Recently, some Chinese mainland tourists paid out of their own pockets and made a special trip to Macau to inoculate the messenger ribonucleic acid (mRNA) crown disease vaccine that has not been approved for use in the mainland, causing heated discussions on the Internet.

According to Caixin and the South China Morning Post, the Macau University of Science and Technology Hospital has become a popular destination for Chinese mainland tourists after the Macau SAR government resumed mainland group tours and electronic visas in November this year, allowing tourists to be vaccinated against coronary disease locally.

Although the Macau authorities only allow tourists to get the mRNA vaccine against the original strain, and the price is high, this does not appear to have dampened the desire of mainland tourists to get vaccinated in Macau. According to the report, vaccination appointments are full for more than a month and will have to wait until late January next year at the soonest.

There is actually no shortage of vaccines in the Chinese mainland. According to incomplete statistics, 13 domestic vaccines have been approved in China, covering inactivated vaccines, recombinant protein vaccines, viral vector vaccines, etc., involving China Biology, Kexing Zhongwei, Kang Yinuo, Zhifei Bio, Kangtai Bio, Wantai Bio, Shenzhou Cell, Clover Bio, Wesker Bio, etc.

However, there is still no trace of the mRNA coronary disease vaccine in the above-mentioned approved list.

The

mRNA vaccine is a new form of high-tech vaccine in the world in recent years. This vaccine encodes a certain genetic sequence on the spike protein of the coronavirus into the mRNA, so that it enters the "instruction" cells in the body like a messenger and makes the spike protein on the surface of the virus. When the body's immune system finds a foreign body, it will naturally resist it and make antibodies in the process.

The Pfizer vaccine (called Fubitai in mainland China and Hong Kong, and BNT in Taiwan) jointly developed by Pfizer in the United States and the German biotech company BioNTech, and the coronary disease vaccine of Moderna, another vaccine manufacturer in the United States, are mRNA vaccines.

Continent has not started mRNA coronary disease vaccine questioned

The epidemic of coronary disease has spread in the mainland, and China has not yet approved any domestic mRNA for marketing, nor has it approved the use of foreign-made mRNA vaccines.

Wang Lai, head of global research and development at Hong Kong-listed BeiGene, told the Financial Times in an interview that it was "regrettable" that the Chinese authorities did not approve the mRNA vaccine. He said the mRNA vaccine provided a longer-lasting and more effective protection than other types of vaccines produced in China.

Many netizens also questioned why the Chinese mainland has not yet approved the mRNA vaccine. "Qiyang who wants to be lazy sheep" said: "Who knows, Hong Kong people and Macau people can fight, but mainland people can't fight. I can't figure out how to think about this logic."

The vaccination rate of the elderly in China is low

Full vaccination is a prerequisite for society to get out of the epidemic and re-open. For China, which has just loosened its epidemic prevention policy, increasing the vaccination rate is particularly important, because in the event of a large-scale infection outbreak in various places, the protection provided by the vaccine will reduce the risk of severe illness and death after infection.

However, the current vaccination situation in China is not ideal.

According to data released by the government, although the vaccination coverage rate in China exceeds 90%, the proportion of adults who get supplements is only 57.9%, and the vaccination rate of the elderly aged 80 and older is even lower, only 42.3%.

According to The New York Times, the World Health Organization said supplements are especially important for Chinese vaccines because most Chinese vaccines use inactivated virus technology, which is less effective against the coronavirus than vaccines with mRNA technology.

Chinese officials recently issued a notice proposing to speed up the elderly's coronary vaccination. The picture shows posters on the streets of Beijing calling for the elderly to be vaccinated. (Bloomberg)

According to Reuters, a doctor in Shenzhen said that the Chinese medical community generally does not doubt the safety of Chinese vaccines, but there are still doubts about their efficacy compared with foreign-made mRNA vaccines. "At least half of the medical and educational people want to get the mRNA vaccine and refuse to get the Chinese vaccine," the doctor said.

Experts worry that insufficient effectiveness of domestic vaccines and low vaccination rates among vulnerable populations could lead to a catastrophic wave of infections and deaths in China. They suggested that the government should speed up the approval process for new vaccines to fight the new coronavirus variant.

Further reading Outbreaks in many places in China, mainland tourists pay for mRNA vaccines in Macau

According to the "Financial Times" report, Jin Dongyan, a professor at the School of Biomedicine at the University of Hong Kong, believes that in order to better deal with the epidemic "tsunami-like outbreak", China should have an accelerated mechanism when approving vaccines, and approving vaccine changes based on epidemic strains, "There is no need to conduct comprehensive clinical trials".

Currently, Chinese vaccine manufacturers including Kexing and Sinopharm Group are conducting clinical trials of their Omicron vaccines. However, these vaccines still use inactivated virus technology to elicit immune responses. Jin Dongyan warned that by the time these new vaccines were approved by regulatory authorities, other new variants may have already become the dominant epidemic strains. For example, the Omicron BA5 strain, which was circulating in many countries, has been replaced by a novel variant strain of BQ.1.1 in the United States; in Singapore, it was replaced by the XBB strain.

A Beijing-based consultant to the Chinese Center for Disease Control and Prevention said China's epidemic toolkit needs to add locally made mRNA vaccines. At least seven pharmaceutical companies in China are working on mRNA vaccines, some of which are in the late stages of clinical trials. But it is expected that "it will not be available until April next year at the earliest."

He said that the most feasible mRNA vaccine option in China at present is to approve foreign-made mRNA vaccines.

Chinese mainland has not approved any mRNA coronary disease vaccine

In fact, Shanghai Fosun Pharma has reached a strategic cooperation agreement with BioNTech in 2020 to distribute its coronary disease vaccine under the trade name "Fubitai" in Greater China. Taiwan and Hong Kong have been vaccinated with this vaccine since 2021, and only the Chinese mainland still does not approve it.

The Chinese official did not explain, and the outside world can only infer. Some public opinion believes that the delay in the approval of the mRNA vaccine by the Chinese authorities is to buy time for China's domestic vaccine and maintain public confidence in the Chinese vaccine. Some analysts also pointed out that mRNA is a relatively novel vaccine technology, and they are worried that this vaccine will cause side effects and allergic reactions.

Many public opinions believe that the problem may lie at the political level. Some analysts pointed out that China competes with the United States and the West in fields such as technology, forcing the authorities to focus on developing and developing domestically produced mRNA vaccines, showing the world that China is not far behind in vaccine development.

There are now signs that China's attitude towards foreign manufacturing of mRNA vaccines has begun to change positively.

In September this year, an mRNA coronary disease vaccine developed in China was approved for emergency use in Indonesia. The vaccine, called AWcorna, was jointly developed by the Military Medical Research Institute of the Academy of Military Sciences of the Chinese People's Liberation Army, Aibo Bio and China's Yunnan Watson Biotechnology joint stock company. Watson Bio is actively advancing the application for emergency use authorization in China.

In November this year, German Chancellor Scholz announced during his visit to China that China has approved the vaccination of Fubitech for foreign residents in China. Some comments said that this move is aimed at advancing the process of Fubitech's approval in China, and it is believed that the Chinese people can be vaccinated with this mRNA vaccine in the near future. China's National Bureau for Disease Control and Prevention later said that relevant departments are formulating plans to speed up the vaccination of the coronavirus.

Chinese medical experts say that strengthening vaccination with heterologous vaccines can increase the level of neutralizing antibodies. (AFP)

Experts recommend heterologous vaccination supplements

In fact, it is not without basis for the Chinese people to turn their attention to other styles of vaccines. Recently, a number of medical experts suggested that the public choose xenogenous vaccination supplements to improve the preventive effect.

Professor Zhang Wenhong, a Chinese expert on infectious diseases, led a research team in a study on sequential vaccination of Omicron, pointing out that enhanced vaccination with homologous or heterologous vaccines can increase the level of neutralizing antibodies. However, heterologous enhancement works better.

Zhong Nanshan, an academician of the Chinese Academy of Engineering, also said that the effect of people vaccinating mRNA vaccines, subunit protein vaccines, adenovirus vaccines and other technical routes vaccines on the basis of inactivated vaccines is better than that of complete inactivated vaccines.

He also pointed out that the real The results of the world clinical study showed that the effect of China's inactivated vaccine combined with the recombinant protein vaccine in preventing infection was no less than that of foreign three-dose mRNA vaccines. It stressed that "China's vaccine will not be worse than the mRNA vaccine, we are confident".

Previously, South East Asia and Middle Eastern countries that mainly administered China's inactivated vaccine have successively changed their policies to implement other vaccines or add an additional dose of mRNA vaccine since last year. Frontline healthcare workers in Indonesia received an additional dose of Modena vaccine at the end of last year after receiving two doses of the Koching vaccine; Bahrain urged the country's population over the age of 50 to receive an additional dose of the Forbitt vaccine after the two doses of the Sinopharm vaccine; Thailand also announced that the Koxing vaccine will be administered after the injection of AstraZeneca vaccine.

In the face of the severe epidemic, whether the Chinese mainland can increase the vaccination rate of supplements in a short period of time will determine to a certain extent how severe the epidemic will be. Facts have proved that both inactivated vaccines and mRNA vaccines can play a protective role, and the approval of more styles of vaccines by the authorities when conditions permit will give people more choices, and it is also expected to increase the vaccination rate and speed up the restoration of normal life order.