AstraZeneca withdraws Covishield pointing to low demand, but did rare side effects also play a role?

AstraZeneca have withdrawn their COVID-19 vaccine Vaxzevria, the first to have been administered against the virus in 2020.
| Photo Credit: Plyushkin/Pond5 Images/IMAGO

The pharmaceutical giant AstraZeneca has reportedly withdrawn its COVID-19 vaccine Vaxzevria, also known as Covishield, worldwide, citing commercial reasons for the decision. “As multiple, variant COVID-19 vaccines have since been developed, there is a surplus of available updated vaccines. This has led to a decline in demand for Vaxzevria, which is no longer being manufactured or supplied,” various media outlets quoted the company was quoted as saying.

A document hosted by the EU’s European Medicines Agency website confirmed that Vaxzevria was no longer authorized in the region. In an email to DW, virologist Wolfgang Preiser said “the demand for SARS-CoV-2 vaccines is very low and unlikely to pick up significantly in the foreseeable future, so I understand the reasoning”.

Vaxzevria saved millions of lives

AstraZeneca, who developed the vaccine with Oxford University, said it was “incredibly proud of the role Vaxzevria played in ending the global pandemic”. More than three billion doses were supplied globally. Independent studies estimate that more than 6.5 million lives were saved in the first year that it was used.

The Oxford-AstraZeneca vaccine was developed within the first months of the pandemic in 2020. It was first approved in the UK on December 30, 2020, with other countries granting the vaccine conditional marketing authorization later in 2020 due to the urgency of the pandemic.

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Vaxzevria was effective against initial ancestral variants of COVID-19 virus—the alpha variant—but was less effective against newer variants of COVID-19, such as the omicron variant. Many governments, including the UK, Germany, and Australia, had stopped using the Oxford-AstraZeneca vaccine before its withdrawal from the market.

“We are still distributing COVID-19 vaccines, but none of them are AstraZeneca any more. They were the first manufacturer with which we concluded our arrangement in 2022,” Olly Cann, director of communications at the international organization Gavi, the Vaccine Alliance, told DW.

The latest COVID-19 vaccine advice issued by the World Health Organisation in April advised that COVID-19 vaccines should target the JN.1 lineage of the virus, which is now the most dominant variant. However, at the time of writing, Preiser said relatively few severe infections were being observed “due to a high level of population immunity stemming from past vaccination, and often also past infection.“

Was the vaccine withdrawn due to side effects?

Although the vaccine was found to be safe and effective overall, it carried a very small risk of developing blood clots as a side effect. The condition is known as “thrombosis with thrombocytopenia syndrome (TTS)”. The rare syndrome occurred in two to three people per 1,00,000 who were vaccinated with the Vaxzevria vaccine.

While studies found the vaccine did not increase the risk of heart attacks or strokes, it has been under intense scrutiny due to TTS. “The side effects are real and may have serious consequences for those affected, but as with all interventions, a careful risk-benefit analysis [was] needed. During the pandemic, the balance was definitely in favour of using the vaccine,” said Preiser, who is based at Stellenbosch University in South Africa.

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In a UK High Court case, AstraZeneca is being sued by more than 50 people, who claim to have been affected by side effects. The British newspaper Telegraph, quoted as the first to break the news of Vaxzevria’s withdrawal from the market, reported that AstraZeneca had admitted in the court case in February 2024 that the vaccine “can, in very rare cases, cause TTS”.

AstraZeneca said the decision to withdraw the vaccine was not linked to the court case or any risks associated with TTS.