Thread by @jonworth

A fortnight ago I wanted to answer a question: would a 🇪🇺 vaccine export ban be justified?

I was somehow instinctively against any such ban, and still am

But digging into it revealed the worst of out politics, media and social media, and how badly we cope with complexity

1/22

The essence of the issue is that this is both an ideological/ethical matter, and a practical one - and the interplay between the two is complicated

No person's response to the question ban-or-not can be based either all on ethics or all on practicality

2/22

Or - putting it another way - export of a small number of vaccines might be easier to justify than export of a massive number that would slow down the exporting region's own vaccination drive

3/22

Then comes the complexity of what even *is* a ban?

UK has no export ban, but is not exporting. This is commonly attributed to the terms of the agreement UK has with AZ, but - I concluded - is more elementary. UK just doesn't have enough production to cover its own needs!

4/22

By contrast the USA has a massive vaccine production, and has been sitting on millions of AZ doses, pending the FDA approval of that vaccine.

So is an export ban to the USA more justified than one to UK?

5/22

What about the actual vaccines? AZ has production and fill&finish in UK, in USA, and in EU. Pfizer/BioNTech does not have production or fill&finish in UK, but one lipid used in the EU supply chain comes from UK... so is the case stronger for banning some firms' exports?

6/22

And should whether a company has met its supply commitments to the EU come into it?

Or what about how much the EU (or EU Member States) have committed to funding a firm's production line, or even the academic research into a vaccine?

7/22

And then you have to actually work out what the hell is even happening.

Especially for AZ what has been shipped where, and by whom, is next to impossible to work out - especially from the Halix plant in Netherlands.

8/22

The EU has a transparency mechanism for vaccine exports, but the statistics are not all public - von der Leyen seems to quote from them selectively, meaning we know more about what was sent to the UK than to USA for example

9/22

Getting stats on imports from anyone else is damned hard too - UK does not want to let on how import-reliant it is, and USA does not want to let on how massive a stock it is sat upon, nor that it's not even supplying Canada or Mexico much

10/22

The corporate comms of AZ (and Halix too) have been dire throughout - and it feels their lack of transparency has been adding to the confusion, not alleviating it

BioNTech and J&J (in Europe at least) are a bit better. Novavax also strange

11/22

Then we come to the journalists and the politicians in this whole issue... Politicians as far as I can tell are having to make decisions here with not much better information than the rest of us have - so often talk complete rubbish

12/22

I've been tearing my hair out at the way von der Leyen, Thierry Breton, Mario Draghi, Jean-Yves Le Drian, Ben Wallace and Matt Hancock (for starters) have talked about these issues

13/22

Journalists then typically regurgitate these statements, without themselves having any grip of what is going on either

You cannot fairly write about Halix without knowing how many doses it has produced. We do not know. So you can't really cover it fairly

14/22

Add on top of that a massive dose of national pride and it gets very messy indeed. Trying to come to any sort of fair assessment of what AstraZeneca in particular has done is - when addressing anyone from the UK - next to impossible

15/22

There has been no media or publication that has been close to universally good, and plenty that have been close to universally awful, when journalists covering the topic have failed to ask themselves even the very basic questions I am posing in this thread

16/22

Don't get me wrong - some of this is fiendishly difficult, and getting stats that are comparable is often hard - but that is no excuse for not asking the basic questions, and not stopping to ask: is there another way of looking at this problem?

17/22

And then add onto that the neverending stream of abject crap on Twitter, and you want to scream

Pretty much every response to a tweet about any vaccine supply issue is negative, and masses of them repeat over and over points you've addressed a thousand times

18/22

Everyone is searching for simple and unitary answers to complex questions, and are not willing to see that there are multiple issues, multiple wrongs

The number of users I have had to block this past fortnight has been damned high

19/22

There have been a half dozen people who have helped me a lot. Helped me to understand, sent me interesting links and stats, and have not always assumed ill intent

@BioHJM @Semyaza666 @arekmakarenko @mattwardman @GregorxxxSamsa you guys rock

20/22

But at the end of this, I am simply down and deeply, deeply cynical. There is no way for a sharp lay person (which is essentially what I am) to understand this. The misinformation and poor reporting are too prevalent, before you even get to the technical complexity

21/22

It is one of the most central issues of the moment: when are we all going to be able to be vaccinated, and where will that vaccine supply come from?

One day I'll get a 💉, probably BioNTech from Marburg. But beyond that... 🤷‍♂️

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