China pushes to expand Covid-19 vaccine development but more work needed on trials: health official

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China is striving to expand its Covid-19 vaccine development with 20 candidates being tested in clinical trials.

“China is in the world’s first phalanx in terms of the number of Covid-19 vaccines in the pipeline,” said Zheng Zhongwei, director of the Development Centre for Medical Science and Technology of the National Health Commission.

“But we have to admit that our vaccine companies are still behind when it comes to carrying out international clinical [trials],” he said. “We still have shortcomings in basic research of some new technologies.”

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Among the 20 vaccine candidates that have entered clinical stages, eight have been approved for phase 3 trials abroad, he told the Boao Forum for Asia’s global health forum in Qingdao on Wednesday.

China had provided more than 350 million doses of Covid-19 vaccine to foreign countries by May 31, he said, and had administered 723.5 million doses nationwide by Thursday.

According to Unicef, the United States tops the world as home to 110 Covid-19 vaccine developers, followed by 41 in China and 22 in Canada. The UN agency said manufacturers from different countries might work together on one vaccine and some firms might have multiple vaccines in development.

China has taken an unlikely lead in the global supply of Covid-19 vaccines, which started before two of its jabs were listed for emergency use by WHO.

Previous safety scandals involving the local pharmaceutical industry eroded vaccine trust in the country. In 2018, for example, vaccine maker Changchun Changsheng Bio-technology was found to have sold more than 250,000 substandard DPT (diphtheria-whooping cough-tetanus) vaccines for babies.

In May last year, Chinese President Xi Jinping pledged that Covid-19 vaccines would be a “global public good” in the pandemic. The country has been developing vaccines based on at least four technology platforms, including the traditional inactivated virus and the new mRNA technology.

The country has also ramped up its production capacity to supply its population of 1.4 billion and the world. State-owned Sinopharm alone could produce up to 5 billion doses a year, its chairman Liu Jingzhen said on Wednesday.

But Chinese vaccines approved by the WHO do not match the over 90 per cent efficacy of the mRNA vaccines being used widely in the US and Europe. Sinopharm’s Beijing subsidiary has a vaccine with 79 per cent efficacy against symptomatic disease, while Sinovac’s is 51 per cent effective, according to the WHO.

A Chinese Covid-19 vaccine modified for the Beta variant of the coronavirus is on track to be tested in human trials and a nasal vaccine that can be administered through inhalation is pending emergency use approval, according to a Chinese military scientist.

“We are applying for the vaccine against the South African variant to enter clinical trials. We hope to use the mutant strain to enhance its immunity and cover the virus mutation,” said Chen Wei, the Chinese military’s top epidemiologist and virologist, at the Pujiang Innovation Forum on Thursday. Under a new World Health Organization naming protocol, the variant that first emerged in South Africa is now called Beta variant.

Major General Chen led the team at the Academy of Military Medical Sciences which jointly developed vaccines with Tianjin-based company CanSino Biologics. A one-dose vaccine was the first produced by the team to be approved for general use in February.

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CanSino said the single-shot vaccine was 65.28 per cent effective at preventing symptomatic infections 28 days after vaccination, according to an interim analysis from the phase 3 clinical trial.

It can be stored and shipped at 2-8 degrees Celsius (38-46F), “making it more accessible, especially to the regions with under-served public health”, the company said in a statement in February.

The vaccine was built on a technology platform using an adenovirus-based viral vector which had been studied since 2003 and produced an Ebola vaccine, Chen said.

“With years of experience, we are more confident and got a vaccine out in Wuhan relatively quickly,” Chen said. Her team was authorised to start a clinical trial in March 2020 and the country approved military use of the vaccine in June last year.

The company started submitting rolling data to the WHO for emergency use listing review this month, according to the UN agency.

The WHO has listed two Chinese vaccines by Sinopharm and Sinovac for emergency use. They are among the four approved for general use in China, while three vaccines have been given emergency use authorisation in the country.

Chen’s team is also developing a vaccine that is “not injected and not stored in a cold chain”, she said.

“We are now applying for emergency use approval for an inhaled vaccine [in China]. We hope that the groups that are reluctant to get injections or need a booster have an alternative,” she said, adding that it could also ease the supply shortage of vials.

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In March, CanSino obtained the Chinese regulator’s approval to start clinical trials for its inhaled vaccine, which is based on the same formula as the injectable version, but with an additional inhalation-atomisation device.

Yu Xuefeng, co-founder and CEO of CanSino, said the inhaled vaccine could boost vaccine supply by five times because it required just one-fifth of the dosage of the injectable vaccine.

“The production capacity can grow by five times without more raw materials or added costs. It can stimulate an immune response in the respiratory mucosa … making it more accessible, safe and convenient,” he told Yabuli China Entrepreneurs Forum.

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