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EXPLAINED | China's One Billion Covid-19 Vaccine Feat: A Milestone Marred by Several Questions

File pic of China's President Xi Jinping.

File pic of China's President Xi Jinping.

Questions have been raised as most beneficiaries of the Chinese vaccines do not report even the most common side-effects.

China has said it has administered over one billion doses of Covid-19 vaccines in the country ever since it accelerated its pace of free jabs for the whole nation in late March.

The National Health Commission (NHC), however, did not disclose how many people had been vaccinated. So far, a total of 21 Covid-19 vaccines have entered clinical trials in China since last year and the government has granted conditional approval for four vaccines for emergency use, as per local media.

The World Health Organisation (WHO) has granted emergency approval for two Chinese vaccines, Sinopharm and Sinovac. China has also supplied and exported the two vaccines to several countries. China’s nationwide vaccination campaign is open to people aged over 18. The country has also approved the emergency use of domestic inactivated vaccines on people aged 3 to 17.

At least 80 per cent of the target population (1.4 billion people) in China is expected to be vaccinated against Covid-19 by the end of this year, Zeng Yixin, deputy head of the NHC said.

The vaccine candidates

Sinovac Biotech Ltd’s vaccine Coronvac, which has already been sold to several countries and is being administered to millions of people worldwide, was given emergency approval last year in July. In February, it was granted conditional approval expanding its scope beyond the high-risk and priority groups already allowed under an emergency clearance.

It is the second locally-made vaccine to be given conditional approval. Beijing authorized the state-owned Sinopharm’s vaccine in December 2020.

Both Sinovacs shot and Sinopharms shot are two-dose inactivated vaccines, relying on traditional technology that makes it easier to transport and store than Pfizer’s vaccines, which requires ultracold storage.

Inactivated vaccines are made from viruses or bacteria killed through physical or chemical processes, which are then inactivated to prevent them from infecting patients with Covid-19. Many other vaccines use similar platforms, including injectable polio, Hepatitis A, and flu vaccines.

Close scrutiny

Sinovac’s vaccine, however, has been subject to intense scrutiny and criticism for lack of transparency. It has announced different efficacy data in different countries across the world. Officials in Turkey, where part of stage 3 clinical trials was staged, have said the efficacy rate was 91.25 per cent.

But in a much bigger trial in Brazil, officials there initially announced an efficacy rate of 78 per cent, but revised that down to just over 50% after including mild infections. The Brazil segment of the trial enrolled 12,396 volunteers, and recorded 253 infections, the company said in a statement Friday.

Its stage 3 clinical trials were held in Brazil, Chile, Indonesia, and Turkey, with a total of 25,000 volunteers.

On the other hand, the two vaccines made by China’s Sinopharm, which got emergency use approval by the World Health Organisation in May, were found to be 73% and 78% effective, by the Journal of the American Medical Association.

Little to no data 

Sinopharm has released very little data publicly, aside from efficacy numbers for its two vaccine shots one developed by its Beijing Institute of Biological Products and the other by the Wuhan Institute of Biological Products.

The Beijing shot is one that was considered by WHO for the emergency use listing.

A separate group advising the UN agency on vaccines had said it was very confident the Sinopharm vaccine protects the 18-59 age group but had only a low level of confidence of efficacy in the 60-plus. Its members said they had very low confidence in the available data about serious side effects in that age group.

Last month, China’s top disease control official, in a rare acknowledgement, said that the current vaccines offer low protection against the coronavirus, prompting the United Arab Emirates to begin offering booster shots to those who received the Sinopharm vaccine six months after vaccination.

In another cautionary tale, Chile, which used the Sinovac vaccine as its major vaccination tool, has also said that it would extend a Covid-19 emergency through September, as cases have soured to some of their highest levels since the pandemic began.

Questions, Questions

During the end of May, China, for the first time, released adverse reactions data for its vaccines and said that the rates of normal and severe adverse reactions were lower than other common vaccines.

A total of 31,434 adverse reactions were reported among 265 million doses used between December 15, 2020, and April 30, 2021, or 11.86 in every 100,000 doses, the Chinese Center for Disease Control and Prevention said, Chinese mouthpiece Global Times reported.

Among adverse reactions, normal reactions like fever and swelling accounted for 82.96 percent while severe reactions such as acute allergies accounted for merely 17.04 percent.

Among severe adverse reaction cases, 188 were deemed “serious," which means 0.07 cases in every 100,000 doses administered, it added.

Slow to start, but now charging forward

China has tripled its daily Covid-19 vaccine rollout this month, inoculating 44 per cent of its population with at least one dose.

It rolled out 17.3 million doses per day in June on average, up sharply from 4.8 million in April, as it expanded the list of approved vaccines to seven by adding three more locally-developed shots, and continued to boost production.

China’s total is roughly a third of the 1.9 billion shots distributed globally, according to Our World in Data, an online research site.

China is now averaging about 19 million shots per day, according to Our World in Data’s rolling seven-day average. That would mean a dose for everyone in Italy about every three days.

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