WHY ISN’T IRELAND, or the EU, using the Chinese vaccines yet? Will they ever be used here? It’s possible but unlikely anytime soon.
While China has developed and approved a number of Covid-19 vaccines, none are yet licensed in Europe.
A number of African, Latin American and Asian countries have chosen to approve and use the Vero Cell vaccine by the Beijing-based pharmaceutical company Sinovac and the Sinopharm vaccine, produced by Beijing Bio-Institute of Biological Products Co Ltd, subsidiary of China National Biotec Group (CNBG)
About half of China’s population have also received at least one dose of a home-grown Covid-19 vaccine.
There has been some criticism about the initial lack of published clinical trial data and then inconsistent real world results for the Chinese Covid-19 vaccines to date, compared to the vaccines already licensed in Europe.
However, on 4 May, the European Union medicines regulator, the European Medicines Agency (EMA), announced that it had started a rolling review of the Sinovac Vero Cell vaccine to assess its effectiveness and safety.
This review is the first step towards the Covid-19 vaccine’s possible approval for use in the EU, with a decision on such expected soon.
No application has yet been submitted by the company for marketing authorisation for the vaccine to supply it in Europe, though.
Meanwhile, on 7 May, the World Health Organization (WHO) listed a Sinopharm Covid-19 vaccine for emergency use, for adults 18 years and older, in a two-dose schedule with a spacing of three to four weeks, giving the green light for this vaccine to be rolled out globally.
Vaccine efficacy for symptomatic and hospitalised disease was estimated to be 79%, all age groups combined, according to the WHO.
Few older adults (over 60 years) were enrolled in clinical trials, so efficacy could not be estimated in this age group.
WHO’s Emergency Use Listing (EUL) is a prerequisite for COVAX Facility vaccine supply, which is helping supply Covid-19 to lower- and middle-income countries and international procurement.
It also allows countries to expedite their own regulatory approval to import and administer Covid-19 vaccines.
WHO has already listed the Pfizer/BioNTech, AstraZeneca-SK Bio, Serum Institute of India, Astra Zeneca EU, Janssen, and Moderna Covid-19 vaccines for emergency use.
On 1 June, the WHO also validated the Sinovac (CoronaVac) Covid-19 vaccine for emergency use. The WHO said vaccine efficacy results showed that the vaccine prevented symptomatic disease in 51% of those vaccinated and prevented severe Covid-19 and hospitalisation in 100% of the studied population.
Again, few older adults (over 60 years) were enrolled in clinical trials, so efficacy could not be estimated in this age group.
Nevertheless, the WHO is not recommending an upper age limit for the vaccine because data collected during subsequent use in multiple countries and supportive immunogenicity data suggest the vaccine is likely to have a protective effect in older persons.
Both of these Covid-19 vaccines are inactivated vaccines and can be stored in standard refrigerators at 2-8 degrees Celsius, thus their easy storage requirements make them very manageable and particularly suitable for low-resource settings, noted the WHO.
Speaking to The Journal, one Irish doctor with strong connections to China, said he didn’t see why the EU or Ireland wouldn’t licence the aforementioned two Chinese vaccines, pointing out that they have been good enough for WHO approval despite the naysayers. He suggested geopolitical reasons might be at play.
He said that, at the very least, any Chinese vaccines approved for use in China itself should be recognised in the EU through the EU Digital Passport certificate, granting people vaccinated with them the same recognition as vaccines licensed in the EU.
Separately a HSE public health medicine expert, speaking to The Journal on the condition of anonymity, said that there may be no need for the Chinese vaccines in Ireland, particularly if they lead to greater vaccine hesitancy in the population.
They said that given Covid-19 vaccine supply has dramatically improved in Europe, maintaining optimum levels of vaccine uptake and avoiding vaccine hesitancy would be best served by sticking with the vaccines already licensed to date.
They said as supply increases the preferred vaccines should be the ones with the lowest reported side-effects, highest efficacy and best supply guarantees, like the Pfizer vaccine, as opposed to new vaccines from China or Russia where there might be some public scepticism.
That scepticism about the rising superpower, common internationally, could mirror similar thoughts worldwide about China’s initial handling of the virus, and criticism over a perceived lack of transparency about Covid’s origins, case numbers and impact on the country.
However, Ireland has had positive experiences with the country since February 2020 in relation to the novel coronavirus.
When news about the first reported cases of Covid-19 in China emerged at the start of 2020, it didn’t seem like something that was ever really going to affect us here in Ireland.
Like previous serious coronaviruses -SARS and MERS – many assumed this new virus would either be contained or die off before it could reach our shores and even if it did, it would not cause too much bother.
Clearly what happened couldn’t be further from that scenario as the resulting Covid-19 pandemic has caused widespread global human and economic devastation in the last 18 months, with over 264,000 confirmed cases and approximately 4,950 deaths in Ireland alone.
From the early days of the pandemic there was “close co-operation” between the Irish and Chinese governments on Covid-19, according to China’s ambassador to Ireland, He Xiangdong.
The first reported cases of coronavirus occurred in China’s Wuhan region in late December 2019 before spreading to Japan, South Korea and Thailand, and then into Europe with the first known case in Ireland confirmed on 29 February.
In an interview with the Irish Times in March 2020, reposted by the Chinese Embassy in Ireland, Xiangdong said that in early February he initiated a meeting between himself, the HSE, the Department of Health and the Irish Department of Foreign Affairs to exchange information. He also had calls with then Minister for Health Simon Harris and Minister of Foreign Affairs Simon Coveney.
Medical knowledge share
The medical community in Ireland was also on high alert in the early days of the pandemic, as they scrambled to prepare for the unknown, which included reaching out to contacts in China for help – primarily in relation to clinical advice and the sourcing of medical equipment and for personal protective equipment (PPE).
On 13 March, facilitated by the Second Affiliated Hospital, Zhejiang University School of Medicine (SAHZU), over 60 medical experts from China and Ireland participated in a special video conference to share information and guidance on the prevention and treatment of COVID-19.
The video conference was a response to a ‘letter for help’ from the Irish medical community, spearheaded by Dr Oisín O’Connell, respiratory medicine consultant in the Bon Secours Hospital Cork, asking how the Zhejiang Province organised manpower and resources within a short time period for the training, prevention, control and treatment of Covid-19.
Dr O’Connell, who also had extensive immunology and ICU experience was very aware of the potential devastating implications of Covid-19 for Ireland with its bottom-of-Europe ICU bed capacity, given the shocking early reports of absolutely overwhelmed health services from China and then Italy.
Before reaching out to China, he sought advice from Cork-based Dr Paul O’Brien, a qualified doctor who had worked in China for a number of years in both the medical and business arenas. His…