The day the UK finally was world-beating

LONDON — For once, the U.K. really was world-beating.

Boris Johnson will be delighted that British regulators were first over the line in approving a COVID-19 vaccine, delivering global headlines and a welcome bit of good news after a bruising parliamentary rebellion against domestic coronavirus restrictions.

Nearly one million doses of the Pfizer/BioNTech vaccine will be delivered to the U.K. for use from next week. By the end of the year, several hundred thousands more will have been sent to Britain, which has ordered 40 million doses of this vaccine, plus more than 300 million doses of other candidate vaccines that have not yet received regulatory approval, including 100 million of the Oxford-produced AstraZeneca jab.

For a country whose record on COVID-19 has been among the worst in the Western world, being at the forefront of the global rollout of vaccines has a welcome feel of redemption for Johnson’s government.

The prime minister himself was uncharacteristically muted in his celebrations, calling the regulatory approval “unquestionably good news” but “by no means the end of the story” and cautioning citizens, via his weekly question session in the House of Commons, “not get their hopes up too soon” over how quickly the two-dose vaccine could be rolled out. His Press Secretary Allegra Stratton, however, said Johnson was in no doubt about the “enormity” of the milestone.

Despite his measured response, Johnson’s impatience for the COVID-19 nightmare to be over was plain to see. When England’s Deputy Chief Medical Officer Jonathan Van Tam noted at a Downing Street press conference marking the vaccine’s approval that mask-wearing and sanitizer might become a part of normal life forever, and that this might not be a bad thing, the prime minister interjected tetchily: “It may be a good thing. On the other hand we may want to get back to life pretty much close to normal.”

U.K. ministers were not going to miss a rare cause for cheer. Health Secretary Matt Hancock, in particular, has fought within government for a tough approach to lockdown measures in the hope of deliverance by a vaccine, often in the face of fierce opposition from Conservative backbenchers. Hancock’s predecessor Jeremy Hunt praised the vaccine approval as a “huge personal triumph for the health secretary who has always backed the science and in choosing and backing, on behalf of the country, the first vaccine to prove efficacious, he has scored a massive goal for the country.”

Hancock himself captured something of the U.K.’s overall COVID-19 experience, calling it a “day to remember — in a year to forget.”

Some ministers, including Hancock, meanwhile could not resist putting victory down to Brexit. Business Secretary Alok Sharma drew swift criticism from Germany’s Ambassador to the U.K. Andreas Michaelis for a tweet crowing that this was the day “the U.K. led humanity’s charge against this disease.”

“Why is it so difficult to recognize this important step forward as a great international effort and success,” replied Michaelis. “I really don’t think this is a national story,” he added, noting that BioNTech is a German company. (He might have also added that the vaccine will be manufactured in Belgium.)

Was it thanks to Brexit?

“We do all the same safety checks and the same processes, but we have been able to speed up how they’re done because of Brexit,” Hancock insisted on Times Radio, a claim that wasn’t quite true. But the new political reality in Britain as a result of the vote for Brexit could well have sped things up in practice. 

While still bound by the EU’s process for approving medicines until the end of the transition period on January 1 — a system which allows any member states to issue their own emergency authorizations — the U.K. swerved an optional EU scheme that could have tied its hands on vaccines and ignored European Commission pleas to move together, something every other member state has stuck to. British speed to approval might not have been down to new legal freedoms, but it moved faster by choosing to stand apart from the EU approach.

Germany’s Health Minister Jens Spahn told a press conference that some EU member states, including Germany “could have issued such an emergency authorization if we’d wanted to” but decided against in favor of the “common European approach.”

“It’s very important we do this to help promote trust and confidence in this authorization. So there may be slight differences in the issuing of authorizations between the U.S., the U.K. and the EU,” he said, adding that the difference would only amount of a “short period of time.”

Asked at the Downing Street press conference whether the approval amounted to a “Brexit bonus” for the U.K., Johnson himself didn’t bite. “What I would say about all of these vaccines are that they are global efforts, you’ve got scientists around the world coming together to make this possible and it’s a truly international thing.”

June Raine, boss of the U.K.’s Medicines and Healthcare products Regulatory Agency, which approved the vaccine, went further, making it clear that Brexit hadn’t been the key to a speedy vaccine approval. “We’ve been able to authorize supply of this vaccine under provisions under European law which exist until January 1,” she said at a Downing Street briefing on Wednesday morning.

Brexit cheerleaders piled in regardless. “We could only approve this vaccine so quickly because we have left the EU,” House of Commons leader Jacob Rees Mogg stated baldly on Twitter. “Last month we changed the regulations so a vaccine did not need EU approval which is slower.” One Euroskeptic Conservative MP added: “Getting the vaccine earlier is clearly an advantage to U.K. citizens, and if we’re not held back by EU joint bureaucracy, that is always going to be a good thing.”

The claims sparked anger from Brussels. “It’s a sad indictment of British politics that everything has to be seen through the prism of Brexit, which has nothing to do with this,” one EU official said. 

“This vaccine is first and foremost an international and European achievement,” argued Véronique Trillet-Lenoir, an oncologist and French MEP from the En Marche party. “We are facing a global pandemic, there is no room for vaccine nationalism.”

Trillet-Lenoir also took exception to the suggestion the EU process is somehow deficient. “We have faith in the European Medical Agency’s approval process, which is based on the highest standards,” she said.

Front of the queue

Brexit-fueled or not, the U.K.’s green light for the vaccine will increase pressure on regulators around the world to finalize their own decisions and enable governments to join Britain in moving to what all hope will be the COVID-19 end-game.

The U.K.’s first wave vaccination program will be prioritized according to a nine-tier system set out by the country’s joint committee on vaccination and immunization (JCVI.) Elderly people in care homes — the population hit hardest by the first wave of the epidemic — are in the first tier, alongside their carers. Over 80s in the general population and frontline healthcare workers will be next in line, with prioritization then descending down an age scale, with extremely vulnerable younger adults in tier four alongside people aged 70 to 75, while younger adults with any underlying health condition that increases their risk of serious illness from COVID-19 are ranked as a tier six priority group, beneath those aged 65 to 70.

By the end of phase one, 90 to 99 percent of those at risk of dying from COVID-19 will have been offered the jab, said JCVI Chair Wei Shen Lim.

But whether the U.K. can turn its early progress on the vaccine front into a population-wide success story will now depend on the finer points of its rollout plan; the approval of the other vaccine candidates it has invested in; and the level of uptake Britain manages to achieve.

Lim said it would be up to local NHS and council authorities to manage the implementation of the program. Vaccinations will take place in hospitals, at mass vaccination centers and in the community, supported by family doctors and pharmacists.

NHS England Chief Executive Simon Stevens, also speaking at the Downing Street press conference, said the bulk of the vaccination program would take place “in the period January through to April.” Hospitals would get in touch with people in the prioritized groups — people won’t need to come forward themselves.

Asked by Labour Leader Keir Starmer how the jabs would be delivered to care homes, given the -70C required storage temperature, Johnson conceded that there would be “logistical challenges to be overcome.” The vaccine can be transported at a higher temperature — 2 to 8 degrees — but can only be kept in this state for five days.

Johnson will hope Wednesday’s victory lasts a little, before the next set of problematic practicalities kick in.

Jillian Deutsch, Ashleigh Furlong and Andrew McDonald contributed reporting to this article.