Chinese vaccine diplomacy falters as nations seek Western gunfire


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(Bloomberg) – As the Covid-19 vaccine rolled out, Chinese fire saved countless lives. They launched inoculation programs in Asia, Latin America, and the Middle East, while richer countries racked up scarce mRNA injections from Pfizer Inc. and Moderna Inc.

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But many governments that once relied on vaccines from Sinovac Biotech Ltd. or Sinopharm Group Co Ltd. relaxes. This preference may already appear in customs data from China, where human vaccine exports fell 21% in August to $ 1.96 billion from $ 2.48 billion in July, after rising steadily since. December 2020.

“Basically people took what they could get” when Covid vaccines first became available, said Nicholas Thomas, associate professor at the City University of Hong Kong who has edited several books on foreign policy and public health.

“But as this has continued, populations in general – rather than just doctors – have become more aware of the differences,” he said. “They realized that not all vaccines are equal in terms of protection. “

This change occurred during the deadly epidemic in Thailand earlier this year. As cases increased and Southeast Asia became the new epicenter of the pandemic, the nation was desperate to buy vaccines. Only one supplier arrived on time: Chinese Sinovac.

The shots allowed the country of 70 million people to start its vaccination campaign earlier than expected, but Thailand was quickly faced with a challenge now facing lawmakers in the developing world.

The effectiveness of Chinese inactivated vaccines ranges from around 50% to 80% in clinical trials. But they are less potent than mRNA vaccines, and questions are growing about their effectiveness against the highly transmissible delta variant. As a result, the Thai government became the first in the world to offer a blow from AstraZeneca Plc to people who had already received a blow or even two from Sinovac. Although not an mRNA, studies in Thailand have shown that the viral vector vaccine from the Cambridge, UK-based company is potent as a booster to the Chinese vaccine, and the dose of Pfizer has proven to be even more effective.

But many Thais quickly expressed a strong preference for Western gunfire – even protesting to demand it – and the country’s opposition began to castigate the government for its dependence on China. Thailand has suspended orders for Sinovac and started purchasing more western vaccines.

“I’m not anti-Sinovac,” said Chaowat Sittisak, a 29-year-old teacher from northern Thailand who received a first dose of Sinovac but ordered a second injection of Moderna at a private hospital. “If the world had only one vaccine and it was Sinovac, I would have it. But we have so many other choices. And I want the best.

Many governments that once relied on Chinese vaccines are now ordering or seeking donations of mRNA vaccines instead. Distance from China set to accelerate as US President Joe Biden pledges to donate 1.1 billion doses of mRNA, Europe pledges hundreds of millions of vaccines, and India prepares to export AstraZeneca vaccines again after reducing shipments after its second deadly wave. In addition to availability and efficiency, freedom of movement can also motivate change: Chinese vaccine recipients can’t get to some places, like Singapore.

Vaccine exports

In a written response to Bloomberg, Sinovac said its CoronaVac injection has been effective in preventing hospitalizations, intensive care admissions and deaths throughout the pandemic. A spokesperson said some countries first deployed Sinovac for the elderly, who are more likely to be hospitalized with Covid-19, while younger populations received different vaccines later, “and this should be taken into account in evaluating the effectiveness of CoronaVac “.

Many countries, including Thailand, have “purchased vaccines from multiple vendors in order to maximize the number of doses available to their populations,” the company said.

As it stands, the list of places moving away from Chinese vaccines – or increasing them with Western boosters – includes Singapore, Turkey and the United Arab Emirates. In the Chinese territory of Hong Kong, which has long offered residents a choice between BioNTech and Sinovac, health officials are now testing whether the Chinese vaccine will work best when paired with a Western booster.

Even in Pakistan, an all-weather ally of Beijing who has used Chinese vaccines for 84% of its vaccination campaign, some are doing all they can to find Western jabs: Muhammad Kashif, a 41-year-old motorcycle delivery man in Karachi, felt lucky to find a rare dose of Moderna vaccine in an overcrowded inoculation center where later arrivals were forced to procure Sinovac.

“I thought it was American, they must have done it after a lot of high level research,” Kashif said. “I’m glad I was able to get it. I think it is much safer.

While Sinovac has allowed Thailand to start its deployment earlier than planned, the 6 million doses that arrived in October will be the last shipment. By 2022, at least three-quarters of government orders will also come from Astra and Pfizer.

Measures like Thailand’s are a blow to China’s vaccine diplomacy ambitions. Nonetheless, governments face a delicate balance between wanting to protect the public and maintaining good relations with China. Thailand’s health ministry was careful to say that while it does not intend to order more Sinovac, it is not suggesting that the injections are not working.

Chinese companies have exported some 884 million doses of their local vaccines through mostly bilateral deals with countries like Brazil and Indonesia. This week, Chile began giving Sinovac injections to children as young as six, strong approval of an injection that formed the backbone of their deployment.

And there are still many parts of the world running out of vaccines. Some African countries, for example, have barely started their vaccination campaigns after struggling to obtain vaccines. Côte d’Ivoire, Burkina Faso and Kenya are all deploying Chinese vaccines, and Beijing is a key supplier to the World Health Organization-backed Covax facility that aims to deliver vaccines to developing countries. President Xi Jinping has pledged to export 2 billion doses this year, corresponding to the commitments made by the Group of Seven countries.

Various studies around the world have shown that jabs are effective in preventing serious illness and death.

Yet Chinese pharmaceutical companies – which were initially less willing than Western companies to release clinical trial data – have not published studies as conclusive that inactivated vaccines are effective against delta.

In the coming year, policymakers may well continue to shy away from the old technology of Chinese inactivated vaccines, says Benjamin Cowling, professor of epidemiology and biostatistics at the University of Hong Kong, who published a recent study in the Lancet showing the Pfizer vaccine generated 10 times more antibodies than Sinovac.

“If you have vaccines that are more effective than others and the cost is about the same, then you will get your money’s worth if you choose the most effective vaccines,” Cowling said. “But I still think supplies are limited, so it might not be as easy as saying, ‘We just want to order the Moderna vaccine,’ or whatever. ‘

“Better alternatives”

In Thailand, the opposition Move Forward party is now calling on the government to reveal the percentage of people who only received Sinovac injections.

“The government already knows that studies and research show that inactivated virus vaccines are less effective against viral mutations than mRNA-based vaccines,” said Wiroj Lakkhanaadisorn, an opposition lawmaker and key critic government vaccine policies. “We should know the vaccination rate that excludes all two-dose Sinovac vaccines because immunity may no longer be sufficient. All ready regions can then reopen. “

Thailand’s health ministry did not respond to a request for comment.

Chaowat, the teacher, said he felt pressured to take Sinovac’s photo because of his job, but hopes to get a photo of Moderna in a month or two.

“The government is turning away from Sinovac because it needs to move forward with its reopening plan and it wants to reduce vaccine reluctance among people who do not want Sinovac,” he said. “They are looking to better alternatives.

(Updates with details on Pakistan’s vaccination campaign.)

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