>> a critical care doctor's is a lack of oxygen caused george floyd's death when he was held down by police. he testified at the trial of derek chauvin, the officer accused of killing floyd last year. president biden's efforts to tackle gun violence. mr. biden will need the support of congress to achieve more ambitious goals. pres. biden: nothing i am about

to recommend impinges on the second amendment. no amendment to the constitution is absolute. gun violence in this country is an epidemic. gun violence in this country is an epidemic. it is an international embarrassment. >> the african union is dropping plans to acquire astrazeneca vaccines, it says not because of concerns of a link to blood clots. they will still receive astrazeneca shots through the covax assistance. turkey has condemned comments from mario draghi, who has likened president erdogan to a dictator. draghi accused erdogan of humiliating the european commission president, left without a seat during a meeting in ankara last week.

the u.k. has accused myanmar of bullying its own ambassador after he was locked out of the embassy in london. he has been removed from his post after condemning the coup on february 1 and calling for the release of the democratically elected leader. votes have been counted in a landmark unionization push at a warehouse in alabama belonging to amazon. final results may not be known until friday. numbers are showing workers have rejected the formation of a union. 3000 workers have cast ballots. next, inside story. ♪

>> rare but dangerous, the astrazeneca vaccine for cid-19 is linked to blood clots. buthe benefits outweigh the risks. should people be worried? this is "inside story or code -- this is "inside story." welcome to the program. many countries have been relying on the astrazeneca vaccine to get them out of the coronavirus pandemic crisis. there have been problems from supply to side effects. now european regulators say the vaccine can in rare cases cause blood clots.

the u.k. has offered alternative jobs to young people who appear to be at risk. the u.k. and e.u. say there are still -- they are still confident in the astrazeneca vaccine's effectiveness. there have been fewer than 80 cases reported in the u.k. despite more than 20 million being given out. even so, it has caused a reaction. >> the reported cases of unusual blood clotting following vaccination with the astrazeneca vaccine should be listed as possible side effects of the vaccine. based on the current available evidence, specific risk factors such as age, gender, or previous medical history of clotting disorders have not been able to be confirmed as the rare events are seen in all ages and men and women.

>> the first connection was made in late february. since then, speculation surged and reactions have been mixed. many failed to come up with a link between the javid clotting. -- the jab and clotting. more than a dozen countries temporarily suspended use of the vaccine. austria, then france, germany, spain, then indonesia, thailand, and the democratic republic of congo. many countries are introducing age limits for the drug. australia, the philippines, and a handful of eu countries have halted astrazeneca jabs for people under a certain age. oxford university, which was behind the creation of the vaccine, continues to stand by his work. in a statement, it's professor

of pediatric infection and immunity said safety has been our priority throughout the development of the vaccine. at university of oxford in 2020. we are sure to see that safety monitoring continues under close scrutiny of regulators and public health authorities as the vaccine is rolled out around the world. the identification of rare cases of blood clots shows the safety system works and has also allowed the u.k. and the eu regulators to conclude the benefits of vaccination continue to outweigh the risks, putting in measures to help mitigate any possible risk. let's bring in our guest in cambridge. chris smith is consultant virologist at cambridge university and host of the naked scientist.

isaac is lead on the outbreak of infectious diseases for the university college london's global citizenship program. in barcelona, jeffrey lazarus at the barcelona institute for global health. welcome to the program. chris, the finding by the european medicines agency about the link between the astrazeneca and the blood clots. this should be bad news for a company that has been battered by setbacks. >> the chief executive acid -- executive offer said -- officer said he regrets going with the vaccine that makes no profit for astrazeneca. it was a wonderful gesture. it seems to be thrown back in their face. it is tricky. of course everyone is concerned with vaccine hesitancy.

one of the things about getting this over the line, getting the pandemic under control, is we have the support and trust of the general public, and that translating into high uptake of vaccines which will suppress the spread of the virus and translate to nonlethal infections. with this image problem the vaccine is laboring under, that could be a problem going forward. >> what do you think will be the immediate implications of the latest finding by the ema? >> the ema have still said the benefits outweigh the risks. they have not defined any age-based recommendations where countries are choosing to do so, restricting to 55 in brussels and over 60's and other countries as well. we see there is a variation here

in terms of interpretation of what the european medicines agency has concluded as well as the u.k. body. what we see as well as we consider the overall benefits of the vaccine not just in terms of mortality rate, but younger people can be affected by things like long covid. there was a recent study that showed one in three people actually went on within six months to receive either a neurological or psychological diagnosis. we really do need to ensure this vaccine rollout continues to avoid greater burden on the health care system. >> how do you explain different interpretations that say there is a link and the u.k. regulators who say there needs to be more investigation before establishing facts? >> it is difficult to explain

how the bodies come up with different findings, but the european medicines agency has for the second time said this is a safe vaccine with very rare side effects. it is common to have side effects with any vaccine or any medicine. it is safe to take it. different european countries have defined different age groups. it is their decision. the important thing is the astrazeneca vaccine gets used. if europeans are going to use all the doses available, that is more doses for the rest of the world. >> is it political that u.k. regulators are -- coming together with platelets, the reason we are seeing those patellar -- fatalities, is considered plausible, however it has to be confirmed, and for it

to be confirmed, this could take a body of work and research and data. >> a good way of thinking about this is to look at the timeline over the life course and the risk profile. a person in their 80's may have a 10% or higher chance of succumbing to severe or lethal infection with coronavirus. someone who is 18 rather than 80 may have a one in a million chance of having a severe outcome if they catch coronavirus. if we map onto that the vaccine, the vaccine has a complication rate of about one in a million, roughly the rate we are seeing blood clots that might may not be associated. let's assume they are. if we vaccinated a million people, we might expect to have one person with the complications. if those are all eating-year-olds, one person with a couple occasions we have

saved 10% or 100,000 lives from coronavirus. but if you contrast that with an 18-year-old, we have caused one person to have complications and we have prevented one person from having publications. -- complication. that ratio is different considered across the range of ages. that has provoked regulators to say we don't think there is a serious issue. and that they have said if you had had one dose, carry on with it. because we have alternatives and until we get the data, we don't want to hold up the vaccination process. vaccines do save lives. therefore, give other people who might be at risk a different vaccine while we continue for those other people for him at risk-benefit analysis is absolutely clear, it is a

lifesaving vaccine. >> the finding of ema is going to create some problem among the people who are going to be more skeptical now. this is going to create a huge problem for astrazeneca, which was hoping that it's vaccine, widely touted as affordable, easy to administer, likely to compete with pfizer and moderna, that image is shattered. >> the flip-flopping has not helped. originally we did see that the older groups were not vaccinated due to the fact that there was -- the idea or feeling there was not enough data on this. that has been reversed to the other direction. the survey so far do show there is a dip in confidence.

due to the different strategy and rollout, the u.k. first identified less cases because we focused on vaccinating the older population first. on the continent there were certain age groups, the elderly originally were left off, and people who were in frontline positions tended to be female, so patterns we are looking at now may just be the result of who the vaccine was given to rather than something more significant. let's not forget there are some countries who have very little or no vaccines at all at this stage. certainly, this is something that can be overcome. it is damaging, but the known dangers of covid outweigh any

potential adverse effects from this vaccine. it fits a typical profile. >> many countries are stepping in saying it is time to start looking for options for people under 30. it is very easy in practice. this means you have to rethink your procedures, your strategies, think about alternatives, which is going to be difficult, particularly in the eu. >> i'm not sure it is that complicated. it just means you are using pfizer, moderna, or johnson & johnson for those younger age groups, rather than astrazeneca. in spain, they have limited astrazeneca use to those age 60 to 64. they will use the vaccines they have, hopefully they will youth the second doses for them, and

that will be more vaccines for the rest of the world. i am hoping we can turn this around and say given the european medicines agency has said it is safe, we can use this to accelerate vaccination programs in other parts of the world, which is extremely important, to avoid concern. as variants flourish, we risk some of them may become resistant to vaccines. >> the eu was tracing 400 million doses of astrazeneca. the u.s., 300 million, trying to be ready for the eventuality of starting the fast track vaccination campaign. what will be the reaction among the decision-makers against the backdrop of the findings of the ema? >> i hope they look at the statistics and the statistics

paint an encouraging picture. we are talking about chance events at one in half a million. that's really low. when you put this up against the complication we are talking about that affects five people in a million per year just by chance anyway, and if people take the oral contraceptive pill, it increases the likelihood of this happening to them eightfold and no one bats an eyelid about that sort of thing. most of the people making decisions around this will be saying, well actually, statistically, we are on sure footing. but we absolute know is this is a very effective vaccine the data show in some cases, 90% plus protection, and it is very cheap. it has one of the longest track records. the construct being used to make this vaccine has been used more than a decade, in west africa

fighting ebola. that construct went into thousands of people, so we have long-term follow-ups. there are reasons to be assured, not least that they have been investigated. >> when you have people who have been skeptical about this whole idea, getting vaccinated against covid-19's way, about -- against covid-19 as the safest way, do you have concerns this could push some people to start comparing between vaccines and say, you know what? that one could be more efficient, safer than the other one? >> we have to establish between people who are anti-vectors before the -- anti-vax's's -- anti-vaxxers before the

pandemic and people seeing headlines in the media. there is just a one in a million chance with the same as being murdered or hit by a car in the next month or so. if we think about it that way, it eases the concerns people have. what is crucial is the public impressions, that there is transparency, that scientists and governments address their public regularly, so the confidence is constantly rebuilt and regained. i do not think that is for this middleground group that wants to understand what it is the real risk is. that is something health care professionals, doctors, can have those conversations and change

people's minds. any vaccine is going to protect themselves and their loved ones. there is also great data about transmission. it is not just about yourself. >> this looks like a mammoth task for astrazeneca when it comes to the american market. the fda is yet to authorize the emergency use. we are starting to hear reports from american officials saying we might not use the astrazeneca at all by the end of the day. >> that is right. if they don't, they will use pfizer, moderna, johnson & johnson. that means more doses of astrazeneca for the rest of the world. the vaccine is desperately needed across latin america and parts of africa where they have very low numbers vaccinated. that is where it should be

disturbing and, through covax or through direct purchase. i am not worried about you up and -- europe and the u.s. people should get their second dose and we have other options. it is the countries that do not have the cold chain to manage pfizer or moderna or because of the cost. as long as it gets used, we are not facing a severe problem. >> the europeans were hoping from day one they would have a comprehensive, united approach when it comes to acquiring the same vaccine from astrazeneca. the germans are saying there are talks with the russians for the sputnik vaccine. could this be an indication we are seeing cracks within the european union about dealing with astrazeneca? >> we have seen cracks from the get-go.

i do not think they have made themselves particularly vulnerable or bolstered their reputation internationally. interesting they are going down the route of the russian sputnik vaccine. it has not been approved yet. the european medicines agency are looking at that. it is closely related to how astrazeneca's vaccine works, modified cold virus, administered a few weeks apart. it is similar to the johnson & johnson vaccine. what unites these different vaccines is they are all based on modified cold virus is used as trojan horses to smuggle into the body the coronavirus coat, message. what is happening with astrazeneca's vaccine, with this rare complication, it could also affect the johnson & johnson vaccine. it could affect the russian vaccine. we have not seen the data. we have not seen the follow-up

on millions of people who have had it. that may yet emerge. it may be we see the same trend. we will have to watch this space. >> what does this leave the eu? it is grappling with a third wave of infections, death tolls far behind vaccinating large terms of their society, they have been grappling with ways to find new vaccines. could this be the moment of reckoning? >> the timing is not great. there is a third wave across the continent. there are more and more restrictions just as the u.k. starts to lift some of those as early as next week. they need to be accelerating the vaccine rollout as quickly as possible. they do have a selection of

other vaccines they could be using. they have to think about how to best leverage the existing public health infrastructure to upscale -- upskill health workers and get jabs in as many arms as possible so we don't end up in a situation where we have the french variant or spanish variant resulting in not only the combination of vaccination rate, but also vaccine hesitancy. these are all, particularly the latter, complicated to address, given the issues we discussed on astrazeneca. another point as well as outside of the u.k. and the eu, we are seeing one of the hotbeds of cases at the moment, and that case is not looking through.

we need to take a global approach. >> this is going to be my question to jeffrey. the whole thing has been uncharted territory for us and the scientific community. they are dealing with something new. they have been trying and testing new vaccines. some of them using old technology. some of them using ultramodern technologies. this whole thing about astrazeneca should be an opportunity for everybody to put in place a mechanism to monitor all the vaccines and look for side effects we might be overlooking. >> absolutely. we have the covax facility for distribute the vaccines to the poor or low resource countries. we need a global mechanism to oversee all the vaccines. we need that or a similar mechanism for production. where we failed is being able to produce enough doses.

this has been one of the great scientific breakthroughs with so many successful vaccines. they have not invested at the same level in the production. vaccines require dozens of components from reagents to vials and resins and so on. we need an overview of what the availability of the different components are and a massive global vigilance of any possible side effects. we need to make sure we are overseeing this in the rest of the world. >> what would be your message to those, bureaucrats and politicians having to make the decision to continue using astrazeneca or not? >> look at the data. the risk profile is good and the performance is very high. i have no conflict of interest. i have no shares in astrazeneca.

i do have a share in being a doctor myself and treating patients who are suffering with this disease. it is an excellent vaccine. >> i appreciate your messages of hope. people are eager to see light at the end of the tunnel. thank you very much indeed for your contribution. and thank you for watching. you can see the program anytime by visiting our website. for further discussion, go to our facebook. you can also join the conversation on twitter. bye for now. ♪

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