AstraZeneca has slashed its delivery plans, telling European leaders that it would hand over 100 million fewer doses by the middle of the year, according to the commission’s president, Ms. von der Leyen.

Only one in five French people now trust the AstraZeneca vaccine, according to a poll by the Elabe Institute published Tuesday.

Now Europe is striking a more aggressive tone about protecting its interests. Italy blocked a small shipment of AstraZeneca vaccines to Australia earlier this month. Ms. von der Leyen upped the ante this week, threatening to use an emergency mechanism, last used during the 1970s oil crisis, that would allow the bloc to seize production of vaccines.

“It is hard to explain to our citizens why vaccines produced in the E.U. are going to other countries,” Ms. von der Leyen said.

Early this month, Toon Vanagt, a Belgian tech entrepreneur, accompanied his 77-year-old father to a vaccination center north of Brussels. Mr. Vanagt, 47, was not eligible for the vaccine himself, but a worker there offered him a leftover shot, which he gladly accepted.

software companies have rushed to link patients with doses that would otherwise expire. But in Belgium, when Mr. Vanagt tweeted that he had been vaccinated, it became a mini scandal. Health officials rebuked the vaccine center, which quickly apologized: “A minor communication problem, very quickly rectified.”

Belgium’s rollout is one example of the Continent’s rigid approach to following vaccination guidelines. In a country where nursing home infections led to one of the highest per capita death tolls, the policy was intended to strictly prioritize the neediest residents.

Many European countries are also stockpiling doses to guarantee that everyone who receives a first injection will receive the second dose on time. The United States and Britain have been more flexible, erring on the side of giving more first injections.

“In the U.S., there is a much more flexible, liberal system and you just vaccinate people who come along. Same in the U.K. And it can go quicker. Here it is quite regulated,’’ said Steven Van Gucht, the Belgian government’s top virologist, who said it was too soon to know which system is better.

Administrative hiccups have exacerbated the problems. In Frankfurt, Elke Morgenstern was escorted out of a vaccine center because she enrolled using the wrong online application. “It was embarrassing,” said Ms. Morgenstern, adding that she qualified for a vaccine because of a pre-existing condition.

Because of the AstraZeneca shortages, she cannot book another appointment before May.

“It is a catastrophe how they are handling things here,” she said.

In the Lombardy region of Italy, once the epicenter of the pandemic, the vaccination campaign got off to a slow start in part because the top health care official refused to marshal medical workers over the Christmas holidays. Technical difficulties worsened the problems at the region’s vaccination centers.

“Some sessions were empty,” said Paola Pedrini, the regional secretary general for Italy’s family doctors federation. “For some others, they called 900 people when they could only vaccinate 600.”

For all the problems, Dr. Slaoui said Europeans are in an admirable position. By the numbers, the Continent is about five weeks behind the United States, with vaccine supply expected to increase steadily. “It’s too late to have taken the first bite,” he said. “But they’re in a good place.”

Dr. Van Gucht, of Belgium, agreed. But he said European leaders will likely take nationalistic lessons from the past months.

“I think we relied a little bit too much on the free markets,” he said. “What you really need to do from the beginning is really make sure you produce the vaccines on your territory and that they’re destined for your own population.”

Jason Horowitz and Emma Bubola contributed reporting from Italy and Melissa Eddy from Berlin.

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