a report this past week, the European Union’s foreign service said that Russia’s drive to promote Sputnik abroad was aimed at “sowing distrust” in Europe’s medicines regulator and stoking divisions.

In response, the Russian state investment agency spearheading Sputnik’s export drive lamented that the vaccine, which it hails as a “vaccine for all mankind,” has fallen victim to “unfortunate daily information attacks.” On Friday, after Brazil raised concerns about Sputnik, complaining of inadequate data, the vaccine’s developer in Moscow, the Gamaleya Institute, issued an angry statement complaining that “unethical forces continuously attack the Sputnik V vaccine for competitive and political reasons.”

The testy arguments in Slovakia over the vaccine reached a peak in April when the country’s drug regulatory agency claimed that Mr. Matovic had fallen for a Russian bait-and-switch. It said the vaccine doses sent to Slovakia at a cost of around $2 million differed from the Sputnik V reviewed favorably in a peer-reviewed February article in The Lancet, a respected British medical journal.

The Slovak claim, denounced by Moscow as “sabotage,” cast doubt on Sputnik’s main selling point: a proven efficacy rate of over 90 percent against Covid-19. The Lancet gave the vaccine 91.6 percent efficacy in February, and Russian scientists have since claimed a “real world” rate 97.6 percent.

But the main issue with Sputnik has never been whether it works — most experts believe it does — but Russia’s repeated failure to follow procedure and provide all the data needed by foreign regulators to assess safety. Slovakia’s regulator made its damning statement not because it had discovered any specific problems with Sputnik but “due to the lack of data from the manufacturer, inconsistencies in dosage forms and inability to compare the batches used in different studies and countries.”

The 200,000 doses that Russia delivered in March were still all unused at a pharmaceutical company in eastern Slovakia as of last week. But Mr. Matovic said Russia had already returned the money paid by Slovakia.

Pavol Babos, a political analyst in Bratislava, said Mr. Matovic was “never pro-Russian” but “very naïve.” Desperate for a way to slow the pandemic and lift his own slumping ratings, the prime minister, Mr. Babos added, “fell into a trap set by Russian propaganda.”

But Mr. Matovic scoffed at accusations that Moscow had played him to promote its own geopolitical agenda. The Russians, he said, “wanted to help, but instead of thanking them we said, ‘You are stupid, and you are cheating people around the world.’”

Most at fault, Mr. Matovic said, was the State Institute for Drug Control, which asserted that the Sputnik V batches Russia sent to Slovakia did “not have the same characteristics and properties” as the version V reviewed by The Lancet. This, he said, “was an extremely incorrect political statement.”

Zuzana Batova, the institute’s director, who has received death threats from aggressive Sputnik fans, declined to be interviewed, saying she did not want to pour oil on the fire.

The head of the Biomedical Research Center, which carried out a series of 14 tests in Slovakia on the Russian vaccine, said she had no concerns over whether Sputnik V works but was troubled by Russia’s lack of transparency.

While the potential side effects of the AstraZeneca and Johnson & Johnson vaccines have been documented in detail publicly, the center’s chief, Silvia Pastorekova, said, “We know nothing about Sputnik’s side effects.”

The Russian vaccine, she said, passed all of her team’s tests but failed to win approval from the state regulator because more than three-quarters of the documents required to meet European norms had either not been submitted or were incomplete.

“We are part of the European family and we should accept the rules of the family,” Ms. Pastorekova said.

Monika Pronczuk contributed reporting from Brussels, and Kristina Hamarova from Bratislava.

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Worry Over 2 Covid Vaccines Deals Fresh Blow to Europe’s Inoculation Push

BRUSSELS — First it was AstraZeneca. Now Johnson & Johnson.

Last week, British regulators and the European Union’s medical agency said they had established a possible link between AstraZeneca’s Covid-19 vaccine and very rare, though sometimes fatal, blood clots.

On Tuesday, Johnson & Johnson said it would pause the rollout of its vaccine in Europe and the United States over similar concerns, further compounding the continent’s one-step-forward-two-steps-back efforts to quickly get people immunized against the coronavirus.

European officials had been confident that they had secured enough alternative vaccine doses to take up the slack of the AstraZeneca problems and achieve their goal of fully inoculating 70 percent of the European Union’s adult population — about 255 million people — by the end of the summer.

On Tuesday, European officials did not immediately say whether they believed the milestone would also survive the Johnson & Johnson suspension. But the European commissioner for health, Stella Kyriakides, wrote on Twitter that “Today’s developments with the J&J vaccine in the US are under close monitoring” by the bloc’s medicines regulator.

months of short supplies and logistical problems.

There is mounting evidence that the concerns are eroding Europeans’ willingness to get the AstraZeneca vaccine in particular, and threatening to elevate already high levels of vaccine hesitancy generally.

YouGov poll published last month, 61 percent of the French, 55 percent of Germans and 52 percent of Spaniards consider the AstraZeneca vaccine “unsafe.” That is in stark contrast to the findings of a similar poll from February, when more people in those countries, with the exception of France, believed that the shot was more safe than unsafe.

Regulators have asked vaccine recipients and doctors to be on the lookout for certain symptoms, including severe and persistent headaches and tiny blood spots under the skin. Doctors’ groups have circulated guidance about how to treat the disorder.

In Poland, where the vaccination campaign relies to a large extent on AstraZeneca and where its use has not been restricted, a recent poll showed that given a choice, fewer than 5 percent of Poles would choose the AstraZeneca shot.

Almost everywhere across the European Union, it seems, many are eager for alternatives, as the new types of vaccines that include the Moderna and Pfizer, which utilize science known as “mRNA,” have not been associated with similar side effects.

Data from the 27 E.U. member states by the European Center for Disease Prevention and Control shows that over all, 80 percent of vaccine doses distributed to the bloc have already been administered. That share drops to 65 percent for AstraZeneca, however, suggesting that many of its doses are sitting unused.

Yet it is hard to predict how serious a blow the latest twist in the AstraZeneca saga — and the new Johnson & Johnson concerns — will be to E.U. vaccination efforts, as officials in Brussels have made big if belated efforts to turbocharge the second-quarter supply of doses.

The European Union is poised to receive at least 300 million doses of various vaccines, three times what it got in the first quarter. Two hundred million are slated to come from Pfizer/BioNTech. Moderna is expected to deliver 35 million doses. Another 55 million doses are due of the Johnson & Johnson jab, and 70 million from AstraZeneca.

In the rosiest scenario, the European Union could get up to 360 million doses by June.

On Thursday, after Spain’s government changed the age threshold for the AstraZeneca shot, two-thirds of people called up for vaccination in Madrid did not show up, Antonio Zapatero, the regional health minister, told a news conference on Friday.

He attributed the no-show by 18,200 people to “confusion” generated by Spain’s central government, which said on Wednesday that the AstraZeneca vaccine should be given only to people over 60. Before this change, Mr. Zapatero said, the rate of abstention was 2 percent.

In Belgium, where the use of the AstraZeneca vaccine has also been limited, the authorities said they did not expect major delays in the overall rollout, but they are still concerned about the confusion that the rare blood clotting issue is causing.

Yves Van Laethem, a top epidemiologist who is the country’s Covid task force spokesman, said he expected a two-week delay that would mostly affect younger age groups in late summer. He said the E.U. regulator guidance had only partly helped in clarifying the situation.

The European Medicines Agency’s opinion “wasn’t very clear, and it is also part of the problem,” Dr. Van Laethem said in an interview. “When you say, ‘We don’t apply limitations, but we just say there are serious side effects,’ there is part science and part diplomacy in that.”

He said the limited effect that the new AstraZeneca issues would have on Belgian’s rollout was in large part because the country had ordered big shares of other vaccines.

Although all E.U. countries have been offered a chunk of each vaccine approved in the bloc so far — AstraZeneca, Johnson & Johnson, Moderna and Pfizer — many opted to forgo parts of their share of more expensive or cumbersome vaccines like Pfizer and Moderna early on, instead favoring the AstraZeneca jab.

“In Britain or Eastern Europe, a big part of the campaigns are based on AstraZeneca,” Dr. Van Laethem said.

Wealthier bloc members like Denmark, France, Germany and the Netherlands can better compensate for the loss of confidence in AstraZeneca, because they acquired extra doses of other vaccines — especially Pfizer — through a secondary market after poorer E.U. nations gave theirs up.

Those countries — including Bulgaria, Croatia, Latvia and Slovakia — are likely to be less able to quickly offer alternatives.

Dr. Van Laethem, the Belgian immunologist, said that the national and European authorities needed to better communicate the costs and benefits of taking the AstraZeneca dose versus and the other authorized vaccines.

Experts worry that even limited concerns over one vaccine’s unlikely side effects can affect people’s overall willingness to be immunized.

“The main thing is to make people understand that the problem is the virus,” he said. “We have to vaccinate people — the risk linked to the virus is higher than those rare side effects.”

Raphael Minder contributed reporting from Madrid and Constant Méheut from Paris.

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Slovakia Claims a Bait-and-Switch With the Russian Vaccines it Ordered

The European Union’s regulator, the European Medicines Agency, has so far declined to approve the Russian vaccine for use and only two members of the bloc, Hungary and Slovakia, have placed orders for Sputnik V. Serbia, which is not a member of the bloc, has also ordered Sputnik V and begun using it in a mass inoculation program that has been far more successful than the stumbling efforts of most European Union states.

Even Germany, a stickler for procedure, has expressed growing interest in Sputnik V. Health Minister Jens Spahn told the public broadcaster WDR on Thursday that he would like to start bilateral talks with Russia over a potential purchase of the vaccine, which would go through only if it is approved by the European Medicines Agency.

The previous day, Markus Söder, the governor of Bavaria, said his government had signed a preliminary agreement to buy 2.5 million doses of the vaccine, which are to be produced at a Russian-owned plant in the southern state. That deal, too, is contingent on E.M.A. approval.

Sputnik V is manufactured at seven locations in Russia, and also at plants in India and South Korea. A number of other countries have signed manufacturing contracts, including Brazil, Turkey and Serbia. Russia has consistently delivered fewer doses of the vaccine than initially promised, suggesting glitches in manufacturing. Producing vaccines at scale is a difficult process and ramping up production has presented problems for Western vaccines, too.

Noting that about 40 countries are using or scheduled to use the Russian vaccine, the Slovak regulatory agency asserted that “these vaccines are only associated by the name.” That raised questions about deviations from the formula reviewed in The Lancet.

“The comparability and consistency of different batches produced at different locations has not been demonstrated,” the Slovak regulator said. “In several cases, they appear to be vaccines with different properties (lyophilisate versus solution, single-dose ampoules versus multi-dose vials, different storage conditions, composition and method of manufacture).”

The Slovak statement could damage Russia’s efforts to establish Sputnik V as a reliable brand. It could also exacerbate lingering doubts left by the vaccine’s highly politicized rollout in Russia, where President Vladimir V. Putin announced that the drug was ready for use in August, before clinical trials had finished.

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