DUBAI – While the United States and Europe are awaiting the results of large-scale clinical trials before implementing Covid-19 vaccines, some other countries are moving much faster with the introduction of urgent experimental Chinese and Russian candidates in an attempt to stem global growth in infections.
In the past month, the United Arab Emirates has offered a Chinese vaccine to thousands of medical workers, teachers, airport employees and government officials in the most ambitious such program outside of China itself. Indonesia plans to start similar emergency vaccinations with three types of Chinese Covid-19 vaccines as early as next month, a senior health official there said.
Russia on Wednesday approved the urgent use of a second vaccine after giving the green light to its Sputnik V frontline personnel in August, with President Vladimir Putin saying the country would boost production in both. China has already inoculated hundreds of thousands of citizens at home, expanding the spread of experimental vaccines beyond clinical trials to students, diplomats and others traveling abroad.
Some Western health experts warn that Russia and China are moving too fast before the side effects and effectiveness of vaccines can be properly identified. Both sides are trying to use vaccine diplomacy as part of broader pressure to increase their global influence at the expense of the United States and its allies, with Beijing in particular maintaining its success against the coronavirus as evidence that its authoritarian system surpasses Western democracies.
“Nothing guarantees the effectiveness of these vaccines and nothing guarantees the safety of those who receive them. This is a dangerous bet that could backfire Russia and China, “said Francois Heisburg, senior adviser on Europe at the International Institute for Strategic Studies in London. “But the proof is in the pudding: If it works, they will look extremely smart and insightful and will claim to have a better model.”
US and European vaccine developers have pledged not to seek government approval for the marketing of their vaccine applicants until they have obtained enough data from the final stage or phase 3 clinical trial. Two of these trials, one from Oxford University and AstraZeneca PLC, and the other from Johnson & Johnson – have stopped in the US due to unexplained diseases among the participants.
Stuart Neal, a professor of virology at King’s College London, said he expects the numerous Phase 3 trials currently underway to begin generating efficacy data by December or January. “I imagine we will see the results of those who dribble,” he said. “We can’t cut corners and we can’t see that we cut corners.”
No coronavirus vaccine is likely to be close to 100% effective, so public confidence in it and the resulting high levels of vaccination among the general population would be crucial to ending the pandemic.
“We need to take vaccine development very seriously and with caution,” said Professor Luke O’Neill, an immunologist at Trinity College Dublin. “The risk is that if they have a safety problem, it will jeopardize vaccinations for any disease.”
Last month, the UAE became the first country outside China to approve the emergency use of a vaccine developed by the state-run China National Pharmaceutical Group, or Sinopharm, after the Gulf monarchy tested it on 31,000 volunteers from 125 nationalities in phase 3. Since then, several thousand workers exposed to the highest risk of contracting the virus, they received the vaccine, firing more each day, said a UAE official who is monitoring the trials.
The UAE has moved much faster than Russia with the release of the vaccine. In Russia, about 2,000 frontline workers have received the Sputnik V vaccine since August, and about 13,000 people have joined the current Phase 3, just over a third of the number in the UAE, people familiar with the project said. Russia plans to eventually provide 40,000 volunteers for the process.
Phase 3 of the UAE began in July in Abu Dhabi and Sharjah, two of the country’s seven emirates, and includes two different types of vaccines developed by Sinopharm. One-third of the participants received a placebo, and the other two-thirds received one of the two strains, said Dr. Naval al-Kaabi, principal investigator of the study at SEHA, the health company in Abu Dhabi.
The efficacy of both strains of the vaccine is currently unclear, as the analysis of the randomized double-blind study can only be performed after a predetermined number of study participants have developed symptomatic Covid-19, allowing a statistically valid comparison between those receiving placebo and those receiving placebo. vaccinated with the vaccine. Dr Kaabi said only one-fifth of this pre-set number, which she did not disclose, had been reached so far.
Similar trials of Chinese vaccines from Sinopharm and other developers are being conducted in more than a dozen countries, including Indonesia, Russia, Brazil and Pakistan. Group 42, an Abu Dhabi-based artificial intelligence company that has merged with Sinopharm in the UAE, is also working with the Chinese Phase 3 company in Bahrain, Egypt and Jordan.
Applicants for the Sinopharm vaccine are based on inactivated viruses, which means that the pathogen is attenuated for human use. Dr Kaabi said no one had contracted Covid-19 among frontline workers vaccinated in Abu Dhabi since the UAE’s emergency authorization was granted on 15 September.
Ken Dietrich, a 63-year-old Canadian consultant at the Sheikh Khalifa Medical City Emergency Department in Abu Dhabi, one of Covid-19’s main treatment centers, said he volunteered for the shooting because people his age were more likely develop a severe form of the disease. “I’m in a mature age group,” he said. “I am convinced that the benefits outweigh any risks.”
Representatives of the UAE say that so far the Sinopharm vaccine has caused only mild side effects among participants in the trials, which include 1,000 volunteers with chronic diseases. Trying to boost public confidence, the country’s health minister, Abdulrahman al-Oways, published photos of himself being shot.
The education authority in Abu Dhabi has sent a message to schools saying teachers will be able to take the vaccine in the coming weeks under an emergency permit. Some schools in Sharjah also offer the vaccine to staff, according to teachers. Employees in contact with passengers at Sharjah airport have already begun receiving the photos, the airport operator said in a statement. Government officials, including police and court officials, as well as some other residents of the city of Al Ain, also received the vaccine, state media reported.
Everyone who receives it is a volunteer and no one is forced to be vaccinated, said Dr. Kaabi. Recipients are advised to get the flu first.
On Monday, following a phone call between Mr Putin and the de facto leader of the UAE, Sheikh Mohammed bin Zayed, Abu Dhabi said it would also conduct phase 3 trials of the Sputnik V vaccine.
China, unlike the UAE, Russia and much of the rest of the world, contains the pandemic at home – which means that Chinese pharmaceutical companies need countries where the virus is still spreading to test the effectiveness of vaccines.
Indonesia, the world’s fourth most populous country, is struggling to reduce cases and speed up tests. The government said Wednesday it plans to procure 18 million doses by the end of the year from China’s Sinovac Biotech Ltd. and CanSino Biologics Inc., in addition to Sinopharm. Ahmad Yurianto, director general of disease prevention and control at Indonesia’s health ministry, said an emergency use permit would only be issued if officials felt confident that the vaccines were safe.
The UAE is a particularly attractive training ground for vaccine developers, as its population of 10 million people consists of many ethnic groups and races. The country, which runs one of the most intensive coronavirus testing programs, has registered 110,000 Covid-19 infections so far, rising in recent weeks to a record high on Wednesday.
About 85% of these cases are asymptomatic, officials say, and the country’s relatively young population and aggressive public health measures have led to one of the lowest death rates from coronavirus cases in the world – 0.4%.
The spread rate of the Sinopharm vaccine in the UAE is skeptical. Some immigrants have privately expressed concern about receiving a vaccine that has been tested for such a short period of time.
In Bahrain, where Sinopharm’s Phase 3 studies are under way, Saqer Al-Khalifa, assistant undersecretary of youth centers and commissions at the Ministry of Youth and Sports, said he too had encountered skepticism about the Chinese vaccine.
Yet, he added, the process has provided an opportunity to serve the rest of humanity by helping end the pandemic. “Here you can be proud of yourself,” he said, “whether you do it alive or not.”
—George Kanchev, John Emont and Chao Deng contributed to this article.
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