The Science of Covid-19 Vaccines: A Case Study of China’s Zero-Covid Measures and the Impact on the Disease

“I have an advantage in that I don’t go to an office to work. I don’t have a job at a company or in a government agency and don’t really come into contact with a lot of people,” she says. “Also I think I protect myself pretty well.”

She believes that the vaccine for COVID-19 is not as good as it could be because it is changing so quickly, and that she doesn’t need to get a vaccine until China re-opens.

The relaxation of the country’s longstanding zero- Covid measures came as a head-spinning change for many Chinese living under the government’s stringent controls and fed a longstanding narrative about the deadlines of Covid-19.

Health experts say the government should raise vaccinations in order to minimize the impact of the disease if it spreads.

A government announcement on December 13 stated that people aged 60 and older need a fourth dose of vaccine, if one is based on a different technology from their primary dose. More than 260 million people in China older than 60 have received a third dose, but only 70% of them are 60 and older.

Given that more than 700 million people will likely catch COVID in China over the next few months, we thought it would be a good time to dig deep into the science of the Chinese vaccines and analyze what the data show, especially when it comes to two major aspects of the vaccines: efficacy and safety.

Product quality issues that have plagued manufacturing in China for years have been the root of the problem for many. Cases like Tan Hua’s resonate.

The Case of Tan: Vaccines for Respiratory Infections and the Death of a Baby Bounced by a Dog

In 2014, Tan, then 34 years old, was bitten by a dog. She saw a doctor and was given a shot of what her mother, Hua Xiuzhen, says they were told was the best rabies vaccine on the market. It didn’t go as planned.

“That very night she got a headache and dizziness. Her memory declined sharply. She had convulsions. She couldn’t see; everything was dark for her. She couldn’t walk straight.

China can force the population to get vaccinations. It has put cities with a lot of people into lock downs.

A string of product quality scandals has occurred in China due to poor oversight and corruption during the past decades of economic growth.

The Chinese government has done a poor job of debunking myths about the disease, despite total control of the media in the country according to a health care expert.

Concerns about the safety for elders have continued. The vaccines are being tested to ensure they’re safe for the elders. There’s a lot of confusion about these vaccines because of the government’s push. I read quite a lot of misinformation about the vaccine’s side effects on Chinese social media.”

A Chinese real estate executive says COVID-19 is “almost a flu” and “not quite so serious” – and why a single vaccine can’t help

Jerry is 33 years old, and he is a real estate executive in Shanghai. He did not want his full name to be used, he only wanted it to be about the topic.

Jerry reckons COVID-19 is “kind of a flu thing” these days; nothing too serious. He hasn’t gotten the vaccine and he believes – despite science to the contrary – there’s no point.

The virus is changing quickly, I think. So not a single vaccine can help,” he says, focusing on vaccines’ ability to prevent transmission rather than stave off serious illness and death.

Jerry reckons that the vaccination rate among his friends may be as low as 60 percent. He says couples are wary of the side-effects of getting pregnant.

Wood notes that it might already be too late for China to benefit from fourth doses because there is already widespread transmission now that many restrictions have been lifted. He isn’t convinced an extra dose will make a big difference to transmission since the Omicron variant of the virus can evade the body’s immune response.

The government should provide assurances of support if something goes wrong if they want to bolster incentives for people to receive the vaccine, according toHuang, a professor at Seton Hall.

The rise and fall of China: The aftermath of the zero-Covid u-turn, a global warning for travelers and healthcare workers

Editor’s Note: A version of this story appeared in CNN’s Meanwhile in China newsletter, a three-times-a-week update exploring what you need to know about the country’s rise and how it impacts the world. Sign up here.

The health tracking function for the mobile itinerary card was planned to be taken down on the following day.

The system, which is separate from the health code scanning system still required in a reduced amount of places in China, had used people’s cell phone data to track their travel history in the past 14 days to identify people who have been to a high-risk city.

Beijing has some of the best medical resources in the country. However, the abrupt zero-Covid u-turn has left people and health facilities ill-prepared to deal with a surge in infections.

Some businesses in Beijing were shut down over the weekend, and city streets were empty as residents worried about the disease or fell ill. There were a lot of people in front of Covid-19 testing booths.

According to China Youth Daily, experts told residents not to go to hospitals unless it’s necessary at the Beijing clinic on Friday.

Health workers in the capital were also grappling with a surge in emergency calls, including from many Covid-positive residents with mild or no symptoms, with a hospital official on Saturday appealing to residents in such cases not to call the city’s 911-like emergency services line and tie up resources needed by the seriously ill.

The Beijing Emergency center has seen a large increase in the number of calls in the past few days, according to Chen Zhi, chief physician of the center.

Zhong Nanshan: The CIV-19 epidemic is rapidly spreading in China, and a top expert cautions against ill-preparedness

A top Covid-19 expert, Zhong Nanshan, said in an interview that Covid was spreading rapidly in China.

“No matter how strong the prevention and control is, it will be difficult to completely cut off the transmission chain,” Zhong, who has been a key public voice since the earliest days of the pandemic in 2020, was quoted saying by Xinhua.

The rapid rollback of testing nationwide and the shift by many people to use antigen tests at home has also made it difficult to gauge the extent of the spread, with official data now appearing meaningless.

CNN cannot independently confirm the number of people in China, but it is thought that 18% of the people there would be affected by Covid-19.

China may be unprepared to deal with the surge of cases after the surprise decision to lift its measures and a nationwide protest against the policy.

The government should focus on booster shots for the elderly and other risk groups now, because of the upcoming Chinese lunar New Year which is considered a peak time for travel to rural hometowns, according to the state media interview.

Measures to be undertaken include increasing ICU wards and beds, enhancing medical staff for intensive care and setting up more clinics for fevers, China’s National Health Commission said in a statement.

Meanwhile, experts have warned a lack of experience with the virus – and years of state media coverage focusing on its dangers and impact overseas, before a recent shift in tone – could push those who are not in critical need to seek medical care, further overwhelming systems.

Bob Li, a graduate student in Beijing, who tested positive for the virus on Friday said he wasn’t afraid of the virus, but his mother, who lives in the countryside, stayed up all night worrying about him. “She finds the virus a very, very scary thing,” Li said.

China’s big bang: Vaccines for Covid-19 have no medical costs, and the problem of vaccination remains the same as in SARS-CoV-19

China’s market watchdog said on Friday that there was a temporary shortage of some hot-selling drugs and vowed tocrack down on price gouging, a week after the major online retailer said it was taking steps to ensure stable supplies.

A state media interview with a doctor in Beijing, stating that people who test positive for Covid-19 and do not have any mild symptoms do not need to take antibiotics was featured on a weekend meme on China’s Weibo social media platform.

People with no symptoms need no medication at all. It is enough to rest at home, maintain a good mood and physical condition ,” Li Tongzeng, chief infectious disease physician at Beijing You An Hospital, said in an interview linked to a hashtag viewed more than 370 million times since Friday.

Older adults who received the updated booster a week or more before illness began had less risk of hospitalization than those who hadn’t received the original vaccine. The study also wasn’t able to analyze the effect of previous infection with SARS-CoV-2.

The CDC recommended a bivalent booster in September to better protect against the omicron variant. Both broad and omicron specific protection can be offered by the new booster, which targets the component of the omicron variation and original virus strain.

The most dominant variant was the omicron BA.5 when seven health systems conducted the first study.

Vaccination coverage for the pandemic? The Kaiser Family Foundation’s comments to the Financial Times on October 18th, 2015, were welcomed by NHC officials

In October, the Kaiser Family Foundation senior vice president and director of global health and HIV Policy said to NPR that she thought it would be an uphill battle. “I do think it’s a tough sell just because of where we are on this point in the pandemic.”

James Trauer, an infectious-disease modeller at the Monash University inMelbourne, Australia, says that it’s critical for China to achieve the highest vaccination coverage possible prior to the major epidemic taking off. He also notes that there is still a lot of uncertainty around the projections about the epidemic’s toll and the impact of measures to slow the spread.

Two studies show that giving most of the population a fourth vaccine dose, along with high levels of adherence to masking and reimposition of temporary restrictions on social interactions, can reduce the number of deaths. Measures like this will ease the burden on hospitals.

“It is never too late to flatten the curve,” says Xi Chen, an economist at Yale University in New Haven, Connecticut, who studies China’s public-health system.

But these estimates include only deaths due directly to COVID-19, and do not take into account excess deaths because of delays in treating people with non-COVID-19 diseases, says Ewan Cameron, a modeller at the Telethon Kids Institute in Perth, Australia.

Both studies agree on mortality estimates and the impact of interventions. “This similarity in large part reflects an agreement that herd immunity will only be achieved after a large, and difficult to contain, spread of transmission throughout the entire country.”

How the NHC came up with the estimates cited by Bloomberg and the Financial Times is unclear, as China is no longer officially tallying its total number of infections, after authorities shut down their nationwide network of PCR testing booths and said they would stop gathering data on asymptomatic cases.

On Friday, a copy of what was purportedly the NHC meeting notes was circulated on Chinese social media and seen by CNN; the authenticity of the document has not been verified and the NHC did not immediately respond to a request for comment.

The Financial Times said it was Sun Yang – a deputy director of the Chinese Center for Disease Control and Prevention – who presented the figures to officials during the closed-door briefing, citing two people familiar with the matter.

China’s COVID-19 vaccine crisis: warnings from a closed-door meeting of the National Health Council, CNN and Xicheng

The figures are in stark contrast to the public data of the NHC, which reported just 62,592 symptomatic Covid cases in the first twenty days of December.

Wang Guiqiang, a doctor who specializes in infectious diseases, told a news conference that deaths caused by pneumonia and respiratory failure after contracting the virus are classified as Covid deaths.

The minutes of the Wednesday closed-door NHC meeting made no reference to discussions concerning how many people may have died in China, according to both reports and the document CNN viewed.

The Paxlovid drug will be distributed to Beijing community health centers in the coming days, according to the state media.

The state-run China News Service reported Monday that after receiving training, community doctors will administer the medicine to Covid-19 patients and give instructions on how to use them.

“We have received the notice from officials, but it is not clear when the drugs will arrive,” it cited a worker at a local community health center in Beijing’s Xicheng district as saying.

The sudden lifting of restrictions sparked panic buying of fever and cold medicines, leading to widespread shortages, both at pharmacies and on online shopping platforms. Long lines have become routine outside fever clinics and hospital wards overflowing with patients in the capital Beijing and elsewhere in the country.

An emergency room doctor in Beijing told the state-run People’s Daily on Thursday that four doctors on his shift did not have time to eat or drink. He said they had been seeing patients nonstop.

Another emergency room doctor told the newspaper he had been working despite having developed fever symptoms. A doctor said that the amount of patients is high and that with fewer staff the pressure is increased.

Hundreds of health professionals from across China have traveled to Beijing to assist with medical centers, in what is seen as a sign of a strained medical system.

It is feared that COVID may lead to new variant but it is possible that they will be found anywhere in the world right now.

Rumors and misinformation run rampant about COVID vaccines no matter where they’re manufactured. But, as NPR has reported, such myths and misconceptions are especially problematic for vaccines made in China. Issues with past vaccines have made segments of the population leery about the made-in-China COVID vaccines. A global health researcher says that the misinformation about the vaccines doesn’t originate in China or on social media.

Initial data shows that the Chinese vaccines have a lower level of protection compared to the mRNA vaccines. Cowling says around 50 or 60 percent effective. Pfizer and Moderna vaccines were able to protect against the original strains of the virus at a very high level.

There is uncertainty about the longevity of protection against severe disease. In one study in Brazil, it was found that the protection against severe disease waned more quickly for CoronaVac than for the Pfizer vaccine. But that study didn’t separate the data by age, and other studies have shown that protection, across the board, declines more quickly for older people. Nevertheless, the Chinese health officials recommend older adults and those with weakened immune systems receive a fourth shot, or second booster, the Global Times reported earlier this month.

The Pfizer vaccine was more effective for older adults after only two doses. The Pfizer vaccine gave about 85% protection for this group while the CoronaVac vaccine gave only about 75%. But, Cowling points out, an extra booster – or third dose – of CoronaVac lifts the protection to about 98%, the same protection observed with three doses of Pfizer.

Cowling thinks the misinformation about CoronaVac or Sinopharm may stem from early data, looking at the vaccines effectiveness against infection (not severe disease).

But with the emergence of the immune-evading variants, such as delta and omicron, eventually all vaccines wound up being basically ineffective against infection, especially more than three to four months after the inoculation.

In the last decade or so, both CoronaVac and Sinopharm have been tested in at least 12 international studies, including one in Turkey with 12,000 participants, one in Brazil with over 3 million people and one in Chile with over 10 million vaccinations. Around 12,000 people were immunized in one study looking at the safety of CoronaVac. They documented 67 adverse events that were determined to be unrelated to vaccine. Given these results, “the data available to date indicate that Sinovac-CoronaVac is generally well tolerated and consistent with the safety profile of other licensed, alum-adjuvanted inactivated vaccines,” WHO wrote in May 2021.