As the roll-out of the Covid-19 vaccines steps up in the UK and further afield, there is a hidden risk to the success of the operation. In December 2020 the law enforcement agency Europol published an Early Warning Notification on the risks posed by vaccine-related crime during the Covid-19 pandemic. Head of life sciences, Charlotte Tillett and head of competition and regulatory, Gustaf Duhs highlight some of the key issues in this short video.
Fakes thrive on shortages
In October 2020, the WHO discovered some counterfeit batches of the influenza vaccine Fluzone in Mexico, which were not authorised by the manufacturer Sanofi Pasteur. Owing to the current pandemic, there was a shortage of influenza vaccines and organised criminals wasted no time in exploiting the opportunity that presented itself. Europol believes that the same scenario is likely to occur in the context of Covid-19 vaccines.
Already on sale, both online and offline, are fraudulent pharmaceutical products alleging to cure or treat Covid-19. For example, hydroxychloroquine, the drug championed by Donald Trump and Brazilian President Jair Bolsonaro, is being sold online on the darknet for as little as $10 with erroneous claims that it is an effective treatment for Covid-19. It would be a logical next step for the groups involved with these to turn their hands to marketing and selling fraudulent Covid-19 vaccines.
What are the risks?
Fake vaccines and other medicines pose a huge risk to public health, as they may at best be ineffective or, at worst, toxic or damaging to health. Experts at Pfizer have found harmful substances in counterfeit medicines including boric acid, leaded highway paint, floor polish, brick dust and heavy metals. Even if they do not contain toxic substances, these drugs will not have undergone the rigorous testing and clinical trials procedure which are required before marketing authorisations are granted.
The European Union Intellectual Property Office and Organisation for Economic Co-Operation and Development recently published a Report on counterfeit pharmaceutical products based on data from 2014-2016. The Report estimates that 72,000 to 169,000 children may die from pneumonia every year after receiving counterfeit drugs, and fake anti-malaria medicine may have caused an additional 116,000 annual deaths. The Report highlights that these drugs often do not contain the required active ingredients and also contain other potentially dangerous substances. Deaths tend to occur in countries where there is a high demand for the drugs, combined with poor surveillance, quality control and regulations, all of which make it easy for criminal gangs to infiltrate the market.
In the case of counterfeit vaccines, there may be further consequences, for example, if a community is assumed to have been vaccinated whereas, in fact, they have received a fake and ineffective vaccine. In this situation, the chances of new outbreaks increase hugely. Fake vaccines may make people lose faith in the public health organisations that are trying to help.
How do fake vaccines enter the market?
Criminals may advertise these fake vaccines using the brands of genuine pharmaceutical products, thereby committing a host of intellectual property infringements including trademark abuse and passing off. As of June 2018, counterfeit versions of 42 Pfizer medicines had been detected in the legitimate supply chain of at least 62 countries, including the US, Canada and the UK. Europol also raises the risk of criminal organisations refilling empty genuine Covid-19 vaccine vials. This, together with counterfeit suppliers becoming ever more expert in copying the packaging of the genuine products, will make it even harder to distinguish the counterfeit vaccines.
Criminal groups can also make substantial profits by directing genuine vaccines away from the legal market. The supply chain may become vulnerable to hijacking and theft (namely storage, transportation and delivery). The Transported Asset Protection Association has labelled this as the “biggest security challenge for a generation.” The diversion of vaccines from the legal market poses a risk to public health, as vaccines found outside the cold chain are not considered safe.
How will people be targeted?
Besides advertising fake vaccines for sale, it is likely that there will be a rise in vaccine-related crime. This may, for example, include suspicious text messages with links to a booking site for the vaccine which mimics an NHS page but asks for personal details including bank account numbers. It is not unusual for GPs to contact patients via text, so it may be difficult to know whether they are genuine or not.
The NHS in conjunction with Action Fraud, the National Crime Agency and the National Cyber Security Centre have issued joint advice reminding people, among other things, that the vaccine is only available for free on the NHS, and that NHS will never ask for payment or for confidential information. They are also asking people to hang up on fraudulent calls, to forward suspicious emails to firstname.lastname@example.org and forward suspicious texts to 7726.
Have Europol’s predictions materialised?
Research from cybersecurity firm Check Point Software Technologies has found that a wide range of fake Covid-19 vaccines are being offered for sale on the dark web. Vendors often accept bitcoin for these products, which are being sold for the equivalent of a few hundred dollars. The use of bitcoin makes purchases untraceable, and there is no way of checking the quality of the products. One vendor claimed that they had received the vaccine they were selling on the darknet from a leading pharmaceutical company. Other vendors sell unspecified Covid-19 vaccines and claim that 14 doses per person are required, which is markedly different from the two doses required for most official Covid-19 vaccines. 
There have been reports of criminals attempting and in some cases succeeding in stealing money and personal details from people keen to get a vaccine. An example of this occurred in December when a 92-year-old woman was approached at her front door by a man who said he would give her the vaccine if she would pay £160. She paid him what he asked for and he administered a fake vaccine. He has since been charged with fraud and common assault.
As of 10 January 2021, there have been 65 reports to Action Fraud (the national reporting centre for fraud and cybercrime) in relation to the Covid-19 vaccine. These have mostly been reports of scam text messages. Although those numbers are small at the moment, we are only at the beginning of the vaccine roll out and the head of Action Fraud, Pauline Smith, believes that levels will increase.
Currently, the vaccination programme in the UK appears to be progressing well but were supply and demand to become unbalanced with a shortage of vaccines or a perceived slowness to roll them out, people would be more likely to start to seek vaccines from other sources, creating opportunities for scammers to ramp up their efforts to defraud those desperate to be vaccinated.