China eyes Southeast Asia to build legitimacy for its COVID-19 vaccine despite unclear efficacy data

A dose of China's Sinovac COVID-19 vaccine being administered in Brazil. Photo: Governo do Estado de São Paulo, CC BY 2.0, via Wikimedia Commons

China has found major buyers for its COVID-19 vaccines in Southeast Asia, even after studies of its Sinovac vaccine have reported wildly divergent efficacy results. The growing acceptance of Beijing’s vaccine without globally-recognized clinical trial results may end up undermining China’s image as a credible vaccine supplier.

By Umair Jamal

China has signed deals with a number of countries, many in Southeast Asia, to offer its COVID-19 vaccines.

Indonesia’s mass inoculation drive using China’s Sinovac Biotech is a key test for the Chinese-developed shot amid questions over its efficacy. For Sinovac, a successful rollout in Indonesia and other Southeast Asian countries may help to legitimize the vaccine globally.

However, the existing confusion over the vaccine’s efficacy and a lack of transparency around safety raise serious questions about Beijing’s credibility as a trusted vaccine supplier.

Is China looking to gain legitimacy for its COVID-19 vaccines by offering easy access and deals?

Beijing is winning praise for offering vaccine support to Southeast Asian countries that have grown suspicious of Chinese interventionism, often tied to investment, soft loans and other forms of patronage.

Much of the region has ordered major quantities of Chinese vaccines, though Indonesia is the first country to rely on a Chinese vaccine for its mass inoculation campaign. China’s Sinovac, which is expected to make up about 40% of Indonesia’s vaccine supply, has partnered with Indonesia’s state-owned PT Bio Farma to produce the shots locally. 

Indonesian President Joko “Jokowi” Widodo was the first major world leader to publicly receive a Chinese vaccine. In January, Indonesia approved the Sinovac vaccine for emergency use, claiming it is “largely safe.”

Malaysia is also planning to secure around 23.9 million vaccine doses from Sinovac and Chinese manufacturer CanSino Biologics. Malaysia’s Pharmaniaga Bhd has signed a deal with Sinovac to secure ready-to-fill COVID-19 vaccines, meaning the final filling of vials or syringes will take place in Malaysia. Pharmaniaga will later produce the vaccine locally.

Thailand is going to receive a delivery of 200,000 doses of the Sinovac vaccine in February. An additional 800,000 doses of the vaccine are likely to arrive by March followed by another one million in April.

The Philippines is also in talks with Sinovac to obtain 25 million doses by March. “We have already conveyed to them our needs, 25 million for 2021,” Carlito Galvez, the country’s vaccine chief said.

For Laos, China has pledged to “ensure the safety” of the country against COVID-19. China has also offered Cambodia an initial one million doses, which would vaccinate 500,000 people but is still a long way short of Cambodia’s goal of inoculating up to 13 million people.

The acceptance and successful rollout of China’s vaccine by these countries will garner legitimacy for the shot not only across Southeast Asia but globally as well. Pakistan is among the growing list of nations that have started their immunization campaigns using the Chinese vaccine. Earlier this month, China offered vaccine support to Nepal, Afghanistan, Sri Lanka and Bangladesh as well. In Turkey alone, Sinovac has signed a deal to sell 50 million doses. China has also vowed to donate 10 million COVID-19 vaccines to developing countries.

The distribution of Chinese vaccines may help to restore Beijing’s image after it was criticized for initial delays in sharing information on COVID-19. China has been blamed for the initial spread of the virus and for allowing it to become a global pandemic.

Photo: Governo do Estado de São Paulo, CC BY 2.0, via Wikimedia Commons

China’s export of COVID-19 vaccines without releasing clinical trial data raises questions

Though China has pushed its vaccines around the world, it has yet to secure the approval of the World Health Organization (WHO) for its drugs. At this point, it is still unclear when the WHO is going to receive Sinovac’s vaccine dossier for review. So far, China’s vaccine rollout appears to be an attempt to show that Beijing doesn’t need Western institutions’ approval or support to take a leadership role in crises like the COVID-19 pandemic.

The data that has been released on China’s vaccines is mixed. Sinovac’s local trial in China showed an efficacy of 65% while trials in Turkey reported 91.25%. Indonesia said that a local trial showed an efficacy rate of 65%, though it only included 1,620 people—too small a sample to be significant. Sinovac’s huge trial in Brazil, which the company said would offer more conclusive data, showed an overall efficacy of only 50.38% but Brazilian researchers announced that the vaccine is safe and effective based on phase III clinical trials.

At the moment, VietnamMalaysia and the Philippines are all finalizing deals with Sinovac despite limited data on efficacy and safety.

“At this point, we don’t necessarily have data that would say that Sinovac is safe and efficacious,” Dr. Jerome Kim, director-general of the International Vaccine Institute, told Devex. He added that the declaration made in Brazil provides little information.

“Throughout the pandemic we’ve seen a worrying trend of science by press release, without full disclosure of trials data, and the announcement by the [Brazilian] Butantan Institute on the Sinovac vaccine provides very little data,” he said.

The ongoing shortage of the Western vaccines has also created a further potential opening for the Chinese vaccines. For example, it is significant to note that the poorer countries of Southeast Asia have invested more heavily in securing access to Chinese-made vaccines. It is possible that with the ongoing supply issues for Western vaccines like AstraZeneca, countries in Southeast Asia aiming to contain COVID-19 as soon as possible may not be willing to wait for final trial results or WHO approval of the Chinese vaccine.

China may have been able to market its vaccines to several Southeast Asian countries in the early stages of the global vaccine drive. It remains unclear how safe and effective the vaccine is and how its side effects, if any, will impact Beijing’s already-tainted image.

About the Author

Umair Jamal
Umair Jamal is a freelance journalist and a Ph.D. candidate at the University of Otago, New Zealand. He can be reached at umair.jamal@outlook.com and on Twitter @UmairJamal15