CLINICAL MATTERS

A recent Reuters investigation e x p o s e d a clandestine US government program run by the Pentagon to discredit Chinese vaccines during the height of the pandemic. Reuters reported that the reason behind the program was to neutralize China’s positive PR generated by the act of sharing its Covid-19 vaccines to other countries, even as the US naturally prioritized its own citizens for its Covid-19 vaccines. The Reuters report also stated that the effort to discredit the Chinese vaccine was payback for China spreading disinformation about Covid-19 and falsely linking the US Military to its origins. A Department of Defense spokesperson did not deny the information, and the Philippine Department of Health has vowed to investigate.

During the pandemic, those of us who advised the Philippine government on the Covid-19 response were increasingly alarmed by the propaganda that was being used to attack the Chinese vaccines. Multiple mainstream US newspapers including the New York Times, the Wall Street Journal, and the LA Times disparaged the supposed low efficacy of Chinese vaccines, even as the World Health Organization declared these vaccines to be safe and effective and included these among its prequalified vaccines. Given the unusual media coordination, we thought that there must be some sort of intentionality behind the anti-Chinese vaccine propaganda. We doubted, however, that those responsible would ever come to light since it was just too below the belt to be attacking a potentially life-saving intervention during the height of the pandemic.

Even as disinformation against the Chinese vaccines was seeded on social media, sympathetic voices in the political opposition took the opportunity to jump on the false information to decry the government’s pivot toward China. This further increased the level of disinformation. In truth, initially only the Chinese had assured the availability of their vaccines to the Philippines. There was talk of negotiations for the Pfizer vaccine not working out because someone had “dropped the ball,” when there was no evidence the US had given any solid assurances that they were going to provide any vaccines earlier than the Chinese. This narrative that a Pfizer vaccine supply was available would have run counter to the actual hoarding that was happening in richer countries that naturally sought to vaccinate their populations ahead of everyone else.

Among those eager to jump on the disinformation bandwagon were politicians who were suddenly talking like vaccine efficacy experts when discussing the “low efficacy” of Chinese vaccines such as Sinovac and Sinopharm. Despite preliminary data that Sinovac prevented 100 percent of cases of hospitalization and death from Covid-19, many chose to focus on the 53 percent efficacy in preventing mild symptoms of Covid-19. This occurred even though the Sinovac clinical trial in Brazil only enrolled highly exposed healthcare workers, and that the variant of concern Gamma was the dominant variant during the clinical. Later real-world evidence among millions of vaccinees showed that Sinovac was much better at preventing Covid-19 symptoms, and at least as effective as other vaccines in preventing hospitalization and death. Meanwhile, efficacy of the mRNA vaccines in preventing symptoms among variants of concern went below 50 percent, just like Sinovac, but continued to protect against severe disease and death. In other words, Sinovac was just as good as any of the vaccines in preventing Covid-19, even as its detractors said it was an inferior vaccine.

Meanwhile, even as the politicians and social media hacks went into overdrive with their anti-Chinese vaccine propaganda, the first shipment of Sinovac arrived in Manila. Those of us who were medical frontliners actively seeing Covid-19 patients couldn’t get it fast enough into our arms. I was the second person to get the Sinovac vaccine in the entire Philippines and I almost cried tears of joy. I knew, based on solid, objective data, that I was going to be protected from severe disease once I completed my two doses. I was no longer at high risk of dying and Covid-19 for me had now become similar to the flu and was no longer the deadly disease that it was for the unvaccinated. Many healthcare workers who were hesitating to get the Chinese vaccine decided to get it when they saw that we confidently received our shots. Many of them were probably saved by Sinovac since they were fully vaccinated just before the peak of the Delta wave hit. Unfortunately, a significant number of people still believed the false propaganda and opted to wait for the American vaccines and ended up dying before these arrived. Indeed, the best vaccine is the one that is available and in your arm.

When the Pfizer vaccines finally became available, I got them as boosters. It turned out that using different kinds of vaccines, known as heterologous vaccination, seems to be more effective than using just one kind of vaccine. This is likely because of the emergence of the variants which have different mutations on their surface proteins. Whole virus vaccines such as Sinovac and Sinopharm may be more effective against new variants since they have many antigens to stimulate the immune system, versus just the spike protein in mRNA and other vaccines. Moreover, the Chinese vaccines do not require the ultra-low temperature freezers that mRNA vaccines need for storage and are much cheaper to manufacture and distribute.

Anti-vaccine campaigns cause a significant amount of damage on so many levels. As the Philippines was still reeling from the Dengvaxia controversy and vaccine confidence was already low, the anti Chinese vaccine sentiment ended up undermining the government’s efforts to boost vaccine uptake ahead of the actual vaccination program. Second, it is truly disheartening to learn that an ally would do such a thing, even as a pandemic was raging around the world and was threatening to kill millions of people. Third, it made our job and the government’s job much harder when trying to convince people to take whatever vaccine was available, further prolonging the process of getting our society to a higher level of protection. Finally, many people who believed the propaganda delayed vaccination with an effective vaccine. They needlessly suffered and, in some cases, died while waiting for the American-made ones.

The silver lining is that despite everything, the Philippines still ended up doing better at pandemic statistics than the US and many other wealthy countries with much more advanced facilities. Our death rate per million population is 130th in the world, because Filipinos still followed the science. They got behind an unprecedented vaccination program, they wore masks, and protected one another even as a pandemic raged around them. And despite all the disinformation, the vaccines–all of them–worked.