London (CNN)When the United Kingdom became the first Western nation to approve a Covid-19 vaccine earlier this week, the news was greeted with praise from some health officials across the pond. But there was one notable exception.
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Dr. Anthony Fauci, America's top infectious disease expert and perhaps one of the world's most recognizable scientists, suggested that UK regulators had not scrutinized the data on the Pfizer/BioNTech vaccine as carefully as their US counterparts, and that the British approval had been "rushed."
"We have the gold standard of a regulatory approach with the [Food and Drug Administration]. The UK did not do it as carefully and they got a couple of days ahead," Fauci told Fox News on Wednesday.
Fauci's comments were the opening salvo in a verbal jousting match between US and UK officials that experts said risked undermining public confidence in the safety of vaccines.
By Thursday evening, Fauci had apologized on British television for his earlier comments.
"There really has been a misunderstanding, and for that, I'm sorry and I apologize for that. I do have great faith in both the scientific community and the regulatory community at the UK," he told the BBC.
"We do things a certain way in the United States, possibly a little different, not necessarily better or worse than what's done in the UK, and I think that's where we slipped, where I slipped. I made it seem one was better than the other. We just do it a little bit differently."
Getting down and dirty
So how did the UK leapfrog the US in the race to approve a vaccine? There is one main difference in approval process between the two countries -- the way regulators treat data.
The UK's independent regulator -- the Medicines and Healthcare products Regulatory Agency (MHRA) -- typically uses data reports from drug makers to come to a decision on approval. This is also the approach taken by several other regulators worldwide, including the EU regulator the European Medicines Agency (EMA).
America's FDA, however, usually re-analyzes the raw data from drug companies before signing off on approval, which can take a bit longer.
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"We in the United States are in a unique position, which is that among all global regulators, we are the ones that actually don't just look at the companies' tables. We actually get down and dirty and we look at the actual adverse event reports, the bad spelling errors that are made by physicians sometimes, et cetera," Dr. Peter Marks, director of the FDA's Center for Biologics Evaluation and Research, told an American Medical Association webinar Thursday.
Professor Stephen Evans, from the London School of Tropical Hygiene and Sciences, said he didn't know how often the FDA's re-analyses resulted in different conclusions to the presentation of data from drug companies. "My suspicion is that that would be rare," he told CNN. "If it all leads to the same numbers, one might argue that it's a delay that hasn't given any gains."
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Evans also said the MHRA had more flexibility when it came to organizing meetings to discuss vaccine data and approvals. The FDA is required to hold public meetings which are scheduled well in advance.
"The FDA provides its own full written assessment of the application, and then both the company's application and the FDA's assessment are reviewed at a day-long public meeting by an independent expert advisory group," Mark McClellan, a former FDA commissioner, told CNN in an email.
"Preparing for, conducting, and responding to the input at this meeting takes a bit of additional time. But it not only helps assure a thorough review -- it also creates more public transparency about important decisions and can help with confidence in the decision in the medical community and the public. Those things are very important as well."