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Beijing-based Sinovac, which manufactures a COVID-19 vaccine from an inactivated virus, has ongoing efficacy trials in Brazil, Turkey and Indonesia, but still in China.
The first people in the world to get a COVID-19 vaccine were not part of a clinical trial. No television channel or newspaper covered the historic event. No company has issued a statement.
On February 29, less than two months after the world awoke at the risk of the new disease, virologist Chen Wei, a division general in the Chinese army, and six army scientists of his team stopped at a communist party of China flag and won injections. Experimental vaccine COVID-19. Chen, a national heroine for her paintings on Ebola vaccines, had reached the starting half of the pandemic, Wuhan, with her organization of the Academy of Military Medical Sciences, as part of the aid to make the candidate vaccine with an advertising company, CanSino Biologics. China’s internal and external commentators then questioned whether the event, widely disseminated on social media, was real. No less than People’s Daily, the Communist Party’s main newspaper, called an image of Chen receiving the “#FAKENEWS” vaccine But Hou Li-Hua, an academy researcher who is running the vaccine project, said it was “real news”: an attempt to protect scientists in the most affected city.
In the United States, the Trump administration’s $10. 8 billion Warp Speed operation accelerated
But the low profile of the historic first injections, the military’s collaboration with a “private” company, and the ethically harsh resolve to start outdoor vaccines from a clinical trial have shown that, in addition to scale and speed, China The immunization effort follows a very different course from that of the United States and Europe. Most Western primary vaccines rely on attractive technologies such as genetically modified viral vectors, designer proteins, and RNA extracts. Three of China’s top four vaccine applicants use an outdated mainstay: the inactivated virus as a whole, a technique that dates back to the first good luck flu shot in the 1930s. And China’s vaccination effort is cursed. for his dramatic good fortune with competitive public aptitude measures to prevent the spread of the SARS-CoV-2 coronavirus, adding the forced isolation of instances and the control of entire cities. While the pandemic in the United States has allowed trials there to temporarily provide signs of effectiveness, “China temporarily crushed the coronavirus epidemic, so it lost the opportunity to verify the effectiveness of its vaccines there,” says epidemiologist Ray Yip. , who is strongly after the progression of the COVID-19 vaccine as an advisor to Bill Gates. “If they had a lot of cases in China, they may have finished an efficacy test earlier than other people. “
So Chinese vaccine developers went abroad, although the United States excluded them from Operation Warp Speed, negotiated agreements with 15 other countries on five continents, arranged large trials in the Arab world, and delivered vaccine applicants to senior government officials, and navigated poisonous politics in Brazil, where the pandemic is wreaking havoc on a vaccine and exploring its production there.
But China is not only looking for promising sites for clinical trials, but without the urgent need for home vaccines to fight a virus that has largely canceled, it is betting on a global game by committing to send any vaccine shown to countries that test for their candidates, or for a percentage of technologies. “They know they don’t want a vaccine involving the epidemic in China,” Yip says. “You can take your time. “
The Chinese company CanSino Biologics had the first COVID-19 vaccine to participate in clinical trials and by April had already moved to a Phase II in Wuhan.
Yanzhong Huang, a fitness expert at Seton Hall University and the Council on Foreign Relations, says the country “actually uses the vaccine to publicize international relations of foreign policy objectives. “warp Speed’s “vaccine nationalism” and aims to “fill the void left in america. “
“It’s a very executed and thought-out strategy,” says Stephen Morrison, who runs the Global Health Policy Center at the
Attitudes towards vaccines contrast with those in the United States and Europe, where there is greater disagreement as true, Morrison says. To the dismay of vaccine experts abroad, thousands of others in China have already been covered up for experimental vaccines. – even before their price and protection have been tested. “There has not been a collapse of religion and it is accepted as true in science and the state,” Morrison says. “There is less concern about the fate of all this. “
The speed at which Chen and his colleagues were able to make those first shots is even more remarkable because CanSino is likely to be slow.
Although some COVID-19 vaccine brands presented their projects the day after the launch of the SARS-CoV-2 series on January 10, CanSino CEO Yu Xuefeng had reservations. “We started looking for him in mid-January, but there’s a doubt COVID-19, he was worried about Yu, it can just be a failure, just like Severe Acute Respiratory Syndrome (SARS), some other disease caused by a coronavirus, which alarmed the world in 2003 but disappeared a year later after corporations and governments invested resources in vaccine development.
Yu, who is originally from China, completed his phD in microbiology at McGill University in Canada in 1ninenine7, and then remained vaccinated for approximately nine years at a Sanofi Pasteur branch. He co-founded CanSino, a perchero. de Canada and China – in 200nine. A team led through Chen in China helped expand his only previous product for approval: an Ebola vaccine founded on an extended and largely innocent virus called adenovirus five (Adfive), in which they sewed a gene from Ebola’s surface protein.
Yu and his team have the idea of making a COVID-19 vaccine with messenger RNA (mRNA) for the surface protein of the new coronavirus, called peak, the cutting-edge technique followed by Pfizer and his wife BioNTech, the “winner” of the race. to report initial efficacy data. But CanSino to go through what he knew, using the Vector Ad5 to bring the complex gene. “I think it was the fastest and most mature way to expand a new vaccine,” Yu says.
In just one month, the canSino candidate in a position to be handed over to Chen and his team, and on March 16, the company presented the world’s first COVID-19 vaccine trial in Wuhan to verify their protection and ability to cause immune responses. defeated Moderna for 8 hours, even though a world crossed by the vaccine race among Western corporations paid little attention to him.
Several American and European suitors, who added AstraZeneca, also followed adenovirus to bring the complex protein, and some opted for an Ad5 vector similar to CanSino’s, despite several fears about the approach. In 2007, two trials of unastrous efficacy of an Ad5- The vaccine-based AIDS vaccine revealed that, for reasons that are still under discussion, the threat of HIV infection is actually increasing. The other fear is that pre-existing immunity to Ad5 may possibly attack the vaccine vector, possibly explaining why, in early trials, the CanSino vaccine caused a weaker-than-expected antibody response. “We see there’s some impact,” Yu admits, “but it’s not black and white. “(Preliminary knowledge of the effectiveness of the AstraZeneca/Oxford vaccine recommends that immunity be opposed to its adenovirus vector possibly also would have compromised this candidate’s performance).
With few cases of COVID-19 at home, Chinese vaccinators have had to check the price of their applicants and 4 in 15 countries are being verified for efficacy.
The other two Chinese actors, Sinovac Biotech and China National Biotec Group (CNBG), a subsidiary of one of the world’s largest vaccinators, state-owned Sinopharm, take a different approach: vaccinating others with the total “dead” virus. it does not require a complicated conception of protein or RNA or genetic engineering: scientists simply inactivate the virus with a chemical (beta propiolactone) and combine it with an adjuvant (alun) that alerts the immune formula well when thwarted. In theory, these vaccines can produce broader responses of antibodies and T cells because they involve the full set of viral proteins, which only one, such as peak Y, unlike mNR vaccines, which will have to be stored at below zero temperatures, inactivated viruses require nothing more than normal refrigeration.
But many scientists inactivated viral vaccines to be outdated, difficult to manufacture in giant and potentially dangerous volumes. Warp Speed flatly rejected the approach. ” Actually, I don’t think the inactivated vaccine is a smart idea,” says Moncef Slaoui, chief scientist at Warp Speed.
A major fear is that inactivated SARS-CoV-2 vaccines can cause a more serious disease, known as “increased respiratory disease,” in immune Americans who are infected. Basically, if a vaccine produces useless antibodies, they can shape immune complexes that this happened with a vaccine opposed to respiratory syncytial virus that was given to young people in the 1960s, and in animal experiments with SARS vaccines and coronavirus disease, Middle East respiratory syndrome. poses challenges; Twice in the last five years, live poliovirus has escaped from European plants that manufacture inactivated viral vaccines against the disease.
But inactivated vaccines against SARS-CoV-2, unlike mRN and other technologies widely supported through Warp Speed, have a strong track record. “There are many tactics for making vaccines, and it’s wonderful that innovation is declining along the techniques shown,” says Nicole Lurie, strategic advisor to the Coalition for Epidemic Preparedness Innovations (CEPI) who has been in the past in the United States. Undersecretary of Preparation and Intervention. ” Inactivated vaccines are one of the many techniques shown. “Meng Weining, senior director of sinovac, said they compared the inactivated technique, which they already use to manufacture six vaccines, with two other methods in animal models. “The total inactivated virus vaccine has given a much, much more wonderful result,” Meng says. .
While it is theoretically less difficult to produce mRN in giant quantities than growing the virus on a similar scale, vaccine experts say inactivated viral vaccine production is unlikely to be an obstacle. The CNBG, for example, has “huge resources: 10,000 workers and scientists, a massive production capacity,” says Nicholas Jackson, who runs CEPI’s Chinese workplace and has worked in the past in the R
If China’s COVID-19 vaccines work, brands say they can also produce 1. 5 billion doses in total next year, and countries that cannot use Warp Speed-funded vaccines, especially those that hosted efficacy trials in China, would possibly have a safer solution. source of vaccines.
Sheikh Mohammed bin Rashid Al Maktoum, prime minister of the United Arab Emirates (UAE), tweeted on 3 November a photo of himself in Dubai, with the right sleeve of his kandura rolled up, with a CNBG COVID-19 vaccine injected. protection of all and smart health, and we are proud of our groups that have worked tirelessly to make the vaccine in the United Arab Emirates,” Al Maktoum wrote. Two of the country’s most sensitive ministers had won the vaccine three weeks earlier.
Mohammed bin Rashid Al Maktoum (left), Prime Minister of the United Arab Emirates, won a COVID-19 vaccine from CanSino Biologics on 3 November from his country’s emergency use authorization.
The United Arab Emirates has the cornerstone of CNBG efficacy trials and is following China’s debatable trail of allowing others to obtain the vaccine outdoors from clinical trials.
In a video convention held on June 23 between Abu Dhabi, Beijing and Wuhan, CNBG’s fitness officers, ambassadors and executives sat at long tables in rooms decorated with the country’s flags and celebrated their resolve to conduct power control together. , Egypt and Jordan and hopes to recruit 45,000 people, CNBG says it arrived in the United Arab Emirates to verify its two total virus vaccines, similar inactivated fixes made through two independent and even competitive laboratories, one in Wuhan and the other in Beijing, because the maximum rate of SARS-CoV-2 infection is expected to accelerate. A sign of power. But international relations and industry also motivated the resolution. The huge foreign painting force of the UAE means that the trial participants come from 125 other countries. “If it can turn out that these vaccines work in the UAE,” Huang says, “means everyone on the Global would think the vaccine would also be painted in their country. “
China would also be expecting a public relations (PR) advantage: The United Arab Emirates and many other participating countries have a giant Muslim population, which Huang says can also help mitigate human rights complaints. China’s recourse to Uighur Muslims in Xinjiang Province. “In fact, they don’t need to have any more enemies abroad,” he says.
Huang adds that through its diversity of overseas testing, China hopes to have goodwill for its Belt and Road (BRI) initiative, a large investment in infrastructure in more than a hundred countries to strengthen trade. Critics have accused the BPI of being a “debt trap. “”International relations that is a form of neocolonialism. ” China needs to work with these countries and prioritize them to get the vaccine because I think they think it will facilitate the implementation of the BIS,” he says.
China’s international relations about vaccination have not always gone well. On November 9, after Brazil suspended a trial of the Sinovac vaccine following the death of a participant, President Jair Bolsonaro visited Facebook. “Dead, invalidated, anomaly,” he wrote: mentioning a Brazilian fitness firm that had indexed imaginable reasons for suspension: death, disability, genetic abnormalities. Bolsonaro’s message was clear: this Chinese vaccine, called CoronaVac, was dangerous.
Brazilian President Jair Bolsonaro and his followers have opposed the resolve of their political rival, Sao Paulo Governor Joo Doria, to invest in the Sinovac vaccine and allow their evidence in evidence of effectiveness. The illustrated mask reads: “No vaccine! Expel Doria. “
“Many other people were surprised by this publication,” says Esper Kallas, who runs the vaccine test site at the University of Sao Paulo to which the player joined. “I was celebrating the failure of a vaccine. ” For Bolsonaro, it was a public relations victory over his main political rival, the governor of Sao Paulo, who subsidized CoronaVac’s trial. The president also welcomed a setback for China, which Bolsonaro, like its ally, U. S. President Donald Trump, has relentlessly criticized.
It turned out that the player had died of a drug overdose, his death had nothing to do with CoronaVac and the trial resumed temporarily.
China has chosen to navigate Brazil’s intimidating policy because with an uncontrollable pandemic (it ranks third in the world for total infections, with over 100,000 new cases per week), the country is a magnet for vaccine testing. and desperately wants vaccines. , the state of Sao Paulo committed $ 90 million to Sinovac for 46 million doses (this, in particular, is 10 times less expensive than what the US government will pay for the vaccines at Pfizer / BioNTech and Moderna) . Sinovac says he can transfer his generation to the Butantan Institute, a major vaccine manufacturer in Sao Paulo, a collaboration Meng describes as a “win-win. “
China has been warmer in other countries. In September, Turkey introduced an efficacy trial in another 13,000 people of the Sinovac vaccine. Serhat, who heads the Vaccine Institute at Hacettepe University, located in Butantan in Brazil, and is on the clinical board of the Ministry of Health, says Turkey has a smart infrastructure for Phase III studies and, unlike the United States and much of Europe, has housed a Chinese vaccinator.
The 3 Chinese brands also have gigantic efficacy tests planned or ongoing in Indonesia, Pakistan, Saudi Arabia, Mexico and Chile (see map above). “It’s a smart strategy,” says ‘Anal’. ‘ When Phase III is performed in other countries, it is more transparent, it is more reliable,” he says.
As much as international vaccine relations and the “soft force game” influence the participation of Chinese vaccinators in effectiveness testing agreements, they are also motivated by capitalism, says Yip, who led the Chinese Cinputs of the US. . . « Everyone is asking for a COVID vaccine,” he says. Everyone needs to tell their other people that they gave us a vaccine for you. “And Chinese corporations intend to benefit by offering them.
Most likely, one or more trials in China will announce knowledge of efficacy at any time. The effects so far for other vaccines have fueled the growing sense that many vaccines will affect what, from the vaccine’s point of view, is a somewhat weak virus. But China is not expecting the effects of Phase III before making extensive use of vaccines at home. Its regulators seem happy with animal studies combined with the minimal knowledge of protection and immune reaction of Phase I and II trials. In June, CanSino won an emergency use authorization to vaccinate the military and, since then, Sinovac and CNBG have been given green clearance to vaccinate giant populations outside the doors of clinical trials.
A batch of 120,000 doses of Sinovac’s COVID-19 vaccine arrived at Sao Paulo International Airport on 19 November and will be used if ongoing efficacy trials show it is and effective.
With the pandemic defeated in its country, China vaccinates its other people as insurance, opposed to a dangerously inflamed world. Yu de CanSino says “thousands” of infantrymen taking part in peacekeeping missions got the vaccine from their company before going to stalls with the top lot of COVID-19. CNBG states that “hundreds of thousands” of others in China have won their vaccines. “By doing this, we can build an immune barrier between other people’s express equipment, such as fitness workers, preventing pandemics “The Body of Workers and Border Inspection Staff,” the company explained in its written responses to Science. Vaccination is “fully voluntary with informed consent,” CNBG issues. In addition, “we have not won any reports of cases of serious adverse reactions and there are no reports of infections for vaccinated people in high-risk areas. “
Meng of Sinovac says that “more than 90%” of corporate workers have won their vaccine because they are considered a high-risk group; He won it because Array is traveling (according to China’s Ministry of Culture and Tourism, 155 million Chinese traveled in 2019 and 145 million tourists visited the country). In October, the corporation began promoting its vaccine – $60 for two doses – in Yiwu, a city in Zhejiang Province. Yip says the government was even making plans to vaccinate all of Beijing after a COVID-19 outbreak in June. Yip says officials “had already drafted the guidelines”; if more than 500 cases had arisen, they would “shoot everyone in Beijing with the vaccine. “Ultimately, touch tracking, testing, and isolation of inflameds limited the outbreak to 335 cases.
Morrison says the Chinese government has obviously “decided at the highest level” that it values the bet to create “field facts” and gain global marketing merit by having the first widely used COVID-19 vaccines. “It’s a big threat and potentially maximum gain,” he says.
But what if damage occurs? “Regulatory warfare should not apply in peacetime. Our lives are turned upside down, ”says Yip, who lives part-time in Beijing.
If your commitment to the vaccine is successful, China’s symbol will grow in importance both at home and abroad. “They have reputational problems, both internal and external,” Morrison says.
In May, Chinese President Xi Jinping told the World Health Assembly, which governs the World Health Organization (WHO), that the country would turn its COVID-19 vaccines into a “global public good,” something indistingmed that led many Chinese observers to scratch their heads. But then China fulfilled this commitment in October by joining the COVID-19 Global Vaccine Access Mechanism (COVAX), a component-led effort through WHO and CEPI to ensure that all products have proven safe and effective temporarily in rich and deficient countries. Countries. .
While joining COVAX probably provides China with an insurance policy to obtain vaccines if its own applicants fail, Morrison says it is primarily a diplomatic decision. COVAX has not won any of the United States or Russia, and China sees that it “could have a controlling influence on a primary foreign mechanism. “In addition, says Alexandra Phelan, a lawyer at Georgetown University’s Center for Global Health Science and Safety who specializes in China,” is an intelligent citizen of the world for this effort. “
If a vaccine made in China is safe and effective, it can help others know that the pandemic started there and how much the government reacted at first, Morrison says. And here, you can simply illuminate the symbol of Chinese vaccines. has been rocked by a series of scandals over the past decade, adding the use of useless vaccines against diphtheria, whoorine cough and tetanus; Inappropriate records for a rabies vaccine; and sales of an expired polio vaccine.
In a way, Yip says that average Chinese elegance would possibly prefer to get a vaccine from a renowned foreign company. “His point of confidence in vaccines made in China is low because of all the repeated scandals,” he says. AstraZeneca and Pfizer have entered into agreements to manufacture their products with Chinese manufacturers. “They will sell 10 times more CNBG, Sinovac and CanSinos, and rate 10 times more,” Yip predicts.
A successful COVID-19 vaccine, manufactured in China, which has been reviewed through outdoor regulators, would reassure the domestic market, Phelan said. “There’s a lot of national territory to catch up on. “
In Brazil, Kallas says a similar dilemma can occur if Butantan, as expected, begins manufacturing Sinovac’s CoronaVac. “Here they say that the neighbor’s bird is the tastiest,” Kallas says. “We have the belief that not everything we do is as smart as the imported product. “
But for now, Brazil is adopting the Chinese vaccine. With the outbreak of cases, the arrival of only 120,000 doses of CoronaVac on November 19 have become wonderful news. The bias opposed to China is little more than a far-right policy of “pollution. “Kallas says, and Brazilian maximum CoronaVac “is a viable option. “
“I suppose, without asking questions, it’s a no-brainer,” he adds. The news of Pfizer and Moderna taken as a relief, but the challenge is that these two vaccines are not available to Brazil. “
In Brazil, as in much of the world, Chinese vaccines that oppose the rate of distortion can still, to the fullest, take the top spot.
Jon is editor of Science.