AstraZeneca exempt from coronavirus vaccine liability claims in most countries
uk.reuters.com
uk.reuters.com
Big pharmaceutical companies have a history of marketing drugs that aren't quite as good or harmless as they are made out to be.
1. We want you to sell us the drug at cost with no profit margin
2. We want you to be responsible for unlimited liability for whatever the drug might eventually do
Oh, and by the way, we want you to rush your testing so you don't have the normal time to verify its safety!
This! The public are acutely aware of the predicament that governments have created and most will be very skeptical of a vaccine that's been rushed through like this especially if a regulator says 'sure its totally safe' when we can all see the data to determine that cannot possibly exist in the near future.
What predicament? The gov't didn't create covid.
> especially if a regulator says 'sure its totally safe'
To my knowledge (and I did work in this area) no regulator will ever declare a drug 'totally safe'.
> most will be very skeptical of a vaccine that's been rushed through like this
Yeah well, you're speaking for a rather large population whose minds you don't know so please don't. Also covid is dangerous so people may be skeptical but still take it.
However today there are ready armies of lawyers to sue for those very rare side effects that have a much lower fatality rate than the disease itself.
Are pharmaceutical companies the pinnacle of honesty and ethics? Of course not. Would it be worthy pulling a covid vaccine out of shelves if it caused a 1 in 1Mi serious side effect? No way.
Sure, you can try to identify and quantify the risk so maybe don't give this vaccine to people who might have a worse outcome, still, nothing is perfect.
Well, yeah, we don't want a drug that kills more people than it saves, right?
> we want you to rush your testing
That's not happening, what will be accelerated will be regulatory approvals and reviews, not clinical trials.
Regulators can decide they're uneasy about potential for birth defects, or side effects with particular other drugs you never tested, or any number of issues. Sometimes a pharmaceutical company just hoped not to be asked, and other times the concern comes out of the blue.
But if we're fast-tracking approval, anything that isn't a red flag won't get in the way. That unavoidably means higher risk to patients overall. Since the virus kills a lot of people every day everywhere it hasn't been eliminated it makes sense to take that risk, but governments (accountable to their citizens) get to decide that, not drug companies.
The trials are most certainly accelerated. Take a look at Moderna's trial of their RNA vaccine.[1]
It's a 2 year trial, but data is collected on a rolling basis. They aren't waiting 2 years for final results, I'm guessing they do a few interim analyses until they see the two arms split in terms of infection rate. Then they'll go to the FDA and see if that's sufficient for approval.
And look at the N-size. 30,000 people for a drug that will be given (potentially) to billions of people. To make a comparison, Gardasil, the HPV vaccine was tested in ~28,000 individuals over 3-4 years.[2] And Gardasil is used in a much more limited population than the Covid vaccine will be.
[1]https://clinicaltrials.gov/ct2/show/NCT04470427?term=mRNA-12... [2]https://www.fda.gov/files/vaccines,%20blood%20&%20biologics/...
(It wouldn't be HN without a splash of pedantry; apologies in advance.)
I'm curious what you mean by this. Women constitute slightly more than half of the population, no? There are probably billions of women at this point who have had Gardisil administered.
So Gardasil is only approved for "girls and women 9 through 26 years of age". Plus there wasn't much expectation of use outside of Western countries initially since it's not cheap and there are likely higher priority vaccines in developing countries (i.e. do you spend dollars on this or meningitis vaccines?). Use is probably pretty broad now, ~10 years post-launch.
Eventually they expanded the label to include "boys and men 9 through 26 years of age".
So all in all, a relatively small slice of the population, where for the Covid vaccine, they're trying to get it approved for pretty much everybody.
https://www.cancer.org/cancer/cancer-causes/infectious-agent...
And it's not limited to women now. Different countries have it approved/covered for men of different ages. I (as a man) recently finished the full course, though I had to pay for it out of pocket.
Most drug companies actually view the US as the beta test country in a lot of ways.
If something makes it to Australia (who are very strict on pharmaceuticals) then it’s usually pretty safe.
And it might be good to know that most countries approve drugs based on the same data - global clinical trials. Australia is looking at the same data as the US when making an approval decision. Some countries require local trials (China and India, I believe).
In addition, there is plenty of collaboration across drug approval bodies when developing or changing regulations. They are all talking to each other to determine the best approach.
Here is a good example of the FDA and TGA (Australia) and Canada approving a new cancer drug together[1]
[1] https://www.fdanews.com/articles/192766-fda-approves-first-c...
FDA approval is slow and expensive, but the political pressure to change that situation has created myriad alternative routes to market authorisation rather than a fundamental reform of the process. Far too many drugs and devices have sneaked onto the market with lower standards of scrutiny and the FDA's post-marketing surveillance isn't up to the task.
The FDA knew about rofecoxib's cardiovascular risks for years and did nothing; they've known about rosiglitazone for years and they've done very little. It's just too easy for bad products to get on the market and stay on the market under the FDA's less-than-vigilant gaze.
I think that's a matter of opinion, rather than a purely factual statement. It intersects with your comment "Far too many drugs and devices have sneaked onto the market with lower standards of scrutiny", because it begs the question "how many is too many?".
It's all a trade-off. The higher level of scrutiny requires more time and more money and can result in people being denied drugs that could have prevented harm or death.
It's my own personal opinion, but I think the FDA does a pretty good job considering the judgements they are asked to make.
And rofecoxib was eventually pulled, but only after careful scrutiny of the risk. It's not hard to do a retrospective analysis and see a safety signal. Pulling a product based on limited data means you may be doing harm by denying people a drug that helps them. Before the COX2s existed, perforated ulcers due to NSAID use weren't exactly rare.
And I'll just end with one final comment - overseeing a safe and effective drug supply is really damn hard. So I try and take that into consideration when evaluating the FDA's (or any countries drug agency) actions.
Alternatively, just don't take anything where the patent hasn't expired. Once the patent has been expired for a few years you'll actually get the truth about the dangers of the drug, because the pharma companies then need to make the old drugs look dangerous in comparison to the new ones. (E.g. why they're publishing fake data about hydroxychloroquine in Lancet and elsewhere.)
The appropriate way to make medical decisions is based on data, but if a drug is still under patent then the data isn't there.
Referring to IQ as a stand-in for intelligence is yet another blind alley.
This is mostly wrong, except maybe for vaccines. The EMA, for example, has vastly lower regulatory requirements for most drugs than the FDA. Many sources actually estimate that, on net, the FDA has killed more people than it's saved simply by excessively delaying the availability of new drugs in the US.
Vaccines go through a different process in the US than most drugs, where the vaccine manufacturers self-certify the safety of their drugs and send a report to the FDA, who either signs off on the certification or doesn't. But the FDA doesn't manage any of the trials, unlike with other drugs. Vaccine manufacturers are also more protected from liability than other kinds of drug manufacturers, via the NVICP.
If a non-vaccine drug is approved first in the US, it's almost certainly because the drug is expensive to manufacture and the only country where the manufacturer can expect to break even (at least at first) is the US.
This has more to do with the fact that if you can’t sell it in the US you’re not making any money off of it. The US is a vital market for novel drugs.
Before someone attempts to read my mind: I, and everyone else in my family, am fully immunized, including some vaccines (e.g. BCG) not normally administered in the US. I also do the flu shot every year.
But I do understand the risks a rushed vaccine could pose, and so I won't be taking it until at least 6 months after the initial wave of vaccination, and a careful study of population-scale safety and efficacy.
(Just to be clear: I am very pro-vax. Get all recommended vaccinations.)
The problem is with the oral Sabin vaccine, not with the injectable Salk vaccine. And the problem is not for the kid that got the injection, but for it has a live virus that escape and after a few infections it can become dangerous to an unvaccinated person.
Anyway, a few years ago they removed strain 2 from the oral Sabin vaccine that was the strain that usually cause the problems, and when a country has no cases for long enough they switch and use only the injectable Salk vaccine.
There are two kinds of Polio vaccine in widespread use. OPV is more effective but involves an attenuated (thus, "live") polio virus in the vaccine itself, you are in effect being deliberately infected with a version of the virus that should be helpless long enough for your immune system to figure out what it is and wipe it out. Because it actually is the live virus and eventually attenuation will wear off if the virus isn't destroyed, it can "leak" working copies of the virus into a population. If everybody in that population was immunised that hardly matters, but if so why are you still vaccinating...
The injectable vaccine used in many developed countries is both less effective and more expensive, but it's "dead", so can't result in anybody getting Polio. Since developed countries do not have endemic Polio it makes sense to just bite the budgetary bullet and use a less effective and more expensive vaccine.
The killed vaccine will only be causing side effects that you'd get from injecting almost anything. Side effects like anaphylaxis - similar to if a person with a severe nut allergy ate a nut. That's a "serious but rare" one-in-a-million type problem, but in the developed world the people who administer vaccines all know about anaphylaxis and will "just" fix it like my friend with a nut allergy would if he's given food with nuts in it by mistake. It's not fun but death should be extremely rare even for that one-in-a-million if prompt intervention occurs.
A more common side effect is syncope. Especially in teenage girls, some fraction of them will faint. It doesn't really matter what's in the shot, they just do. It's often psychosomatic, so it's important other patients don't see it happen (e.g. use a curtain) or it'll spread. Alone and unsupervised syncope could be fatal (you fall down, maybe smack your head on something), but that's extremely rare when supervised, you're usually sat down to get a shot, so you should just sort of slump over and get put into recovery by the person administering the shots.
Some vaccines are associated with GBS but it's fuzzy, the numbers are all over the place - they might actually cause less GBS than not being vaccinated, given how mysterious GBS is that could even make sense, maybe getting and fighting off diseases triggers the syndrome more often than the vaccination does.
> Thus, in areas with poor sanitation and low vaccination coverage, the spontaneous reversal of the vaccine[OPV]-derived virus to a virulent form and its spreading in the environment can lead to unvaccinated people becoming infected. Clinical disease, including paralysis, caused by vaccine-derived poliovirus (VDPV) is indistinguishable from that caused by wild polioviruses.
The numbers are in https://en.wikipedia.org/wiki/File:Number_of_cVDPV_cases_sin...
> 2017: 96 cases
> 2018: 104 cases
> 2019: 364 cases
For even more details and numbers of cases by country: https://en.wikipedia.org/wiki/Polio_eradication#2017
So that's why I asked which Polio vaccine.
> This panel, described by one participant as raucous and riotous [35], provided a forum for all of the stakeholders [36]. In support of the vaccine, the FDA summarized the VAERS data and concluded that the evidence did not support a causative association. The vaccine manufacturer, now GlaxoSmithKline following a corporate merger, assured the assembled parties that the LYMErix™ vaccine did not cause harm to its recipients. They reviewed the status of their phase IV post-marketing surveillance. Practising physicians spoke of vaccine efficacy by describing the dramatic reduction in Lyme disease cases in their own practices.
> Others raised concerns about the vaccine's safety. Scientists argued a potential role for genetic susceptibility and OspA-related autoimmunity in vaccine complications. Poignant presentations by several ‘vaccine victims’ described in detail their suffering. The prosecuting lawyers for the largest class action suit claimed that manufacturers suppressed reports of adverse events from the licensing trial and provided inadequate warnings to genetically susceptible individuals.
> After hearing compelling testimonies from all the interested parties, the panel concluded the benefits of LYMErix™ continued to outweigh its risks. The panel made no changes to the product's labelling or indications. However, the FDA required the manufacturer to provide more vaccine safety and efficacy data by increasing the enrolment in their ongoing phase IV trial. The LYMErix™ vaccine remained available for public use.
> Market withdrawal > Spawned by the press coverage of vaccine risks and the ongoing litigation, vaccine sales fell off dramatically in 2001. On 26 February 2002 GlaxoSmithKline decided to withdraw LYMErix™ from the market citing poor market performance [37].
> On 9 July 2003 the pharmaceutical giant settled the class action suits with Sheller, Ludwig & Bailey as well as several other smaller law firms. The final agreement included over 1 million dollars in legal fees for the prosecuting lawyers, but provided no financial compensation to the ‘vaccine victims’. The plaintiffs’ attorneys stated that the voluntary removal of LYMErix™ from the market accomplished the main goal of the suit. Despite the settlement, the manufacturer continued to deny that LYMErix™ caused harm and indicated that the decision to settle represented a choice based on economic concerns (i.e. the desire to avoid the costs of lengthy litigation) for a product showing relatively poor performance in the market.
In this particular case, AstraZeneca are not doing the research for a COVID-19 vaccine. They have struck an agreement with the University of Oxford to manufacture and distribute the university's COVID-19 vaccine (still under development).
https://www.ox.ac.uk/news/2020-04-30-landmark-partnership-an...
"To back its claim to forgo profits from the $1.2 billion collaboration in the United States, Astra has even granted the government access to financial accounts related to the venture, according to Dobber."
With no profit at stake, I would bet they sell directly to the governments. I wonder if this means they can make no profit in any country... That would certainly be good news for the world at large but it's not clear to me from the text in the article.
If they made it for the us "profit free", then sold the patent/manufacturing process to their international subsidiaries for $1, then the rest of the countries and AstraZeneca is benefiting at the expense of the united states. We'd be basically funding the r&d for the vaccine and giving it to AstraZeneca for free.
In this case, a treatment that is going to be given to 10-100K times as many people, most of whom are not suffering from an acute, life-threatening condition at the time of treatment, has a much different threshold for weighing the risks of possible harm.
A cancer treatment which cured 999 of 1000 patients and killed the 1000th outright would be a major breakthrough. A flu vaccine that did the same would rightly be rejected.
Really makes it difficult.
Certainly this particular vaccine situation is unique, but indemnifying AstraZeneca, especially after asking them to sell the vaccine at cost, doesn't seem unreasonable.
Reading the article it sounds like it’s supposed to be a break-even affair.
There are actual aired television commercials where the quickly spoken disclaimers include "death" as a side effect. I only notice this because I have subtitles enabled. They say it very fast.
They are also exempt from all double blind placebo testing by the FDA because they have carved out a special exemption. Vaccines are classified as “biologics” which is a relic from the cold war era.
If someone gets vaccine damaged they have to go through a special vaccine court, which to this day has paid out $4.5 billion. Getting an award requires the awardee signing an NDA as a requirement.
Why August 15? It is independence day and PM would like to make an announcement that India created the worlds first vaccine.
[0]https://scroll.in/article/966815/with-demand-for-vaccine-by-...
Take it or leave. The, say $2 Billion in, profits that AstraZeneca can make from the vaccine don't justify being sued by 3 billion people for every headache or miscarriage. Or for real problems it may cause. By the way, in USA vaccine suits are settled by a special fund https://www.hrsa.gov/vaccine-compensation/index.html otherwise no one would make them.
There hasn't been a single day with over ten thousand worldwide deaths from corona so far.
The Childhood Immunization Act of 1986 indemnifies all vaccine makers in the United States and requires a $0.75 Federal Excise Tax per dose that the government uses to indemnify vaccine manufacturers. Also, any such lawsuits can only be filed in The US Court of Federal Claims, an administrative court. No features of common litigation like discovery, expert witnesses, etc.
But also for other reasons. Here's the thing: Once a covid vaccine becomes available I expect pretty much every expert on the topic to look at the data, to think about the safety and many of them will comment on it. If there are concerns about the safety of this vaccine then someone will tell us.
What I want to express is this: We will know plenty of things about how risky a vaccine will be. We will have to make decisions. Both as a society and as individuals. Those decisions won't be easy. But I'm not really concerned that we won't hear about the downsides of a potential vaccine.
Obviously here some countries will choose the former at least for the early coronavirus vaccines. This could create a useful middle-ground where the most vulnerable groups are vaccinated early and the rest of the population waits for post-release data.
these vaccines are developed in a process far more open than any typical pharmaceutical research. The risks at issue here are unlikely to be of the bad-faith variety that can be discouraged with liability.
Instead, these will be genuine known and unknown unknowns. There will be a lot of scrutiny, which will allow governments and the public at large to make these decisions under uncertainty with the benefit of the best possible information at the time.
With the company not enjoying a significant informational advantage, the moral and practical case for liability just doesn't make any sense.
That is a standard approach for the otherwise intractable collision of a legal system that apportions the damages of anything that goes wrong on the party mostly responsible for it, and the medical reality of almost all interventions coming with some potential for grievous harm: by default, your surgeon would always be "responsible", in sense of civil law, not morality or criminal law. Because the general principle allocates responsibility with those making decisions.
"Informed consent" is about getting you into a position to make decisions, and thereby share in the responsibility.
That is usually interpreted to mean the party with the money gets stuck with the damages. Nobody sues a penniless person.
I’m fine with the exemption, it’s the speed of development and testing that concerns me. We can’t possibly know the side effects after short trials.
I chuckle a bit when I read "country X was one of the few that dealt with Covid the right way". To me, it's funny to call out the winner when when the "race" has just started.
Come back in 2 years and we'll see which country had the right approach. It wouldn't surprise me it's Sweden.
This would be very difficult. There are two elements you'd need to be right.
On the one hand the pandemic has to turn out to be unstoppable. No vaccine, no amount of test & trace, it just spreads forever and so Sweden is "lucky" to have already had the worst of it as every country undergoes wave after wave. But all signs so far are quite the contrary.
On the other hand, no improvements to gold standard treatment, even though we've already seen some small improvements those somehow are reversed.
Without that second one, Sweden has excess deaths because it used less-than-great treatments due to inexperience, while other countries get to learn from history when, (in that two extra years) lots of their people supposedly get the virus and need treating.
Sweden's gamble made very little sense when it was made. I will say one thing for Anders, his position is that if you make this gamble, you must stick with it. There is no point taking such a gamble and then chickening out after a week or two as some countries did. That makes sense, but it was a bad gamble.
There was a huge part of our deaths that were caused by lack of protection and procedures in the elderly homes at the start of the outbreak. This isolated event skews the numbers very much. Looking at the whole picture where we're approaching something around 50% immunity (T-cell plus antibodies). Compare this to nations around us experiencing second and third waves and not getting close to our immunity numbers. But sure, you can look at the numbers as they are, I wouldn't judge you, it's too bad that such an outlier event has such power on the numbers though.
Werlabs anti body measures of Stockholm news https://www.mynewsdesk.com/se/werlabs/pressreleases/nivaan-a...
Herd immunity possible at above 40 percent https://www.svd.se/ny-berakning-stockholm-kan-na-immunitet-i...
T-cell response https://svt.se/nyheter/inrikes/immunitet-mot-corona-storre-a...
Maybe ... it's because of this:
> No one is using face masks and the official consensus is that it doesn't provide enough contamination protection to be currently worthwhile.
All the evidence I've seen is quite clear; masks are effective.
And let's consider that the U.S., seen by many to be the worst handler of this pandemic thus far, is currently only ~8% of the way done. Yet Stockholm has already _blown_ through 33%.
Sweden, on the whole, is at 9.4%; again surpassing the U.S. by a good chunk.
I feel like the point of your comment was to suggest that Stockholm is doing well. The data is clear that they are not. In fact, they are doing quite poorly. I would take a good hard look at anyone in your government not vehemently pushing for mask use.
> I'm far removed from the belief that we need a rushed vaccine to cope with this pandemic.
I cannot for the life of me fathom why the impending death of 60,000 fellow citizens, and 600,000 disabled with chronic illness wouldn't convince someone that a vaccine is needed ASAP.
At delaying herd immunity and prolonging the pandemic.
Isn't there a lot of nuance to that, in the sense that it depends on other factors? As far as I understand it, the advisory body in the Netherlands (which sounds like it's in a similar situation to Sweden) does consider masks to be effective, but marginally so, in the sense that compared to social distancing, they are far less effective in combating the spread. And since they can't tell for sure yet to what extent the wearing of masks affects people's adherence to social distancing, they are afraid that mandating masks might be counterproductive if it leads to less distancing.
I deliberately wrote that a _rushed_ vaccine is not needed. All the side effects need to be carefully considered. Even some vaccines that weren't necessarily rushed proved to have really horrible side effects when deployed to the population at scale.
I'm simply saying Stockholm is probably approaching 50% immunity soon (T-cell + antibody). If you isolate the outlier event that is the very poor treatment at the elderly homes at the start of the outbreak, causing a huge part of our deaths numbers, you get a completely different picture.
And people gave you solid evidence that Sewdish numbers are not the result of early elderly outlier events. You should stop claiming that in so many posts when it seems untrue.
Just like people get flu shots every year to prevent widespread outbreaks, a Covid vaccine that gives temp immunity would save millions of lives.
Why do you think there’s such a big deal about people getting annual flu vaccine shots, especially the most vulnerable?
Those countries that tried to do what you suggest are the ones with the longest economic downturns.
You should read about pandemics of the past.
And as very solid evidence from experts, the famous IGM economists poll of most of the world's top economists covered this exact question [1], which I'll repeat:
"Abandoning severe lockdowns at a time when the likelihood of a resurgence in infections remains high will lead to greater total economic damage than sustaining the lockdowns to eliminate the resurgence risk"
100% of them selected Strongly Agree (41%) or Agree (39%) or Uncertain (14%), not a single vote on any part of the Disagree spectrum, which is nearly unheard of for a question in economics, and these responses were also rated highly confident. Check other questions and polls to see how rare this strong of a response is.
Shortsighted action ignorant of the history of economics almost always makes things worse.
Have a good day.
[1] http://www.igmchicago.org/surveys/policy-for-the-covid-19-cr...
But sure, all those people in elderly homes got the short end of the stick in the beginning. But please be level headed and don't judge the whole strategy on that.
Are you referring to a relatively low death rate as "abysmal"? This might make sense from a certain perspective but it's confusing in English.
> The United States, however, already has a law to exclude tort claims from products that help control a public-health crises in the form of the 2005 Public Readiness and Emergency Preparedness, or PREP Act.
It's also important to note that AstraZeneca has also pledged to supply the doses with no profit:
> AstraZeneca, Britain’s second-largest drugmaker, has pledged to supply a total of more than 2 billion doses at no profit in agreements with the United States, Britain and European countries, among other nations and organisations.
The exemption from liability claims is a function of the massive scale, the rushed timeline, and the lack of profit to defend claims in court.
When you're supplying a vaccine at the scale of billions of people, it's inevitable that many people will convince themselves that the vaccine is the cause of unrelated medical issues. Even if the vaccine turns out to be just as benign as every other vaccine out there, having tens or hundreds of thousands of people attempt to sue these companies under the mistaken notion that the vaccine caused their problems could be extremely costly.
The alternative would be a much more expensive vaccine (profit margins to buffer against potential losses) delivered much later (additional years of safety testing and R&D).
It's going to be well known any of the vaccines available will be considered risky.
I'm not sure people are considering how society will react to that.
There will be a decent chunk of people that will be very apprehensive and they will probably be relentlessly shamed for their apprehension. Look at the amount of shaming that goes on regarding masks. I don't think there would be any less for a vaccine that somebody doesn't want to take. It'll probably just deepen the divide between people even further.
It's also completely reasonable for the company to take the stance they do.
https://en.m.wikipedia.org/wiki/National_Childhood_Vaccine_I...
"Cures are nice, but the money is in chronic conditions." That's all too real. Look at the history of ulcer treatments.
The last thing we would need is for anti-vaxxers to have a genuine concern and this raises many red flags.
So many governments have failed at every turn to deal with this virus it hardly inspires confidence that we should trust them on this especially as they are all desperate to get economies back on track so their own control procedures may be softened. And if there are significant side-effects I doubt there's globally any 'compensation' fund large enough.
Because this decision is most definitely making a call about the value of saved lives / avoided sickness, versus the likelihood of unintentionally caused sickness due to vaccine side effects.
I wonder what the acceptable numbers / risk percentages are.
If anything, not doing so, would make me _more_ concerned because it seems like overconfidence, or refusing to acknowledge how long it normally takes to do clinical trials on something before releasing it the public.
I know there are predatory pharmaceutical companies who would put their own profits way ahead of others... I just don't think in a global pandemic its going to be easy to intentionally lie about, or misrepresent, the effects of a cure to said pandemic. No amount of signed contracts would protect the company from the sheer volume of people marching to take their heads.