Redemption for AstraZeneca, the Misunderstood Shot of the Global Vaccine Rollout

Ava Kelley, Editor

When the Oxford-AstraZeneca vaccine released its initial clinical results, it was hailed as a necessary and game-changing candidate. Compared to the vaccine race’s other “winners”, Pfizer and Moderna, AstraZeneca was widely viewed as an accessible, affordable alternative that required less stringent storage conditions. [1] Like other leading vaccines, the AstraZeneca shot can drastically reduce severe or fatal cases of Covid-19. [2] 

Today, the global vaccine rollout is well underway. It is also wildly unequal. While the United States and 42 other mostly high-income countries are on track to vaccinate their entire populations within the year, 67 low-income countries have not vaccinated anyone at all. [3] 

Public health officials maintain that vaccination delays will mean more deaths and illnesses.

Yet in countries rich enough to get their hands on tons of doses, delays and bad press have dogged the AstraZeneca vaccine. In one particularly unsettling news story, the United States currently possesses tens of millions of unused AstraZeneca vaccine doses awaiting results of clinical trials while countries that have already authorized it experience shortages. [4]

Then, in mid-March, EU countries like Germany, Spain, Italy, and France suspended use of the AstraZeneca shot in their vaccine rollouts for fear of blood clots. The suspension should not have come as unexpected to anyone paying attention. 

AstraZeneca was met with suspicion by many citizens in these countries long before its suspension. Germany is one example. While public health officials hailed AstraZeneca’s accessibility for developing countries, the German media gave the AstraZeneca vaccine unjust, negative press from the start, framing it as a “second-class” vaccine.

Behavioral economics gives us one lens to think about these issues. Though there are lots of aspects worth exploring, I will think about the AstraZeneca vaccine conundrum in two ways related to incorrect beliefs—over-inference and a perceived failure of reciprocity.

In behavioral economics, over-inference, put simply occurs when people assume representativeness that’s not really there from a sample. In AstraZeneca’s suspension, for example, the rare cases of blood clots attributed to vaccination occurred at lower rates than they did in the general population. However, nearly every newspaper one could think of reported on these worrisome side effects.

People can over-infer when faced with rampant reporting on one issue, regardless of the tiny sample of people who actually experienced the blood clots. 

The second factor behind this vaccination conundrum is reciprocity. Behavioral economists have found that perceived failures of reciprocity can result in self-interested, even punitive behavior. [5]

It is also possible that Germans who were once motivated to get the vaccine feel spited by the government. In one recent example, some frontline workers resented being offered the AstraZeneca shot rather than the Pfizer. [6] These healthcare workers may view themselves as giving a lot to the pandemic response but perceive a failure of reciprocity when they are offered what they perceive as the second-class shot. 

Now what? In some ways, the damage is done. Even though most countries resumed using the AstraZeneca vaccine following an investigation by the European Medicines Agency (EMA), the rollout will likely be an uphill battle to get shots in arms if people are fearful of adverse side effects. [7]

But there’s work to do. To combat the bad press, missed appointments, and outright rejection of the AstraZeneca vaccine, EU countries with a myriad of doses should embark on full-fledged information campaigns on AstraZeneca’s behalf. Leaders should advertise themselves receiving what is viewed as the inferior vaccines, and public health ministries should create press releases to combat negative press. (need a couple more lines)

[1]  Meredith, Sam. “AstraZeneca’s Covid Vaccine Might Seem Less Effective Than Its Peers – But it Has Some Advantages.” CNBC, 23 November 2020.

[2]  Steinhauser, Gabriele, and Jenny Strasburg. “AstraZeneca’s Covid-19 Vaccine Defended by World Health Officials.” The Wall Street Journal, Dow Jones & Company, 8 Feb. 2021, 

[3] McCann, Allison, and Lazaro Gamio. “Who Can and Can’t Get Vaccinated Right Now.” NYTimes, 19 March 2021.

[4]  Weiland, Noah and Rebecca Robbins. “The U.S. Is Sitting on Tens of Millions of Vaccine Doses the World Needs.” NYTimes, 11 March 2021.

[5]  Mullainathan, Sendhil. “Development Economics through the Lens of Psychology.” Working paper.

[6]  Eddy, Melissa. “Germans Clamor for Covid Vaccines, but Shun AstraZeneca’s Offering.” NYTimes, The New York Times, 25 February 2021.  Beaubien, Jason. “European Scientists Zero In On AstraZeneca Blood Clot Link.” NPR, NPR. 21 March 2021.