“I didn’t realize there were so many layers to vaccine inequity,” Dr. Raghib Ali of the University of Cambridge told The Associated Press.

The newest layer of vaccine inequality? European Union regulators have not approved Indian-made AstraZeneca vaccines — but they approved European-made versions of the same vaccine, reported the AP.

  • WHO approved Indian-made AstraZeneca vaccines in January, per the organization’s website.
  • COVAX, the U.N.-backed vaccine distribution initiative for low income countries, has also given these vaccines to many countries, reported ABC News.

WHO, doctors and public health experts have strongly criticized the new EU ruling — and its implications.

What did the EU say about the AstraZeneca COVID-19 vaccines?

The regulators said that AstraZeneca has not completed the necessary paperwork for approval.

  • EU regulators said they were uncertain of the details of production practices and quality control standards in the Serum Institute of India, per ABC News.

But, according to the AP, “some experts describe the EU move as discriminatory and unscientific, pointing out that the World Health Organization has inspected and approved the factory.”

  • The EU has approved Pfizer, Moderna and Johnson & Johnson vaccines, reported ABC News.
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What are the implications of the controversial EU ruling?

The EU ban on Indian-made AstraZeneca has concerning implications for international travel and for vaccine campaigns worldwide.

  • Millions of people immunized with the Indian-made AstraZeneca — either through COVAX or not — will not be allowed to enter the EU despite their vaccinated status, per the AP.
  • Countries within the EU can choose to follow EU regulations or to enact their own vaccine regulations, further complicating travel, said ABC News.

The EU ruling may also undermine public trust in vaccines at a crucial time as the delta variant continues to spread and cause outbreaks worldwide, reported ABC News.

  • “People who were already suspicious of vaccines will become even more suspicious,” said Ivo Vlaev, a professor at Britain’s University of Warwick, via the AP.
  • “They could also lose trust in public health messages from governments and be less willing to comply with COVID rules,” he said.
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How have doctors and health experts responded?

The WHO has urged all countries to recognize all the vaccines it has authorized. Failing to do so means “undermining confidence in lifesaving vaccines that have already been shown to be safe and effective, affecting uptake of vaccines and potentially putting billions of people at risk,” the organization said in a joint statement this month.

  • “Vaccines that have met WHO’s threshold should be accepted,” said Dr. Mesfin Teklu Tessema, the director of health for the International Rescue Committee, per the AP. “Otherwise it looks like there’s an element of racism here.”
  • “You can’t just cut off countries from the rest of the world indefinitely,” said Dr. Ali of the University of Cambridge, per ABC News. “To exclude some people from certain countries because of the vaccine they’ve received is wholly inconsistent because we know that these approved vaccines are extremely protective.”