Concern is mounting that China’s COVID-19 vaccines are less effective at quelling the disease, raising questions about nations from Brazil to Hungary that are depending on the shots and Beijing’s own mammoth inoculation drive.
While vaccines developed by Pfizer and Moderna, and even Russia’s Sputnik shot, have delivered protection rates of more than 90 percent, Chinese candidates have generally reported much lower efficacy results.
Research released on Sunday showed that the rate for Sinovac Biotech’s vaccine — deployed in Indonesia and Brazil — was just above 50 percent, barely meeting the minimum protection required for COVID-19 vaccines by leading global drug regulators. Other Chinese shots have reported efficacy rates from 66 to 79 percent.
Illustration: Mountain People
Anxiety over the disparity spilled into the open last weekend when Chinese Center for Disease Control and Prevention Director Gao Fu (高福) told a forum that something needed to be done to address the low protection rate provided by Chinese vaccines, Chinese news Web site The Paper reported.
The rare admission by a Chinese official went viral on social media before China’s censors swung into action, with posts and media reports about Gao’s comments quickly edited or taken down.
Gao then backtracked, telling state-backed newspaper the Global Times that his remarks were misinterpreted and were only meant to suggest ways to improve the efficacy of vaccines.
Gao suggested that following up inoculations with additional booster shots and mixing different types of vaccines could help tackle the effectiveness issue, the Global Times said.
The concerns put a question mark over a vast swathe of the global vaccine rollout, particularly in the developing world, with richer countries’ domination of supplies of the highly effective messenger ribonucleic acid (mRNA) vaccines seeing nations like Turkey and Indonesia turn instead to Chinese shots.
Beijing, which is also donating vaccines to some nations, has been ramping up its own inoculation drive. It aims to vaccinate 40 percent of the Chinese population — or 560 million people — by the end of June, an ambitious effort that would require it to move at twice the pace of the US.
“They don’t really trust it themselves,” said Therese Hesketh, an expert on China’s healthcare system at University College London. “They really did a rush job on the vaccine and the clinical trials have never been properly scrutinized. I’m aware from colleagues in China that there’s huge vaccine hesitancy anyway.”
Chinese vaccine developers have been repeatedly criticized for a lack of transparency and lag foreign peers in publishing full trial data in peer-reviewed medical journals.
Sunday’s study of the Sinovac vaccine’s late-stage trial in Brazil came three months after its first efficacy readouts, while state-owned Sinopharm has yet to publish full data from phase 3 trials for its two inactivated COVID-19 vaccines.
While a separate Sinovac study involving more than 10,000 people in Turkey put the vaccine’s efficacy at 83.5 percent, it just added to questions about its effectiveness.
The company has said that differences in the severity of outbreaks, various COVID-19 strains in circulation and the definition by which cases are identified in studies have contributed to different results across several trial sites.
“The confusion that has arisen highlights the importance of full transparency with publication of results of trials in the peer-reviewed literature,” said Martin McKee, a professor of European Public Health at the London School of Hygiene and Tropical Medicine.
One reason for the low efficacy in the trial in Brazil was that the two doses of the vaccine were administered at a short interval of 14 days, the study said.
The researchers noted “a trend to higher efficacy” among a limited number of participants who got their second dose in no less than 21 days.
Home to the world’s second-worst COVID-19 outbreak after the US, the stakes are high for Brazil’s vaccination rollout.
The country is relying on the Sinovac shot, known as CoronaVac, and a booster developed by the University of Oxford and AstraZeneca.
The British shot is also under scrutiny as some people developed blood clots after receiving it.
Dozens of other countries, from Bahrain to Chile and Serbia, have also approved one of the Chinese vaccines, as well as shots by other manufacturers, with varying success in fighting the virus.
Asked about the Chinese vaccines at a news briefing on Monday, WHO Immunization Department director Kate O’Brien said that it is most critical “that we are in a phase of constraint of supply of vaccines around the world.”
“We’re learning about the best use of each of the vaccines as we go forward,” she added.
At home, China is already walking a tightrope trying to keep its vaccination rates on a par with some other countries, especially the US, to avoid a delay in lifting border restrictions and resuming international travel.
While China is working on more effective vaccines, including shots that deploy mRNA technology, it should continue to roll out those that have been approved for now, said Benjamin Cowling, an epidemiologist at the University of Hong Kong.
“They can provide a high level of protection, particularly against severe COVID,” he said.
Fearing that a heavy-handed approach could draw a backlash, Chinese officials have so far refrained from making shots mandatory and have spoken out against forced inoculation.
Officials have instead dangled rewards and applied peer pressure among workers in the massive state sector to significantly raise vaccination rates, and are now issuing nearly 4 million doses per day from less than 1 million at the start of this year.
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