A lack of transparency in COVID-19 vaccine trials and secrecy over deals between governments and drug companies risks the success of the global pandemic response, new research from Transparency International Global Health and the University of Toronto warns.
For Whose Benefit? is an in-depth study of the development and sale of the world’s top 20 COVID-19 vaccines, including those developed by AstraZeneca, Moderna and Pfizer/BioNTech.
Through detailed analysis of clinical trial data and nearly 200 contracts for vaccine sales up to March 2021, the report reveals a pattern of poor transparency and a disturbing trend of governments censoring key details of their orders from drug companies.
Clinical trial transparency is the only way to monitor the safety and efficacy of vaccines and is a key safeguard against selective reporting of results or manipulation of data. Despite this, analysis of the registered clinical trials for the top vaccines reveals that results from just 45 per cent of these trials had been announced. Of this figure, 41 per cent had provided only top-level results via a press release or press conference, with the full data not made available for media scrutiny or academic review.
Clinical trial protocols had been published for just 12 per cent of trials. There were no publicly accessible protocols for 88 per cent of the registered trials in our analysis and, therefore, no way of knowing the conditions under which they were carried out.
Jonathan Cushing, Head of Transparency International’s Global Health Programme, said: “These results make for worrying reading and carry important implications not just for the COVID-19 response, but also for future health emergencies. The lack of transparency of many clinical trials combined with the huge financial incentives for producing effective treatments leaves the door wide open for selective reporting of results or outright data manipulation. The lack of publicly accessible data creates space for misleading and potentially dangerous half-truths, disinformation, and conspiracy theories, which in turn contribute to vaccine hesitancy.”
The research also highlights poor transparency in contracts between drug companies and governments. Of the handful of contracts that had been published, almost all include significant redactions of key information such as total price paid, price per dose and delivery schedules.
Analysis of 183 contracts for 12 different COVID-19 vaccines reveals that only 7 per cent of vaccine contracts between developers and governments were published through official channels. Just one contract (0.5 per cent) was published without redactions. Most feature entire pages of redactions which obscure information of critical public interest.
There are large disparities in the price paid. For the Oxford/AstraZeneca-developed vaccine, upper-middle income economies like South Africa are paying an average of 25 per cent more per dose than high-income economies like the European Union.
“Equally as disturbing is the lack of transparency over the contracts between governments and vaccine developers,” Cushing said. “Hiding contracts from public view or publishing documents filled with redacted text means we don’t know what governments have signed up to. Given the huge amounts of public money invested in research and development around the world, citizens have the right to know everything about the vaccines their taxes helped to fund.”
With recent polling showing that one third of the world’s population – 1.3 billion people – are unwilling to take a coronavirus vaccine, transparency is vital to build confidence.
Transparency International Global Health calls on:
- National governments to adopt and enforce legislation requiring the pre-registration of all clinical trials and the publication of summary results within 12 months of their completion. All governments that have bought vaccines should also follow the lead of the United States and publish their contracts.
- Vaccine developers to publish their clinical trial protocols on a publicly accessible registry (if they have not done so already). Developers should also only use media to announce clinical trial results in tandem with data analysis published in a peer-reviewed medical journal, trial registry or as a pre-print article.
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Notes to editors
The research was conducted by Transparency International’s Global Health Programme and The World Health Organization Collaborating Centre (WHO CC) for Governance, Accountability, and Transparency in the Pharmaceutical Sector hosted at the Leslie Dan Faculty of Pharmacy, University of Toronto.
The report analysed 20 leading COVID-19 vaccines that were in, or had completed, phase 3 clinical trials as of 11 January 2021. It also examined contract data for the following 12 vaccines:
- Moderna, mRNA-1273
- Pfizer/BioNTech, Comirnaty (BNT162b2)
- Medicago (w/GSK adjuvant), CoVLP
- Bharat Biotech, Covaxin (BBV152)
- CureVac, CVnCoV
- Sinopharm (Beijing), BBIBP-CorV
- AstraZeneca, AZD1222 / Covishield (ChAdOx1 nCoV-19)
- CanSino Biologics, Convidicea (Ad5-nCoV)
- Johnson & Johnson, Ad26.COV2.S
- Novavax, NVX-CoV2373
- Sinovac Biotech, CoronaVac
- Gamaleya Research Institute, Sputnik V