In this interview, Ryan discusses the pitfalls of 27 member countries negotiating an agreement, the problem of vaccine production being so slow in the EU and plans to increase sequencing in Europe to better understand which coronavirus variants people are getting sick from.

Pierre Pailler: Is the European vaccination campaign going as planned?

John Ryan: It’s going as planned in the sense that we have already authorised three vaccines, the contracts for which are being fulfilled. And another vaccine, Johnson & Johnson, is in the process of being authorised by the European Medicines Agency (EMA).

We have enough quantities ordered to cover the entire population several times over. And the advantage is that all vaccines are produced in our territory.

But the European Commission has been criticised for the delay of the European campaign, in particular compared to the United Kingdom or the United States...

Let's say it's easy to criticise... But this is the first time we've done this. And we had to get the 27 member states around the table and make quick decisions about buying vaccines that didn't exist. Which is not easy.

Obviously, when you have the money, when you are alone and agile while having the possibility of acting quickly with political support, you can go faster. But I don't see how we could have moved forward much faster with 27 countries around the table...

If this is so complicated as 27, why was it necessary to act together?

It is easier to order a large quantity in terms of economic and contractual conditions. If you're a small country like Greece, Cyprus or Ireland, you have to put a lot of money on the table to get what you want. Not to mention countries like Slovenia or Poland, which are not used to these kinds of negotiations. Faced with the pharmaceutical industry, they immediately lose out. Most member states would no doubt have experienced a shortage.The advantage here is that everyone received the vaccine on the same day. In terms of solidarity, this is a strong signal.

Is the outcome of the negotiations beneficial?

We were concerned about not overpaying and having quality vaccines made in Europe. We bought a lot of vaccines, which gave us an economic advantage in other parts of the world. So, the prices are really good.

And the quality is there because it has been verified by the EMA. So far, with 15 million people vaccinated, we have not seen any serious side effects. Even compared to a conventional flu shot, side effects are minimal. It's reassuring: the quality is there, the price is there, the quantity is there.

But these negotiations lasted much longer than in the United States or the United Kingdom...

The EU has made the producers of the vaccine accept responsibility for their product. While negotiations have been different in other parts of the world, where governments have accepted their own responsibility for side effects or manufacturing defects.

So, there is a level of manufacturer responsibility that is greater with us than in other jurisdictions. Which took a long time to negotiate.

Why was this an important point?

We are vaccinating the entire population, so it is much more likely that if the vaccine fails, something will happen on a large scale: if we vaccinate ten people, the side effects will be reduced, but if you have to vaccinate 100% of the population, obviously something will happen at one point or another. It's logic. Moreover, it’s not directly due to the vaccine, but to pre-existing diseases, for example allergies. The risk is much greater for a company to have its liability incurred because of the side effects in case of vaccinating on a very large scale.

While negotiations are over, vaccine deliveries aren’t following. Spain has been forced to suspend its campaign for lack of vaccinations. Why?

This is due to the production capacities in the companies. And that's something that's not going to go away tomorrow.

How do you explain why factories in Europe have production problems?

I believe there is an economic aspect that has been overlooked. According to my information, we have been discussing these issues with the pharmaceutical industry for at least five or six years. Back then, the problem was that many vaccines were in the public domain: they were 25 years old and there was no patent protection. The cost price for the pharmaceutical companies was very low. Therefore, it was much more interesting for them to do research on different products. The pharmaceutical industry specialising in vaccination was therefore not particularly profitable...

When can we expect to see the first positive effects of the vaccination campaign?

The most important thing in a vaccination campaign is to vaccinate exposed people: people who work in hospitals, those in essential trades who have contact with the public, and those who are vulnerable from a health point of view. If we manage to vaccinate these populations most at risk, the mortality rate will drop. This is already the case in some member states, where this number is already falling.

But questions seem to remain unanswered about the effectiveness of the vaccine, such as its effect on the transmissibility of the virus...

The issue of the transmissibility of the virus after vaccination--whether being vaccinated prevents us from transmitting the virus--is not finally settled. All we know today is that it keeps us from getting seriously ill. Complicating matters nowadays, vaccinated people think they can take off the mask.

Hence the problem around the vaccination passport...

Yes, quite. What does the vaccination passport mean? That you can't get seriously ill? Or that the virus can no longer be transmitted? The tourism or travel industry, especially air travel, seems to me to have misunderstood the meaning of vaccination. Currently, we know that vaccination prevents people from getting seriously ill. Period.

Are you worried that the vaccines won't work on the new variants?

This is really the big concern right now. We bought these vaccines. But they were made in relation to the original strain. And there is concern with all these variants now arriving from Brazil, Japan, or South Africa: will the vaccines be as efficient as expected?

How long would it take to adapt the vaccines to variants that are more resistant to current vaccines?

According to the pharmaceutical industry, it would take months to adapt vaccines to variants. With messenger RNA, it's faster than if you had to start over. But it won't happen overnight. You have to remake it, do clinical trials again... because you have to test it first. It's not something you can do in five minutes.

Do the contracts provide for the delivery of such new vaccines?

No, we did not anticipate that... We would have to make an amendment to the contract for it to be considered the same product. It’s not that complicated, amendments are common. And this is in the interests of both parties. I don't believe there is any reason to worry from a contractual point of view.

Sequencing capacity is also a problem in Europe…

There is very little sequencing done in member states, so we don't know which strains are circulating. In the UK they do 10% sequencing of positive tests. In the EU, it is less than 1%. We know that people are positive, but we don't know if they are positive with South African, British or Brazilian. And we don't know if the vaccines are as effective for some as for the others...

On 17 February, we are going to launch an initiative to fund sequencing on a much larger scale at EU level. As well as to increase vaccine production.

This interview was first published in French on paperjam.lu and has been translated and edited for Delano.