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First, the workers of the state companies were dosed. Then government officials and vaccine company personnel. Next: teachers, supermarket employees and people who travel to risk areas abroad.
The world still lacks a proven coronavirus vaccine, but that hasn’t stopped Chinese officials from trying to inoculate tens of thousands, if not hundreds of thousands, of people anyway. Three candidate vaccines are being injected into workers that the government considers essential, along with many others, including employees of the pharmaceutical companies themselves.
Officials are drawing up plans to give injections to more people, which amounts to a big gamble that the vaccines will eventually prove safe and effective.
China’s rush has puzzled world experts. Many of the injections seem to take place outside of the typical drug approval process. The candidate vaccines are in phase 3 trials, or the last stages of testing, most of which are conducted outside of China. People in these trials are closely followed and monitored. It is not clear that China is taking those steps for everyone who is receiving the vaccines within the country.
Unproven vaccines could have harmful side effects. Ineffective vaccines can create a false sense of security and encourage behavior that could lead to even more infections.
The widespread use of vaccines also poses consent issues, especially for employees of Chinese vaccine manufacturers and state-owned companies who may feel pressured to roll up their sleeves. The companies have asked people who take the vaccines to sign a nondisclosure agreement that prevents them from talking about it with the media.
“My concern for company employees is that it may be difficult for them to refuse,” said Dr. Kim Mulholland, a pediatrician at the Murdoch Children’s Research Institute in Melbourne, Australia, who has been involved in overseeing many vaccine trials. , including those from a Covid-19 vaccine.
As China competes with the United States and other countries to develop a vaccine, its rivals are moving more cautiously. American companies have vowed to scrutinize a vaccine before its widespread use, despite pressure from President Trump to go faster. In Russia, the first country to approve a vaccine even before trials were completed, authorities have yet to administer it to a large population, according to officials and health experts.
It’s unclear how many people in China have received coronavirus vaccines. Sinopharm, a Chinese state company with a vaccine candidate in late-stage trials, has said hundreds of thousands of people have received its injections. Sinovac, a Beijing-based company, said more than 10,000 people in Beijing had been injected with its vaccine. Separately, he said almost all of his employees, about 3,000 in all, and their families had taken it.
Hong Kong-based Phoenix Television said this month that its Chinese journalists had received the Sinopharm vaccine.
Tao Lina, a vaccine expert in Shanghai, said part of the government’s motivation was to “test” the public’s willingness to receive a vaccine, laying the groundwork for wider acceptance.
“I think this is our country feeling guilty,” said Tao, a former immunologist at the Shanghai Center for Disease Control and Prevention. “That is, even without an epidemic, everyone should consider the possibility of a resurgence and weigh whether they want to get a vaccine or not.”
Vaccine candidates in phase 3 trials have previously been tested in smaller groups of people. Phase 3 involves giving one candidate and a placebo to hundreds more, to see if they are safe to take and if they are effective in stopping the coronavirus. About 100,000 people are involved in those trials, according to disclosures from the Chinese company. However, virtually all are found in other countries, because the coronavirus has been largely domesticated in China.
Still, the Chinese government had already approved three vaccines for emergency use in other households. In July, he said he would prioritize medical workers, epidemic prevention personnel, border inspection officials and people who “ensure the basic operations of the city” to receive vaccines.
Now, it looks like those groups could be expanding.
This month, the government of Shaoyang, a city in Zhejiang province, asked local officials to identify more people who could qualify as “emergency users.” The inclusion of people in schools, kindergartens and nursing homes, as well as travelers heading to “medium to high risk areas” was recommended.
Other government notices have asked local officials to identify people as vaccine candidates, although it was not always clear whether they would be inoculated before or after the vaccines had passed Phase 3 trials.
Stiff containment efforts appear to have tamed the virus in most of China. Still, the outbreaks in Beijing and the Wild West in recent months have spooked the country’s leaders, who worry that the lockdowns could disrupt the economic recovery. Chinese public health experts are also concerned that the arrival of winter and the need to keep people indoors could lead to another outbreak.
On Friday, Zheng Zhongwei, an official with the National Health Commission of China, said the government had “gained the understanding and support” of the World Health Organization after China’s cabinet approved the program of use of emergency. A WHO spokesman said China had issued a “national emergency use authorization”, which is issued at the discretion of countries and is not subject to WHO approval.
A senior Chinese official said this month that a vaccine could be available to the public from November. That same day, a spokeswoman for the UAE Ministry of Foreign Affairs said on Twitter that the government had authorized the Sinopharm vaccine to be administered to its front-line workers after successful Phase 3 trials in the Emirates.
Raina MacIntyre, who heads the biosafety program at the Kirby Institute at the University of New South Wales in Sydney, Australia, said she would not recommend the use of emergency vaccines before the conclusion of phase 3 trials. AstraZeneca, the A British-Swedish company this month halted late-stage testing in the United States on a vaccine candidate after a volunteer became seriously ill for unknown reasons.
Defective vaccines can cause major health problems. In 2017, children who got the Sanofi dengue vaccine got sicker. Children vaccinated against respiratory syncytial virus, or RSV, in the 1960s also suffered side effects, so the trials were scrapped.
Extensive inoculation campaigns also increase the risk of receiving multiple vaccines, which could have adverse effects on a person’s immune response.
“It may take three to six months before we get the results from the Phase 3 trial; you don’t have to wait that long,” said Dr. MacIntyre. “It’s potentially muddying the waters by the time we have Phase 3 trial data for the best possible vaccine.”
However, China may not want to wait.
In an interview with China Central Television, the state broadcaster, Mr. Zheng, the health official, said that when cold weather came, the government might consider expanding the scope of who qualified for emergency use, adding people who work in markets, transportation and the service industry.
“The goal is first to establish an immunological barrier between special populations, so that the operations of all cities have a stable guarantee,” Zheng said.
Vaccine manufacturers and local governments emphasize that participation is voluntary, and many people who get vaccinated pay a considerable amount to do so. According to government advisories, the vaccines would cost about $ 148, putting them out of reach for many in a country where 600 million people earn that amount in a month.
It is not clear if recipients have been fully warned about the risks of taking an unapproved vaccine.
Dr. Mulholland of the Murdoch Institute said he would administer an experimental coronavirus vaccine only to healthcare workers, especially in places like Brazil, which has one of the highest case counts in the world, and will continue to monitor them. “They can be educated about the potential risks,” he said.
Jerome Kim, director of the International Vaccine Institute, said he would like to know if Chinese authorities were tracking vaccine recipients. You are concerned that people will engage in risky behavior if they believe they are protected by a vaccine of unknown efficacy.
“That has all kinds of negative consequences,” Dr. Kim said. “They could be infected and not know it, or they could be spreading the infection because they are relatively asymptomatic if the vaccine works partially.”
That possibility seems not to have puzzled many in China.
On a recent Tuesday, Chen Deming, a former trade minister, boasted at a trade and investment forum in Beijing that he didn’t need to wear a mask because he had taken a vaccine in Phase 3 trials. “Everyone, please relax.” he said, drawing laughter and applause from the audience.
Later, in an interview on the sidelines of the event, Chen, who will turn 71 this year, said that his vaccine was developed by Sinopharm and that he had developed antibodies to protect himself against the coronavirus. He said a third of the Ministry of Commerce staff had joined him in requesting the vaccine.
“Since I go abroad sometimes, I asked to take it,” Chen told a New York Times reporter. Later, he added, “Do you want an injection too?”
Keith Bradsher contributed reporting. Amber Wang, Claire Fu, and Liu Yi contributed research.
