In the UK, which continued to inject its ‘own’ vaccine for a long time, the efficacy rate turned out to be not much inferior to that of Pfizer.

Because production eventually picked up steam, and it was often used in poorer countries, The Economist concluded that AstraZeneca “almost certainly saved more lives than any other vaccine” in 2021. A later analysis by data company Airfinity qualified this somewhat. AstraZeneca was in first place with more than six million lives saved in the first year of vaccination, but it also had to tolerate Pfizer in its wake.

In a press release, AstraZeneca looks back with pride on the role the vaccine played in ending the pandemic. The British-Swedish group cites an oversupply of adapted vaccines as the reason for the discontinuation.

Virologist Johan Neyts (KU Leuven) follows that explanation. “The market has become a lot smaller. How often will it be boosted? Probably only in high-risk patients. Although perceived and real problems also played a role in the decision.”

The question is also whether there is a future for the technology at all, Neyts points out. Because so many people have been vaccinated – 3 billion doses worldwide, of which 1.4 million in Belgium – the question is whether there is no immunity against the cold virus from which AstraZeneca started, as a result of which the vaccine no longer works.

In addition, the rare thromboses also occurred with the Johnson & Johnson vaccine, which uses the same technology. That vaccine is also on the verge of death: it is no longer authorized in the US, among others, and has no longer been commercialized in our country since last month.