The Vaccine – is it all Over?

On 9 November 2020, BioNTech/Pfizer announced that they had developed a vaccine which was effective in preventing 90% of people from contracting covid-19. At the conclusion of Phase 3 trails on 43,000 people, they declared that their vaccine had been shown to be effective on all ages of people and without causing significant side effects. A week later American company Moderna revealed that they too had developed a viable vaccine, this time with 95% effectiveness. Was this the end, or, to paraphrase Winston Churchill, was this the beginning of the end, or at least, the end of the beginning? How would the world react? Would a wave of euphoria ripple across the world or would the response be cynicism or mistrust? Given that the vaccines utilised cutting-edge biotechnology, (with the first ever use of RNA-based treatment on humans) would this be perceived as a triumph for scientific endeavour? Would national governments and/or supranational bodies such as the World Health Organisation be given praise for their roles? How quickly could the vaccines be manufactured and distributed? Who would get the vaccine first? Who should get the vaccine first? Would the distribution of the vaccine be done equitably, or would it be monopolised by wealthy countries at the expense of continued suffering in the Global South? Would people agree to be vaccinated in sufficient numbers to eradicate the virus for good?

On 19 November the Pandemic Perspectives group debated these issues, guided by articles in The Conversation, ‘Who should get the vaccine first?‘, The BBC, ‘Covid-19:Normal Life back by Next Winter, says Vaccine Creator’, Gavi, (The Vaccine Alliance) report on COVAX, and Oxfam’s report that a ‘Small group of Rich Nations have bought up 90% of the supply of vaccine contenders.’

After discussing the remarkable technology that had led to the vaccine’s development, the group began by exploring their own reactions to the announcement. The collective response was surprisingly muted, characterised by Richard Kendall as a ‘cultural shrug’. A number of explanations were put forward for this. Niall Gallen & Alastair Gardener both felt that it was largely a consequence of the awareness that it really wasn’t ‘all over yet’ – problems of implementation remained, distribution would be slow, and, in the likelihood of further lockdowns meant it still felt that we would remain in ‘viral mode forever’. Alastair noted that doubts remained over the longevity of any immunisation conferred by the vaccines, the possibility of mutation, and speculated that the future pattern might be akin to a deadly seasonal influenza. Richard suggested that faith in the UK government had been so eroded during the pandemic thanks partly to ‘over-promising’, that scepticism was unsurprising. Alastair suggested that our vision of the end of a pandemic had been conditioned by filmic representation, where the scientist’s eureka moment concluded the narrative, and the final scenes were of survivors rebuilding a new world from the ashes of the old. As such instant resolution was an impossibility, we were inevitably disappointed. Ronan Love expanded this theme, arguing that the structural issues that had led to the pandemic in the first place had not been addressed, noting the role of climate change and the animal human transmission of pathogens making further pandemics likely.

The group then debated who would receive credit for the breakthrough. Richard advanced the view that it would be seen as a triumph for firstly science, which might provide a boost for the status of experts, but that ultimately it would be seen as a triumph of the free market, as success had been achieved by competition between multinational representatives of ‘Big Pharma’. Sadegh Attari expanded this argument, referencing his article ‘Bill Gates’ Vaccine – How I learned to Stop Worrying and Love Neo-liberalism’. He argued that although governments were ‘pivotal entities’, both as funders of the R & D that enabled the vaccine breakthrough, and as the primary source of funding for the direct research into Covid vaccines, this was wholly unreflected in a media coverage that was more likely to attribute success to billionaire philanthropists. Ronan concurred, noting Marina Mazzucato’s work The Entrepreneurial State, that debunks the prevailing myth of a lumbering bureaucratic state and a nimble, creative private sector, arguing that the opposite was true, that the private sector commonly followed innovation and investment by states into high-risk areas of development. David Christie contested the view that governments would gain little credit from any defeat of the covid virus, arguing that the distribution of vaccines through the organs of the state would ultimately result in them being considered the saviours of their populace. He noted that the more discredited bodies were the supra-national ones, from the EU to the WHO who were largely perceived to have failed in their responses at a time of crisis. Richard and Niall largely supported David’s view, noting how from the outset it had been nation-states that had formulated the primary response to the pandemic, and the crisis had demonstrated their weakness and dependence on national imperatives. Ronan acknowledged the ineffectiveness of supra-national bodies, arguing how the crisis had illuminated the fact that such bodies did not sit at the apex of the global political economy, but had always been understaffed and underfunded and dependent on the aegis of nation states. He also noted that even in the grip of the pandemic, the EU had struggled to agree a budget and was currently deadlocked due to objections of Poland and Hungary. Sadegh noted that it was only from a Western perspective that the weakness of the WHO could come as a surprise. Ronan hypothesised, however, that when the narrative of the pandemic solidified, failings by any of the key participants may well be airbrushed out, with the story told as though it couldn’t have happened otherwise and historical contingencies and policy failures written out.

Debate moved on to the question of the ‘politics of distribution’. David argued that while the broad parameters of who would get the vaccine first seemed to be universally accepted (the elderly, those with co-morbidities, front-line health and care workers), other groups such as BAME who appeared to be disproportionately at risk would also have a case for early access – something that would be deeply controversial politically. Niall noted that whilst in France, these decisions had been subject to a national consultation no such discussion was likely to take place in the UK. Alastair concurred, reminding the group of the UK government’s hostility to any attempt at consultation during the pandemic, either with the devolved governments of the UK or regional bodies in England. Ronan and Richard argued that no such debate was necessary, that it was the role of government to decide, and that a consensus on prioritisation had largely been reached. Ronan felt that any consultation over who constituted a key worker would ultimately be divisive, noting that cases could be made for groups such as shop-workers or taxi-drivers as key workers, and that balancing competing claims would be distracting and counter-productive. The question of regional distribution was raised, with no firm conclusions over its desirability reached. Carmen noted that in the US, Trump had made a public declaration that despite New York’s position as the epicentre of covid contagion in America, it would not receive any privileged access to vaccines. She attributed this as a direct consequence of Trump’s political hostility to New York’s Democratic governor. Such naked political favouritism was not envisaged by the UK members as being likely on this side of the Atlantic.

David raised the issue of nationalism and the distribution of covid vaccines, noting the Oxfam article that outlined how 90% of the output of potential vaccines had been secured by a handful of wealthy countries. He posited the near-certainty that the suffering would long continue in the global south after the virus had been controlled in the developed world. Sadly, no one disagreed, with Ronan noting that it would always have played out this way with those with the greatest resources securing their interests first. Richard described it as a particularly brutal form of Realpolitik. David noted that the politics of distribution would also be filtered through an increasingly bipolar world, with access to vaccines granted in return for affiliation to Chinese or American blocks and with other strings attached. Ronan demurred, arguing that this was too simplistic, noting that the world was multi-polar rather than bi-polar and nations such as Russia and India would play significant roles. Niall argued that the politics of distribution were dependent on how the virus mutated, the consequences of a one off event like Spanish Flu might well lead to geopolitical manipulation, but that multiple pandemics might force the world to cooperate and strengthen the hand of bodies such as the WHO.

There was much more, join Pandemic Perspectives to have your say or set up your own group…