Pharmaceutical companies have never had it so good. The rapid rollout of Covid-19 vaccines has made household names of Pfizer and AstraZeneca and the whole industry is winning praise for co-operation.

But the decision this week by some governments to suspend use of the Oxford/AstraZeneca vaccine over fears of possible blood clots shows just how fragile public trust can be. What has been a public relations triumph could, if handled badly, turn out to be a trap.

Big Pharma’s reputation has been down in the dumps for years, after a series of scandals involving Medicare fraud, improper payments to doctors and poorly tested drugs that damaged health. Recently, the opioid epidemic and high charges for both new and old medicines have further alienated the public. Political pressure was mounting in the US, the most profitable market.

Covid-19 changed all that. Since January 2020, the share of the US public that has a positive view of the sector has nearly doubled from 32 to 62 per cent, the highest since the survey began in 2003, says Rob Jekielek, managing director at The Harris Poll. And 56 per cent in the UK told The Association of the British Pharmaceutical Industry in January that their view of pharma had improved during coronavirus.

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AstraZeneca and Johnson & Johnson have promised not to profit from their jabs “during the pandemic”. Yet Pfizer said last month that it expected to sell $15bn of its Covid vaccine this year, with profit margins in the “high 20s” as a percentage of revenues. The company notes that under its tiered pricing strategy, low-income countries pay a non-profit price. But the rollout to poorer countries has been slow.

If the pharma companies are seen to favour those who can pay higher prices, that would reinvigorate the debate over the pricing of other medicines. Already, US campaigners are demanding an antitrust investigation of rising prices in the insulin market. “We should now be holding pharma companies to a higher bar because they’ve shown us what they can do,” says Olivia Webb, a health policy analyst at the American Economic Liberties Project.