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Some nations using China’s vaccines are battling outbreaks. So do they work?

Earlier this year, life beyond COVID shutdowns looked closer than ever for Chile, Mongolia, Bahrain and the Seychelles. All four nations were among the most vaccinated in the world, having secured large stores of China’s Sinovac and Sinopharm vaccines. But, by June, these four countries were battling some of the world’s worst COVID outbreaks. So are the vaccines failing?

What are China’s vaccines?

Since late 2020, China has exported hundreds of millions of doses of its Sinovac and Sinopharm vaccines to at least 70 countries and is relying on the shots for the mammoth task of vaccinating its own 1.4 billion people. “China is now the world’s biggest exporter of COVID vaccines,” says epidemiologist Michael Toole, who has been reviewing the rollout for the Burnet Institute. Vaccines work by training your body to mount an immune defence against the virus without you ever having to catch it. China’s vaccines use “inactivated” (dead) coronavirus to pull off the trick, Toole explains, as do our existing flu and polio vaccines. The Moderna and Pfizer vaccines developed in the West with new mRNA technology instead use a segment of the virus’s genetic code, while the AstraZeneca, Sputnik V and Johnson & Johnson shots use another harmless kind of virus to deliver the piece of COVID-19 needed to build immunity.

A shipment of Sinovac lands in Cambodia in June 2021.

A shipment of Sinovac lands in Cambodia in June 2021.Credit:Getty Images

Do Sinovac and Sinopharm work?

As Russia did for its Sputnik vaccine, China skipped the final stage of clinical trials undergone by Western vaccines in order to roll out Sinovac and Sinopharm faster. But unlike with Russia’s shot, China’s data has been less robust since, limited by smaller sample sizes. Where Sinovac was rolled out in Brazil, it only halved the chance of developing symptoms of COVID (even a Chinese official commented off-hand that’s “not high”). But protection went up to 67 per cent in Chile and 85 per cent in Turkey. “I’d say they’re about on par with AstraZeneca,” says Toole. “Sinopharm seems better than Sinovac, it stops about 78 per cent of symptomatic cases, but it did its trials earlier, before certain variants were circulating.” Virologist Gary Grohmann, who consults for the WHO, says the data deficient for the Chinese vaccines (as well as both the misinformation and propaganda swirling around them) make their performance hard to assess, but he expects they will prove about 50 per cent effective. As with other vaccines such as AstraZeneca and Pfizer, however, both Sinovac and Sinopharm still have a very high chance of stopping you from dying of COVID, the key measure of any vaccine’s success. (And, while monitoring for side-effects after vaccination is considered less thorough in both China and Russia, Toole says no safety concerns have been flagged.) The World Health Organisation has approved both of China’s vaccines for emergency use, as it has Moderna, Pfizer, AstraZeneca and Johnson & Johnson. Grohmann says they will be now an important addition to the WHO’s COVAX scheme for delivering doses to developing nations, which has struggled to attract enough supply.

So why the concern?

No vaccine is guaranteed to stop the virus spreading (Pfizer and AstraZeneca are both thought to reduce the spread of COVID by up to half, for example) and so outbreaks have dogged even the world’s fastest vaccination campaigns. The UK has fully vaccinated more than half its population, mostly with AstraZeneca and then Pfizer, but is clocking up tens of thousands of cases a day again. Even Israel, where more than 60 per cent are vaccinated, has seen spikes, most recently driven by unvaccinated children. But in both countries, hospitalisation rates (and deaths) have stayed low, notes Deakin University chair of epidemiology Catherine Bennett, which is a sign the vaccines are working.

While there will likely be breakthrough cases for every vaccine (a small number of fully vaccinated people in the UK have recently died from the more contagious Delta variant, for example), in Mongolia both deaths and caseloads have significantly spiked again. It’s mostly using Sinopharm. Chile is largely relying on Sinovac, and its own recent surge in cases has overwhelmed hospitals, and sent the country back into lockdown. A study there found the chance of ICU admission still fell by 89 per cent among those fully immunised, but protection was much lower for those who had only had one dose. In Indonesia, where Sinovac is also leading the country’s immunisation rollout, at least 10 of the 26 doctors who died in June of COVID were fully vaccinated. “The death rates there are going up very quickly,” Toole says. People who have had two doses have also died in the Seychelles’ recent outbreak, though its government says most critical cases were not fully immunised.

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