China’s Covid-19 vaccines in demand, but will efficacy data affect its diplomacy goals?
- Beijing could make ‘vaccine diplomacy’ gains by providing doses to developing countries in short supply
- But the release of efficacy data in Brazil for the vaccine of Chinese firm Sinovac served as a reminder that such efforts rely on medical credibility
Wang also offered 300,000 doses to Myanmar, reportedly including vaccines produced by both Sinopharm and Sinovac, with “a batch” of the doses to be free.
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How well Chinese vaccines perform in late-stage clinical trials has drawn worldwide attention, with high expectations that China could help fill a supply gap for developing countries after most Western vaccines were snapped up by rich countries.
Butantan’s announcement whipped up political bickering in the Philippines, with some lawmakers arguing CoronaVac was too expensive given its apparently low efficacy, while regulators from some other places said they would review the data further.
In the longer term, the vaccine supply landscape for developing countries may change as the United States under its new president, Joe Biden, relinquishes the “vaccine nationalism” touted by the Trump administration and joins the global distribution initiative Covax.
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After Butantan announced its efficacy data on January 12, Sinovac broke its long silence on its trial data to defend CoronaVac.
The efficacy rate on severe cases, however, has yet to be based on enough cases to make the distinction statistically significant.
The company also said the trials were conducted on health care workers, arguing the efficacy in protecting them may have been affected because they would have been constantly exposed to Sars-CoV-2, the coronavirus that causes Covid-19.
The Pfizer-BioNTech and Moderna vaccines both reported efficacy of about 95 per cent, while the Oxford-AstraZeneca vaccine was found to be 70 per cent effective.
But even with an efficacy of 50 per cent, scientists said it was an important supply line for developing countries.
“It is not yet known if the reduced efficacy of [CoronaVac] reflects weaker immune responses or different populations,” said Dan Barouch, director of the virology and vaccine research centre at Harvard’s Beth Israel Deaconess Medical Centre, who is co-developing a Covid-19 vaccine with Johnson & Johnson.
“Still, a vaccine with 50.4 per cent efficacy could have an important role in areas that currently do not have access to other vaccines.”
Serhat Unal, professor in medicine at Hacettepe University, who coordinated those clinical trials in Turkey, said the aim was to recruit 13,000 volunteers and wait to reach 40 infections among them before making final efficacy analysis.
Jerome Kim, director general of the International Vaccine Institute, said it was important for trials in different countries to use the same protocols if the company wanted to combine the findings.
Sinovac chairman Yin Weidong last week said the three overseas trials were designed differently, without stating whether the firm intended to present a combined result later.
“[The protocols] were conducted independently by three different research [institutes],” he said. “All the findings were done by the researchers from the different countries independently.”
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Kim said confusing data released by Sinovac and its partners would undermine public trust.
“When you only present a part of the data, then have to amend it, it damages your credibility,” he said. “For vaccine companies, credibility is important. We are going to give this vaccine – if safe, efficacious and manufactured at an international standard of quality – to healthy people to keep them healthy. Being able to stand with strong data on safety and efficacy is critical assurance.”
Huang Yanzhong, senior fellow for global health at the Council on Foreign Relations in New York, said lower efficacy may affect people’s willingness to take a vaccine if they have other choices, and it may take longer for developing countries to achieve herd immunity because higher vaccination rates would be required.
“Countries may face domestic pressure in terms of purchasing the China-made vaccines,” he said.
In terms of prices paid by governments, Chinese vaccines are more expensive than the Oxford-AstraZeneca one, though they should be cheaper than the mRNA vaccines.
The Oxford-AstraZeneca vaccine is offered at US$2.16 to Europe, while one report said it was offered at US$5.25 to South Africa. Pfizer-BioNTech set an initial price of US$20 per dose, but a recent tweet by a Belgian minister said it charged European countries about US$15.
Now it seems [China] will focus more on technology transfer and encourage countries that have the capacity to make the vaccines themselves
“Now it seems [China] will focus more on technology transfer and encourage countries that have the capacity to make the vaccines themselves, and use that to approach other countries,” Huang said.
Chinese President Xi Jinping said last May any vaccines developed in China would be treated as a “global public good”, and Sun Yang, of China’s National Health Commission, told the World Health Organization this month that China “would like to make more contribution” to the fair distribution of Covid-19 vaccines.
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Huang said China’s foreign policy goals played a role in its prioritising of countries to receive vaccines.
An example was Wang Yi’s trip to five Africa nations immediately before his Asean tour. In a marked contrast with the Asean trip, no concrete deals were signed despite pledges of cooperation, sparking concerns that Africa, which needs vaccines, may be left at the back of the queue.
“There may be strategic considerations. Wang made the donation during his trip to the Philippines, [and] it appears that they are prioritising Southeast Asia strategically,” Huang said, adding that China also wanted to ensure it had enough supplies to inoculate its own population.
The dynamic could change as the United States enters the fray as a global supplier. On Thursday, Biden’s chief medical adviser Anthony Fauci confirmed that the US intended to join the United Nations-led Covax, having opted out during the Trump administration.
Huang said the US was signalling it may depart from vaccine nationalism, although it was too early to say whether it would also pursue bilateral deals to advance its own vaccine diplomacy.
“Given the United States is focusing on domestic vaccination campaigns, it may not have the incentive to earmark a certain proportion of vaccines for vaccine diplomacy,” Huang said. “That will make China one of the dominant players in the game.
“How [the US] may use vaccines as a diplomatic tool will shape how that vaccine diplomacy plays out.”
Additional reporting by Simone McCarthy and Zhuang Pinghui
