China is trying to navigate its largest coronavirus outbreak without the tools it could have adopted months ago, the kind of vaccine that has proven to provide the best protection against the worst outcomes from COVID-19. In early spring 2020, a Chinese pharmaceutical company, Fosun Pharma, delivered an mRNA vaccine made by Pfizer and BioNTech – and finally reached an agreement to produce it. It has not yet been cleared in mainland China, despite being approved for use by separate authorities in Hong Kong and Macau.
Now health experts say delays – putting politics and national pride above public health – can cause unavoidable coronavirus deaths and deep economic losses as entire cities will be locked down to contain the country’s unprotected population. “The biggest problem is the delay in reopening,” said Shi Chen, a health economist at Yale University’s School of Public Health. “The consequences will be huge, the supply chain will be disrupted, all kinds of services will be disrupted.” Studies have consistently shown that vaccines with the mRNA vaccine, developed by Pfizer-BioNTech and Moderna, provide the best protection against hospitalization and death from Covid-19. Older Chinese vaccines have been shown to be relatively effective against the original strain of the virus, but much less so in recent times.
As the evidence becomes clearer, even countries that initially used the Chinese vaccine and some less effective Western-made vaccines are turning to booster shots and the mRNA vaccine for new vaccines. Not China. Regulators have not publicly stated why they did not work – mRNA vaccines have been approved in many parts of the world and have proven safe and effective in millions of people. But a Chinese health official and another directly involved in the talks told the Associated Press that the authorities had backed down because they wanted to master the technology in China and not rely on foreign suppliers. Both spoke on condition of anonymity because of the sensitive nature of the issue.
For more than a year, the method seemed defensible. The country was able to keep the virus better than any other large country through its strict “zero covid” method, which isolates infected people and locks up communities when an infection occurs. But now, the highly contagious Omicron variant is testing that strategy, requiring more extensive and prolonged lockdowns that are taking a greater economic and human toll. While other countries are able to operate closer to normal because their people are protected by vaccines or previous infections, China has only its lockdown strategy left to avoid large numbers of hospitalizations and deaths.
China may be changing its mind. The Communist Party-owned Global Times reported last month that Fosun Pharma was still working with health authorities for its approval, and that Shanghai authorities had recently issued a new policy that would allow the import of the COVID-19 vaccine. Shanghai-based Fosun did not answer questions about the announcement. China’s National Health Commission has directed questions to the country’s drug regulator, the National Medical Products Administration. The company did not respond to a fax request for comment.
Meanwhile, Abogen Biosciences hopes for a Chinese-developed mRNA vaccine center, a startup founded in 2019 by American-trained scientist Bo Ying, who once worked for Moderna. The company has partnered with more established companies in the country, such as Valvax, a non-governmental organization founded in 2001, and the Military Medical Research Facility Academy of Military Medical Sciences. Abogen has raised more than 7 1.7 billion since 2020. According to a study published in the Lancet Microbes Journal, a small, preliminary test among people designed to assess safety has found that the company’s vaccine candidates have achieved an immune response.
The results were “promising”, said Dr Binita Bal, who studied the immune system at the Indian Institute of Science Education and Research in Pune, India, although she said the shot triggered a direct comparison with Pfizer and Modern. Vaccines will help scientists better evaluate its effectiveness. But the large study needed to show whether the shot works to prevent infection or symptoms has not been completed. Abogen did not respond to requests for an interview.
Even if studies could be completed and the vaccine proved effective, creating the millions of doses needed would be a challenge, experts say. Abogen created a manufacturing facility in December 2020 with an estimated capacity of up to 120 million doses per year. Making that vaccine and ensuring quality on a scale will be a difficult hurdle because mRNA is still a new technology, says Scott Wheelright, chief operating officer of Bioinos Biosciences, a Chinese biopharmaceutical contract maker who has negotiated with Abogen.
Meanwhile, Chen, a health policy expert at Yale, said the Chinese government should better protect its aging population through both Pfizer vaccine approvals and booster shots. Using a Chinese phrase that means “completely abandoned,” Chen says the change doesn’t have to be “zero covid” all or nothing. “It doesn’t have to be Tang Ping or Zero Kovid,” Chen said. “I don’t think there are only two solutions, and we can be stuck in a middle ground.”