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Doubts grow over the future of AstraZeneca’s Covid vaccine

AstraZeneca - Dado Ruvic/Reuters
AstraZeneca - Dado Ruvic/Reuters

Britain may be about to start its Covid booster jab roll-out, but already the wheels are in motion for next year's vaccine blitz. This week, ministers announced they had struck a deal for 35m Pfizer booster shots to be delivered in the second half of 2022.

"While we continue to build this wall of defence from Covid-19, it's also vital we do everything we can to protect the country for the future too – whether that's from the virus as we know it or new variants," Sajid Javid, Health Secretary, said.

Among the scientific community, news of the order raised some eyebrows. By last week, Britain already had more than 500m jab doses on order with eight vaccine makers. Of the vaccines which had been approved here, the UK had ordered more than 210m doses.

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"I find it all a little bit disturbing," said Clive Dix, the former interim chair of the vaccine taskforce. "I think it's crazy we're going down that route [to buy doses for 2022] already." In his view, decisions over boosting seem to be rushed.

"I would personally just say let's boost with the AstraZeneca vaccine this year, which we have available and which is a very good vaccine - and only then should we start thinking about next year."

Still, while he sees AstraZeneca's vaccine as among the best, he says it is hard to ignore its "tarnished reputation" - centred around concerns over the few cases of blood clots associated with the jab. A study recently suggested rates of clots were "similar" with Pfizer's vaccine.

"It's so sad that both as a British company and one of the front-running companies with vaccines, it seems to have this reputation," Dix shrugs. "It rolled up its sleeves and did something really important."

News of the latest deal suggests the UK may now be envisaging a reduced role for AstraZeneca in the next vaccine booster rollout.

Already, across Europe, its use has been dwindling. In the UK, where initially ministers spoke of wanting to "lead the world in developing a coronavirus vaccine" and "backing our scientists to the hilt in doing so", now more than a year later, few AstraZeneca jabs are being given.

Between July 21 and August 11, only 700,000 AstraZeneca vaccines were administered across the UK - driven by the fact it is only advised for those over 40, many of whom had already been vaccinated. During that same period, 3.2m Pfizer doses were given.

The slowdown in the UK’s use of the jab meant AstraZeneca was able to start sending doses produced in an Oxford vaccine factory, previously the subject of a bitter supply row with the EU, over to the Continent. There, Pfizer and Moderna jabs are used more widely.

All this has sparked questions over what the future holds for AstraZeneca in vaccines. Before the pandemic hit, the company had little to do with vaccines, with Merck, Pfizer and GlaxoSmithKline clear leaders in the field.

AstraZeneca's chief executive, Pascal Soriot, has said the "goal initially was really to come in and help". He added: "That was it. And so one option for us was to come in and help, deliver this vaccine, and then go back to our core business."

Still, this shift back to the core business has not been guaranteed. While one executive suggested last month that the company could spin off the vaccine work, AstraZeneca bosses have been clear that decisions have yet to be made. In May, Soriot said the firm had not "decided, really, what we’re going to do long-term with vaccines".

Among some shareholders, pressure has been mounting for the firm to exit the space. Analysts say the Covid-19 vaccine is seen by some as a distraction for a company which could instead be focusing attention on its cancer work.

What's more, AstraZeneca has a huge task ahead of it in integrating immunology giant Alexion, which it bought for $39bn (£28bn) late last year - no mean feat for a firm whose own market cap stands at £132bn.

But support for an exit is not universal. Ketan Patel, a fund manager at AstraZeneca shareholder EdenTree Investment Management, says the company cannot pull out - and in fact, should not. "The assumption is that because the UK, Europe and the US are vaccinated, the world goes back to normal now, but we need the rest of the world to get vaccinated."

It is in this area that AstraZeneca is already playing a leading role. As of earlier this month, AstraZeneca had delivered 91m doses of its Covid-19 vaccine to the Covax scheme, which distributes vaccines to developing countries, equal to around two thirds of the total amount of jabs given to the project.

"They're playing a key role in vaccinating the rest of the world. And of course, the assumption is that Covid is just one illness, one strain, but there's more strains coming through, so I think this could be a step for AstraZeneca in actually developing a vaccine division, like Roche and GlaxoSmithKline," Patel says.

Such a move would take more effort than it may initially seem. While AstraZeneca has helped to make and distribute the vaccine, it does not own the platform behind the AstraZeneca-Oxford Covid vaccine.

AstraZeneca itself also does not have the significant vaccine manufacturing operations required to scale up this work.

Adam Barker, an analyst at Shore, says building the business is something "it couldn't really do on the cheap".

It may also not be something AstraZeneca would want to do, given that its jab uses different technology to others. "I would say that a lot of focus has shifted to mRNA vaccines," Barker says, referring to jabs such as Pfizer's which essentially tell the body how to make the Covid spike protein which then allows it to react to that spike protein by making antibodies. AstraZeneca's is a more traditional-style vaccine.

"I think a lot of work will be going towards the mRNA types of vaccines, which theoretically could be updated quicker to variants," Barker says.

Still, experts say we should not write off AstraZeneca's work too early. Sir John Bell, the Oxford vaccine tsar, said data based on the disease appeared to show that Pfizer's durability declines steadily but rapidly, whereas AstraZeneca's does so much less quickly. "The immunity should be longer and more durable," he explains.

The recent order with Pfizer does not mean use of the AstraZeneca Covid jab will end in Britain. The Government "will be over-purchasing because no one knows where this goes next," Sir John says. "As we know, they won’t necessarily use it."

With an ever-ballooning jab stockpile, it appears Britain's plans on how it can "keep the nation safe for years to come" may simply involve buying big and seeing what happens - and AstraZeneca may still play a significant part.