‘Everyone was left to guess what went wrong’: An open letter to AstraZeneca’s CEO on transparency

Dear Pascal Soriot,

I’d like to talk to you about your priorities.

Your company, AstraZeneca, is investing heavily in the development of a Covid-19 vaccine — and you have said you have no intention of turning a profit on any vaccine in the midst of a pandemic.

But I have concerns about your commitment to transparency. When the news broke late Tuesday that a participant in your late-stage Covid-19 vaccine trial experienced a serious reaction, the company would only confirm the trial was put on hold in order to review safety data due to a “potentially unexplained illness.”

On Wednesday morning, another statement was issued with essentially the same information, and very little specifics.

That same morning, though, you held a conference call with JP Morgan clients, who learned more details than had been disclosed to the public. The participant developed symptoms consistent with a rare but serious spinal inflammatory disorder called transverse myelitis. While that diagnosis hadn’t been confirmed, you shared that she was now recovering.

I’m glad to hear she is doing better, but why was that information not disclosed more widely?

Whatever your reasons, I think you did the wrong thing.

In the middle of a pandemic — when the whole world, literally, is hoping a useful vaccine is on the horizon — everyone was left to guess what went wrong and what it might mean.

I understand this was a single instance in a large trial, but there is already so much distrust surrounding Covid-19 vaccines. The issue, as you know better than most, is highly politicized thanks to President Trump’s transparent push for a vaccine prior to the Nov. 3 election. Polls indicate that Americans are worried politics is overtaking science.

As a result, Trump’s attempts to bully the Food and Drug Administration prompted you and the chief executives from eight other vaccine makers to issue a public pledge earlier this week to only seek approval if the safety and effectiveness data is sound.

Clearly, you understand the public is concerned about the impact this serious reaction can have on the trial and the extent to which a vaccine will actually be safe. No one wants to be a guinea pig so someone else can get re-elected to office.

“Skepticism is rampant,” said Art Caplan, a bioethics professor at the New York University School of Medicine, “and a high standard of transparency is needed.”

But whatever his faults at least Trump is transparent. You, on the other hand, well, not so much.

The failure to be more forthcoming right away only raises further questions about vaccine safety – at least for those who are unfamiliar with vaccine development. Vague reassurances about a “routine action” are meaningless when the whole world is scrutinizing your every move.

“The entire public has an interest in, and is deeply affected by, how quickly these vaccine trials are moving and whether they’re ultimately safe and effective,” Holly Fernandez Lynch, an assistant professor of medical ethics at the Perelman School of Medicine at the University of Pennsylvania, told me.

“And it’s intensified with the White House pressure to move things quickly and Trump’s comments. We’re in a precarious state of public trust and withholding information about a bad thing — or what might be a bad thing — in a trial further erodes that trust,” she added.

Now, I understand that you have a fiduciary responsibility to tell shareholders about material information. But to what extent the added details that were provided on the investor call are, in fact, material is unclear to me. If it is material, though, then your company should have released the information to all investors in a press release.

It is, however, clear that the information wasn’t simultaneously shared with the public.

“They may argue that what was said was not material and, therefore, it did not have to be publicly disseminated,” Charles Elson, a professor of corporate governance at the University of Delaware, explained to me. “Material information shouldn’t be disclosed selectively to particular investors. If you disclose, it has to be fair disclosure.”

In this case, Pascal, I do think the optics appear questionable.

“I’m not sure there was anything material that came out” on the call, says John Coffee, a professor of securities law and corporate governance at Columbia University. “They were filling in listeners on what was already known to be a serious adverse event.”

“But it may not have been the ideal way to deal with investors. It has a scent of selective disclosure. So at the same time, I suspect it’s a gray enough area for some to say he was conveying material information to institutional investors.”

In short, I believe there was a lack of fairness.

As a result, you missed an opportunity to bolster confidence in vaccine makers and the pharmaceutical industry as a whole.

And this should have been your priority.