The continuing politicization of COVID-19 vaccines is undermining medical science and the international response to the pandemic. “Vaccine nationalism is very troubling,” Jeremy Levin, chair of the Biotechnology Innovation Organization’s (BIO) executive committee, told BioWorld.

Specifically referencing China’s recent requirement that foreign visitors to the country be vaccinated with a COVID-19 vaccine developed in China, Levin said such political gamesmanship not only interferes with medical science, but it erodes confidence in the vaccines in general and raises questions about the safety and efficacy of a person receiving two or more different COVID-19 vaccines – something that hasn’t been tested.

There’s also the question of access. To date, five COVID-19 vaccines have been developed and approved or authorized for emergency use in China, but they’re not broadly available throughout the world. Although China’s vaccine makers are working with manufacturing partners in other countries to increase the use of their products, manufacturing capacity in and outside of China is limited, just as it is with other COVID-19 vaccines. Additionally, none of the vaccines developed in China has been submitted yet for authorization by the EMA, FDA or many other regulatory authorities. (See COVID-19 vaccines developed and authorized in China, below.)

Requiring proof of vaccination for entry into a country may be a sensible response to the pandemic, but Levin said a specific vaccine shouldn’t be required when there are several that have proved safe and effective in vigorous trials. A global response to a pandemic requires confidence, he noted. Calling into question other approved vaccines and products damages that confidence.

While COVID-19 shouldn’t be used as an opportunity to exert political influence, “there’s lots of opportunity to benefit on a purely commercial scale” through increased collaborations, joint manufacturing and trade agreements related to medical products, Levin said.

The pandemic also gives the World Health Organization (WHO) the opportunity to establish norms for international standards and recognition of vaccines. For the WHO to fill that role, the nations of the world must understand that viruses don’t recognize borders, Levin said. If political policies result in creating a safe haven for the coronavirus, they will open the door for variants to take hold and continue the pandemic.

In the past, it took a concerted international effort to eradicate smallpox, yellow fever and other infectious diseases that could pose pandemic threats. Countries need to learn from the past rather than seeking to turn the pandemic into an opportunity to “gain the hearts and minds” of potential allies, Levin said.

Vaccine perceptions

But the success of using the pandemic as a political tool could provide an incentive to further drive government-sanctioned misinformation campaigns and preference for domestic products. Levin said Russia’s misinformation campaign that disparaged other COVID-19 vaccines for the advantage of its Sputnik V has “had a massive astronomical effect” and played a role in the concerns that led to chaos with the rollout of Astrazeneca plc’s vaccine in the EU. “All of this is very dangerous,” he said.

While it may have hurt confidence in other vaccines, Russia’s campaign did raise trust in Sputnik V. A recent survey conducted by Yougov, a U.K.-based market research and data analytics company, found that people in Argentina, Algeria, Brazil, India, Mexico, the Philippines, Serbia, Vietnam and the United Arab Emirates had equal confidence in COVID-19 vaccines developed in Russia and the U.S. About 54% of those participating in the poll expressed trust in vaccines coming from those countries, compared with 48% for vaccines from the U.K. and 27% for products from China or Sweden.

Also, the poll showed that Sputnik V enjoyed the most public awareness, with nearly 74% of respondents saying they had heard of it. The Pfizer Inc.-Biontech AG vaccine was recognized by more than 69%, and Astrazeneca plc’s vaccine was familiar to nearly 60%. Sinovac Biotech Ltd.’s Coronavac was the most familiar vaccine developed in China, with 44% indicating they had heard of it.

However, familiarity doesn’t always translate into trust. When asked which vaccine they would prefer, 37% of respondents chose the Pfizer-Biontech vaccine, followed by 33% choosing Sputnik V. Two vaccines from China were next in line – Coronavac and one of Sinopharm’s two vaccines, preferred by 27% and 25%, respectively.

Conducted between Feb. 18 and March 3, the poll showed that 23% of respondents preferred Astrazeneca’s vaccine, but that was before concerns were raised about a small number of blood clots reported in people who had received the vaccine. Although subsequent investigations have shown the benefits outweigh the risks, the public perception of the vaccine has changed. For instance, some countries in Latin America are refusing to use the vaccine.

As for other vaccines, about 17% of the respondents preferred those developed by Johnson & Johnson or Moderna Inc. Convidecia, a vaccine developed by China’s Cansino Biotech Ltd., rounded out the list, with 8% of the respondents preferring it.

Nearly half the respondents indicated they would only want a vaccine if it had at least a 90% efficacy rate, and 84% said they would be willing to postpone vaccination if all that was available was a product with 60% efficacy. But regardless of preferences, most people across the world will have to get whichever vaccine is available.