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Macron, Merkel and European Council President Charles Michel (R) at a summit in October. Photo: Yves Herman/Pool/AFP via Getty

Italy on Thursday blocked the export of 250,000 AstraZeneca doses to Australia, becoming the first EU country to exercise an export ban due to a vaccine shortfall in the bloc.

Why it matters: The controversial step exposes multiple major challenges to distributing vaccines — even among the world’s richest countries.

The state of play: AstraZeneca has already been running way behind schedule in providing doses to the EU. Now the company says it will provide less than half of the doses originally promised in the second quarter as well.

  • That has infuriated European leaders, who are under pressure due to a remarkably inefficient vaccine rollout to date. Just one dose has been administered in the EU for every three in the U.S. and every four in the U.K., adjusted for population.
  • That helps explain the decision by Italy, backed by the European Commission, to block a shipment of 250,000 doses bound for Australia from a U.S.-owned plant near Rome, where the vials were being filled.
  • The action was taken under a system developed in January — amid a fractious dispute with AstraZeneca over access to doses produced in Britain — to allow for vaccine exports to be blocked if a company hasn’t met its obligations to the EU.

Yet, but: Supply isn't the only problem. EU countries including Italy are already sitting on hundreds of thousands of unused AstraZeneca doses.

  • There has been a general sense of hesitancy surrounding the vaccine, fueled in part by an erroneous report on its efficacy in a German newspaper and by French President Emmanuel Macron’s bizarre claim that it was “almost ineffective" in people over 65.
  • France and Germany only approved the vaccine for people over 65 this week after delaying due to insufficient data.
    • By the numbers: France had only administered 16% of the AstraZeneca doses it had received as of last Friday, while Italy and Germany have both used around 21%.

Driving the news: Real-world data from the U.K. — which is relying heavily on the homegrown vaccine, which was developed at the University of Oxford — now suggests the vaccine is highly effective at preventing hospitalizations among older people even after a single dose.

Between the lines: EU countries have caused two international incidents, with the U.K. and now Australia, over access to a vaccine that they’re hardly using.

  • And all of this is happening at a time when countries around the world, many of which will be relying on the AstraZeneca vaccine, haven’t gained access to any vaccines at all.

What to watch: Italy’s decision also underscores the difficulties that countries relying on imports are facing in receiving doses.

  • Canada, for example, has ordered more doses relative to its population than any other country, but it's received relatively few.
  • Meanwhile, the U.S., which has the world’s largest vaccine manufacturing capacity, according to Airfinity, is on course to produce enough doses by May to cover its entire adult population.

Go deeper

Mar 4, 2021 - Health

The danger of a fourth wave

Expand chart
Data: The COVID Tracking Project, state health departments; Note: Anomalous Arkansas case data from Feb. 28 was not included in the calculated change; Map: Andrew Witherspoon/Axios

The U.S. may be on the verge of another surge in coronavirus cases, despite weeks of good news.

The big picture: Nationwide, progress against the virus has stalled. And some states are ditching their most important public safety measures even as their outbreaks are getting worse.

Figuring out Florida's "extremely vulnerable" vaccine qualification

Illustration: Annelise Capossela/Axios

Qualifying for a COVID vaccine as "extremely vulnerable" under Florida's new guidelines is entirely up to doctors' discretion, Gov. Ron DeSantis said at a press conference Wednesday.

Why it matters: Being "extremely vulnerable" is the only way Floridians under 65 who are not frontline workers or firefighters, police and teachers 50 and up can get the vaccine so far.

Canada vaccine panel recommends 4 months between coronavirus doses

Prime Minister Justin Trudeau during a February news conference in Ottawa, Canada. Photo: David Kawai/Bloomberg via Getty Images

Canada's National Advisory Committee on Immunization (NACI) on Wednesday recommended extending the interval between first and second doses of COVID-19 to up to four months to boost inoculation numbers.

Why it matters: The panel said taking such action would allow about 80% of Canadians over 16 to receive a single dose by the end of June.

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