What Went Wrong With The Rollout Of The AstraZeneca Vaccine? : Goats and Soda Oxford-AstraZeneca promised its COVID-19 vaccine would be effective, cheap and available worldwide. Five months after its launch, the path forward has been anything but smooth.

It's The Vaccine That's Lost A Lot Of Trust. But AstraZeneca Still Has Its Fans

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NOEL KING, HOST:

In the fight against the COVID-19 pandemic, one of the most important and shunned vaccines is the Oxford AstraZeneca. That vaccine was expected to be widely used in low- and middle-income countries. It's inexpensive and easy to store. It's also being manufactured in 25 sites around the world, but it has had problems. Here's NPR's Jason Beaubien to explain.

JASON BEAUBIEN, BYLINE: The AstraZeneca vaccine was born out of a spirit of altruism. It was developed jointly by researchers at the University of Oxford and the multinational pharmaceutical company AstraZeneca. And they vowed to make it widely available on a not-for-profit basis. It first won approval for use in the U.K. on December 30 of last year. And the first jab was given five days later.

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BRIAN PINKER: To be honest, I didn't feel a thing.

BEAUBIEN: An 82-year-old retired maintenance manager named Brian Pinker got the first official dose of the newly authorized AstraZeneca vaccine at a hospital in Oxford.

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PINKER: The vaccine means everything to me. I mean, to my mind, it's the only way of getting back a bit of normal life.

BEAUBIEN: The launch of the AstraZeneca vaccine was a moment of optimism. It was being trumpeted as the vaccine for the world and for good reason. It cost 10 times less than some of its rivals. It didn't need special refrigeration. AstraZeneca was offering to license it to other manufacturers. But five months after its launch and after 400 million doses have been administered worldwide, AstraZeneca is one of the most controversial vaccines on the market. The company is facing lawsuits over production delays. There have been questions about the accuracy of some of its clinical trial data. It still hasn't gotten a stamp of approval from U.S. regulators. And then a few months ago, reports started to emerge linking it to rare but serious blood clots.

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UNIDENTIFIED PERSON #1: Germany, France, Italy and Spain all pause distribution of the Oxford AstraZeneca vaccine.

UNIDENTIFIED PERSON #2: While they investigate reports of rare but serious blood clots.

UNIDENTIFIED PERSON #3: The decision experts here are calling a disaster.

BEAUBIEN: European drug regulators ultimately concluded that the blood clots were an extremely rare, manageable side effect and that the benefits of the vaccine far outweighed the risks. Still, the damage was done, and some wealthier countries, including Norway, decided to stop using AstraZeneca entirely. But for low- and middle-income countries, it does remain the primary vaccine being offered.

ROSE WAKIKONA: What choice do we have? Sincerely speaking, what choice do we have?

BEAUBIEN: Rose Wakikona is with the Center for Health, Human Rights and Development in Uganda. Less than 2% of Ugandans have so far been vaccinated against COVID with AstraZeneca. And Wakikona says there's a perception that they're being given a second-tier product.

WAKIKONA: All that's available is AstraZeneca and no one has offered us any other option, none whatsoever.

BEAUBIEN: She says if she had a choice, she'd probably take Moderna or Pfizer. And she has a point. The effectiveness of AstraZeneca is high in preventing infections but is still less than that of Moderna or Pfizer. Also, in some limited studies, it appears to hardly work at all against some variants of the virus. But some of these problems were completely out of AstraZeneca's control. And Adam Finn, a vaccine expert at the University of Bristol, says this vaccine is great.

ADAM FINN: It's an amazing vaccine. It's - we've used it a lot in the U.K. now. It's the sort of one of the two main vaccines in our program, along with the Pfizer vaccine. And the results we're seeing with it in use are really impressive.

BEAUBIEN: Finn, who was an adviser to the WHO on several vaccine trials, says it clearly prevents disease and it was instrumental in containing the outbreak in the U.K.

FINN: So I think it's going to be a really key part of trying to bring COVID under control around the world.

BEAUBIEN: However, that's become complicated because the largest supplier of AstraZeneca for low- and middle-income countries was supposed to be the Serum Institute of India. As the COVID crisis exploded in India, Serum has diverted all of its production to deal with the domestic crisis, and it may not resume exports until the end of the year. Pascal Soriot is the CEO of AstraZeneca.

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PASCAL SORIOT: We have a global supply chain, and it's going very well in some parts of the world and more challenging in other parts.

BEAUBIEN: He was speaking at a virtual forum hosted by the media platform Devex during the World Health Assembly. He said the cut off of exports from India has had a huge impact in the availability of their vaccine globally.

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SORIOT: So what we're trying to do is increase supply from elsewhere, but it's very difficult because, you know, supply chains are very stretched already.

BEAUBIEN: Soriot says making vaccines is complicated, and his company doesn't have the capacity to set up new manufacturing facilities right now. And even if the company did, it would take time to get those production lines up and running.

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SORIOT: What people would need is a vaccine today, and that creates a lot of challenges.

BEAUBIEN: Despite those challenges, despite shortfalls in production and despite a tarnished image, AstraZeneca is still producing millions and millions of doses of vaccine every day. And the international vaccine sharing program, COVAX, is still relying on it to be the workhorse of the effort to contain COVID globally, particularly in lower income countries. Jason Beaubien, NPR News.

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