As the global pandemic progresses, Chinese vaccine manufacturers falter both with delivery and efficacy of their vaccines.
China was the first off the blocks in bringing a COVID vaccine into active use, and had started conducting trials as early as May 2020. At least four companies in China have been mass producing COVID vaccines, most of which are of the killed fragment variety. Sinovac (Coronavac), Sinopharm and CanSino are the three main players in the Chinese vaccine market.
Sinovac and Sinopharm have bagged large orders from several countries after initial trials were said to have shown a high efficacy of the virus. However, the data from these trials has been hard to come by and often released piecemeal, which gives no proper idea of either safety or efficacy. The trial results too have greatly varied with some showing an efficacy of only 50% and others of over 90%. This article takes a critical look at production, efficacy and diplomacy of Chinese vaccines.
China started conducting trials on their indigenous COVID vaccine as early as April 2020, and claimed 79% efficacy in phase 3 trials in December 2020. However, by September 2020 they were mass vaccinating large sections of their population without phase 3 trials. China tied up with a few countries to conduct international trials. The results have been mixed. A recent comprehensive study by Brazilian researchers showed an efficacy of just 50.4% for the Chinese vaccine company Sinovac’s Coronavac vaccine when mild cases were included as opposed to 78% for moderate and severe disease. Brazil has ordered more than 380 million doses of Coronavac. Despite the somewhat disappointing results, Brazil has authorized Sinovac for emergency use along with the AstraZeneca vaccine. Singapore has announced that it would review Sinovac’s Coronavac vaccine for safety and efficacy in light of the findings of the Brazilian researchers, while proceeding with inoculation of its population with Pfizer and Moderna vaccines.
In another trial, Turkey reported 91.25% efficacy of Sinovac vaccine. However a closer look shows that the statements were based on an endpoint of just 40 cases in a trial of 1322 volunteers. UAE reported 87% efficacy of Sinopharm in their trials, but again the data of the trial was not shared publicly. UAE offers both Pfizer and Sinopharm vaccines to their resident population.
Very few trial results of Chinese vaccines have been published or are publicly available. China claimed that it had conducted phase 3 trials of Sinopharm on 60,000 volunteers and found 79% efficacy, but refused to release the data while giving approval to the vaccine in December 2020.
Sinovac, CanSino and Sinopharm have been quite opaque with their trial data. Sinovac in particular has had a troublesome history and officially admitted to paying bribes and incentives for receiving approvals for their vaccines. CanSino has also struggled to find partners for conducting trials of its vaccines. Earlier last year the company tried hard to cover up the poor results of its single dose vaccine and said a second dose may be needed to boost immunity.
Turkey has ordered 50 million doses from Sinovac but has received about 3 million. We see this pattern repeating in all countries that have ordered the Chinese vaccines: hardly any have actually received them. To cope up with the demand, Sinovac claims to be upgrading its facilities to produce one billion doses of vaccines annually. However, it has managed to only reach an upgraded capacity of 300 million doses annually. This number is barely enough to vaccinate a tenth of China’s own population of 1500 million. Additionally, China seems to be prioritizing inoculation of its own population over supplying to a world in crisis as it prepares to vaccinate 50 million people by February 2021, before their New Year.
Peru, South Africa, Serbia and Bahrain are some of the other countries that have approved Chinese vaccine and struck deals for supplies of millions of doses each. However, most of them are yet to receive any consignments of vaccines. Peru conducted trials of Sinopharm that were halted due to a “serious adverse event”. It has granted approval for the vaccine but is still awaiting delivery of its first consignment of a million doses against their total requirements of 26 million. Peru has struck deals with Pfizer and the global vaccine alliance COVAX initiative to fill the gap. South Africa and Morocco are turning to India for securing their supplies. CanSino has offered 20 million doses of its single-shot vaccine to Pakistan on special pricing that is presently undisclosed, but has yet to strike a deal.
Indonesia has received three million doses of “safe and halal” Coronavac but with delays in delivery from China, it is turning to the world’s largest vaccine manufacturer Serum Institute of India for fulfilling its requirements of 270 million. Trials conducted by Indonesia showed efficacy of Coronavac at about 65%. Their deal with China includes supply of materials and components sufficient to produce 45 million doses in Indonesia.
China’s Vaccine Diplomacy, or Coercion?
China has promised millions of free doses of vaccines to friendly countries. However, hardly any of these “gifts” have materialised so far. Pakistan is still awaiting its five lakh free doses. Bangladesh was promised free vaccines that have not been supplied, and has also pulled the plug on Chinese vaccine trials after China asked them to share costs. India quickly stepped in, gifted two million doses of the Covishield vaccine to Bangladesh with no strings attached, and simultaneously Serum Institute of India also bagged an order for 30 million doses of Covishield from Bangladesh.
Cambodia has received a million doses from China free of cost, but the country is already deeply indebted to China via “soft loans” of billions of dollars.
Brazil President Bolsonaro sent a special flight to collect two million doses of the AstraZeneca vaccine from India and publicly thanked India for the supplies. However, China, despite having struck deals with Brazil for 380 million doses, was reported to have refused to supply Sinovac’s vaccine Coronavac until the Brazilian Foreign Minister, who had called SARS-COV2 the “Communist virus”, was sacked.
It is likely that China will end up antagonizing most if not all countries that it purports to support with grants due to its coercive ways that seek to extract their pound of fresh from the charity.
In summary, despite the early bird advantage, China is struggling to prove both efficacy and safety of their vaccines. With lack of adequate manufacturing capacity despite tall claims, it is also failing to deliver on supply of vaccines to other countries that placed orders with Chinese companies. As a result, many of them are turning to other options.
Having over-promised and terribly under-delivered, it will be interesting to watch how the Dragon maneouvres itself out of this difficult situation.