Delays in sharing clinical trial data is one of the key reasons behind skepticism.
Hassan Jamil didn’t think much about the Sinopharm vaccine shots he received in the middle of last year. It was July and Covid-19 was spreading like wildfire, killing people and ravaging economies.
A supply chain expert who works in Abu Dhabi, the capital of the United Arab Emirates, Jamil was amongst the early volunteers to receive the jabs made by China’s state-run pharma company during its international trial phase.
“For me it wasn’t a matter of choice. I travel to other countries frequently and knew this was my chance to get the necessary inoculation,” he told TRT World.
If there was any fear about the efficacy or an adverse reaction, he took consolation in the fact that members of UAE’s royal family and government officials were also getting the shots.
The trials of Covid-19 vaccines manufactured by Sinopharm and another Chinese company, the privately run Sinovac Biotech, have become a subject of debate. Experts say the complete result of the trials haven’t been made public, leaving many to question their efficacy.
Sputnik V, a vaccine developed by Russia’s Gamaleya Research Institute of Epidemiology, is facing similar criticism - even though a recent independent review published in the Lancet medical journal found it to be 92 percent effective.
“I think the main reason why there is distrust in the Chinese and Russian vaccines stems from their approval before having full clinical trial validation,” said Jeremy Rossman, an emerging disease expert at the University of Kent.
“From a health standpoint, this was a dangerous idea and has decreased the trust in the vaccines.”
A survey published last month by UK-based polling company, YouGov, showed that many of the 19,000 participants from the US, Europe, Australia, Hong Kong, India and Indonesia, were more inclined to use western vaccines.
Yet despite the concerns, many countries including Algeria, Argentina, Brazil, Indonesia and Turkey have opted for Chinese and Russian vaccines. Many of them have carried out their own trials and have now begun inoculation drives.
That’s simply because the supply of more ‘promising’ jabs made by Pfizer and Moderna and AstraZeneca, have been gobbled by the wealthy nations - despite warnings from the World Health Organisation (WHO) that this could leave hundreds of millions of people in poor countries vulnerable to the deadly virus.
A matter of trust
Russia became the first country to give any vaccine a go ahead when it approved Sputnik V for trials in August last year. Yet that didn’t inspire confidence among other nations which were desperately trying to reopen schools, factories, and airports.
In contrast when Moderna and Pfizer announced promising results of their trials late last year, the global stock markets rallied.
Even though Covid-19 vaccines have been made in record time, the western pharmaceutical companies not only completed the necessary trials in people but also communicated the results.
“It is about transparency and data. Pfizer, Moderna and AstraZeneca have phase 3 clinical trials published in peer reviewed journals - that is the transparency that is required,” said Raina MacIntyre, a professor of global biosecurity at the University of New South Wales in Sydney.
“A media release by a company is not the same. When phase 3 trials of these other vaccines are published, they can be validly compared in safety and efficacy to the other vaccines.”
The report about Sputnik V being 92 percent effective has been published in peer-reviewed Lancet just this week.
“It will be interesting to see if the trust in the Russian vaccine changes now that they have published their Phase III trial data,” said Rossman.
“There is a chance the geopolitics also plays a role here, but I think the distrust is largely stemming from a lack of transparency.”
When it comes to vaccines, openness is important especially when many people are hesitant about side effects and don’t trust vaccination campaigns, experts said.
Lack of transparency can raise doubts, said Stephen Evans, a professor of pharmacoepidemiology at the London School of Hygiene and Tropical Medicine
“That’s a pity because there are good scientists in China and in Russia and they are perfectly capable of producing vaccines.”
The state’s role
The FDA and MHRA, the US and UK drug regulators, are fiercely independent. A new medicine has to go through multiple stages of review before it can be marketed.
In Russia and China the line between the companies that make the vaccines and the regulatory bodies approving them gets blurred, said Evans.
“Their manufacturing, regulation and decision on authorisation and usage are all strictly controlled by the government.”
Such a widespread control of state means that Chinese and Russian authorities can easily hide negative information about their vaccines.
“You can not be sure that they will allow the failure to become public. In the west there have been cases where GSK and Novartis stepped back and went to redesign their drugs when they did not produce good results,” he said.
Another reason why American and European drug manufacturers enjoy greater trust in the general public could be the power of their brands.
Across the globe, millions of people buy Bayer’s Aspirin, Sonofi’s Lantus insulin shot or Pfizer’s Viagra, on a daily basis. This is not the case with Chinese and Russian drug companies.
That might partially explain the hesitancy towards Sputnik V and Sinovac’s CoronaVac, said Ellen T’ Hoen, director at the Medicine Law and Policy, an NGO which advocates affordable drugs.
Ultimately it comes down to the question of how much trust people have in the government bodies approving the vaccines, she said.
“Most of the drugs sold in Europe are generics and come from India. No one expresses any concern about these medicines and that’s because people have confidence in the regulatory authorities.”
But tens of millions of people are desperate to go back to pre-Covid lifestyle.
Jamil is often asked by family and friends what they should do. “It’s not a matter of options right now. Just take whatever vaccine that’s available before it’s too late.”