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The vaccines that could use a shot in the arm

IN A PANDEMIC, trust is everything.

Beijing and Moscow saw early the potential benefits of pulling ahead in the race to produce an effective inoculation against COVID-19. Apart from the public health benefits and the keen awareness in both governments of the need to be self-reliant, a clear win would validate top-down models of government and innovation. It would also mean a much-needed image boost, at home and abroad.

In the end, both have had success. Moscow in August, to great fanfare, became the first to grant regulatory approval for a vaccine, one of its two leading candidates. By then, Beijing had already allowed doses of one of its own vaccines to be given to its military. About a fifth of all shots listed by the World Health Organization as undergoing clinical trials are Chinese. Yet without more transparency about research and testing — and a little less propaganda —  neither country will earn the confidence needed to reap the full reward.

For an indication of the trust deficit, look at the way the market responded to Russia’s green light for its Sputnik V vaccine, or to news the flagship vaccine is more than 90% effective. They were yawns compared to the unbridled enthusiasm after Moderna Therapeutics published encouraging data in July, or indeed ongoing excitement as the vaccine from Pfizer, Inc. and German partner BioNTech SE goes through the US regulatory approval process. Last month, positive results for that inoculation from a large-scale clinical trial were enough to push the S&P 500, MSCI World, and the MSCI All-World indexes towards record highs, in no small part thanks to the robust evidence about the vaccine’s effectiveness.

China faced a higher trust hurdle from the start. It saw the first cases and there were questions from the earliest days of the outbreak over how swiftly it had shared information, perhaps missing opportunities to slow the spread. Even if it was not a repeat of 2002 and 2003, when Beijing took months to disclose the outbreak of Severe Acute Respiratory Syndrome, or SARS, wariness lingered. Then there’s the impact of past vaccine scandals, most recently over substandard inoculations in 2018. Controls have been overhauled since.

It’s no accident that Brazil’s president, Jair Bolsonaro — no stranger to mixing health policy and the demands of populist politics — in October criticized the Sinovac Biotech Ltd. vaccine being tested in his country by arguing people didn’t feel safe “because of its origin.” In a confusing set of events, the final-phase trial was suspended and then reinstated less than 48 hours later.

Russia’s plight has not been too different. The country has not been a vaccine research or production powerhouse, but an increasingly isolated government still saw the opportunity to boost its international standing and earn the sort of halo Soviet science did with the race to put humans in space. The first vaccine was, no surprise, named Sputnik V.

Yet with scarce data and plenty of government promotion, the dash for approvals and show over results has not translated into impressive diplomatic or domestic wins. For Russia, manufacturing hiccups haven’t helped at home, nor have accusations from several countries in July that Moscow-backed hackers tried to steal research. According to an October survey by the Levada Center, an independent pollster, 59% of Russians questioned said they would not take the vaccination. As Tatiana Stanovaya, head of political consultancy R.Politik put it to me, the Kremlin, which saw the vaccine as a question of pride and self-affirmation, simply overdid the hype. The result has been an acute lack of public trust.

Beijing and Moscow got to the finish line with impressive speed, but without the first mover advantages they had hoped for. Whatever happens next, they should consider the two specific reasons for the predicament.

The first is how the vaccine has been treated in early stages of testing. Everyone has cut corners, as breakthroughs that usually take years are happening over months. Too much is at stake. But there are questions in particular regarding extensive experimental use in both countries. China has injected thousands with unproven shots outside the trial process, many of them workers who may not have been at liberty to refuse. In Russia, scientists inoculated themselves and some of the country’s wealthiest submitted to the experimental serum too, as early as April. Testing cohorts have also been small.

Most important, though, is the question of transparency. Russia has published some information from its phase 1 and 2 studies for the Sputnik vaccine. Immediately after its first results were published, though, concerns were raised by a group of Western scientists, querying, for example, repeated patterns in the data that were not fully explained. Since, scientists from leading Russian universities have also asked for more information, further questioning methodology and data analysis. Even less is known about the second vaccine candidate. So too in China. The United Arab Emirates has said the Sinopharm vaccine showed 86% efficacy in Phase 3 tests, but more detail is required on side-effects and demographics. It could still receive China’s full approval later this month.

Russia and China are already reaching much of the developing world with their easier-to-store and likely cheaper vaccines. Beijing has joined COVAX, the WHO-backed scheme to distribute shots. Alibaba’s logistics arm, for example, has already established a cold chain route to Addis Ababa. Russian officials say orders have been placed for 1.2 billion doses. Humankind needs as much success as it can muster. It just needs a little more data too.


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