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China’s plans for ‘vaccine passport’ may be hampered by lack of data

A medical worker extracts the recombinant novel coronavirus (COVID-19) vaccine into a syringe in Wuhan, Central China's Hubei province, on March 24, 2020. The first batch of 108 volunteers received inoculations after a clinical trial of the novel coronavirus vaccine in China kicked off on March 16. [Photo by Zhu Xingxin/chinadaily.com.cn]. Sketched by the Pan Pacific Agency.

BEIJING, Mar 15, 2021, SCMP. After closing its borders to almost all foreign visitors for over a year, China has floated the idea of allowing international travel ahead of its hosting of the Winter Olympic Games in February 2022, South China Morning Post reported.

Diplomatic missions on Monday were sent a note and disk of a “public key” to decrypt the “health certificate for international travel” – China’s version of a vaccine passport – which contains information about holders’ coronavirus and serum antibody tests and inoculation status.

Foreign diplomats praised it as “a good step forward” and said they appreciated the fact that China had initiated a discussion on the issue. However, data transparency could stand in the way of it achieving mutual recognition of vaccines before allowing international travel.

“To start the mutual understanding of vaccines, we need to really understand what the Chinese vaccine is,” said Irit Ben Abba, Israel’s ambassador to China.

“And China would probably like to understand the effects of the vaccine that we are using,” she said, adding that she would like to push for mutual recognition in a “few weeks”.

Israel has already agreed with Greece, Cyprus and the Seychelles to allow vaccinated citizens to visit, which Ben Abba said was partly because they had all used the same vaccine, developed by Pfizer-BioNTech. It would be possible to reach a deal with China, but the two sides would have to “share information on the vaccine and its effects”, she said.

China has approved four domestically developed vaccines – two by state-owned China National Pharmaceutical Group, and one each from Sinovac Biotech and CanSino. Although they have been used to inoculated tens of millions of people in China and sent to 97 countries, detailed data about their final-stage clinical trials have yet to be published.

Data about other vaccines rolled out elsewhere in the world – by Moderna, Pfizer-BioNTech, AstraZeneca and Sputnik – have been published in journals, but only the Pfizer-BioNTech product is going through the approval process in China.

A European diplomat who declined to be named said negotiations with China had not started and no decision had been made on whether to negotiate as an individual country or as the European Union, with the latter his favoured option.

Data on the safety and efficacy of the vaccine would be required when the vaccine was not approved by the European Medicines Agency (EMA), the person said.

If the vaccine had passed prequalification certification or been approved for emergency use by the World Health Organization, it might still not be recognised by the EU, the diplomat said.

Two Chinese vaccines, one by Sinopharm’s Beijing unit and the other by Sinovac, are being reviewed by the WHO and the results may be released as early as this month.

“I just don’t see EU countries will readily recognise a vaccine just because the WHO did, or it will be a very big pressure to hold political responsibility for whoever makes that decision,” the diplomat said.

Scott Rosenstein, director of the global health programme at Eurasia Group, said the US Food and Drug Administration and the EMA had been consistent in not recognising vaccines that had not been analysed by their own regulatory agencies, but countries without a stringent regulator might look to prequalification by the WHO.

“For countries that do not have the resources to rigorously analyse clinical trial data, WHO authorisation can serve as a stand-in for domestic authorisation,” he said.

Beijing was also likely to require domestic data analysis before recognising a vaccine developed outside China, he said.

In the absence of data and no recognition of vaccines, an option for entering Europe with an unrecognised vaccine would be testing in a designated laboratory for tilters of neutralising antibodies, an indicator of how effective a vaccine is.

“You can try to prove the neutralising antibody levels have reached certain high levels, but then comes the question of setting an acceptable level,” the diplomat said.

Another source said China and the US were engaged in talks on vaccine recognition but no major progress had been made.

Ben Abba said she hoped the negotiation of vaccine understanding could start soon or “it would be very difficult to accelerate our economic ties”.

“The first thing I was asked when I went to meet my counterparts in China’s foreign ministry was to see if we can bring Israeli businesspeople to the import-export conference in Shanghai in November. But in order for that to happen, we need to allow these people to come in without quarantine, without having to be under any kind of isolation,” she said.

China’s foreign ministry told the South China Morning Post that Beijing was seeking to establish reciprocal arrangements on the basis of “accommodating each other’s concerns” but the idea of ending or reducing quarantine periods would require a further review.

“China will make the proper arrangements based on experts’ opinions and is willing to maintain close communication with all countries,” it said.

Despite the hopes of many countries to reopen their borders, it has yet to be shown how vaccine passports would help against silent transmission of the coronavirus or its many variants.
Some countries, including China, have been pursuing zero infections while others have sort simply to mitigate risk – trying to reduce Covid-19 cases but limiting disruptions to economic, political and social systems.

Another diplomat, whose home country is experiencing high numbers of infections, said it would be interesting to see how the quarantine situation looked when the two sides opened their borders to each other.

“The idea of a vaccine passport depends on how infectious the vaccinated people are. There is a balance between risks and benefits and if China only accepts zero infection there will be no way out of this,” the European diplomat said.

“In Europe it’s a different mindset which involves some risk and the risk is manageable.”

There is also the issue of how long the vaccines offer protection and how effective they might be against coronavirus variants, which Rosenstein said could hinder the vaccine passport idea.

“It’s still probably too early to really know the duration of protection afforded by vaccines. It’s possible that some parts of the world will have outbreaks with newer variants that evade the current crop of vaccines and those areas will be less permissive when it comes to vaccine passports,” he said, adding that much of the discussion was likely to happen later this year and throughout next year.

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