Getting international travel and commerce back on track may hinge on vaccine acceptance.

This story first appeared on TheStreet.com on Monday, March 15, 2021

I’m due to go get my COVID-19 vaccination, the first jab, Tuesday. But I’m one of the few and the brave in Hong Kong.

There has been apathy, antipathy and resistance to vaccinations in Hong Kong, resulting in a very slow take-up. Only around 5% of the eligible population of Hong Kongers has taken advantage of the free program. According to one doctor, 40% of the people who have actually reserved their injection do not show up.

It’s understandable that there’s skepticism about a new vaccine, developed at record pace. I get it. A process that normally takes a decade took a year. It took me a day to make up my mind.

But the main detriment to the initiative in Hong Kong has been coverage of six deaths in the city of people who have taken the Chinese vaccine, Sinovac. That has dampened any enthusiasm that may have existed — and that was in shorter supply than doses anyway.

Oh, and the Sinovac vaccine should not be approved in Hong Kong, in my view. The health authorities here are not following their own rules, and have passed a special exemption to get the drug cleared for use, against protocol. Ordinarily, any drug would have to have its clinical-trial results published, and peer reviewed in medical journals. But that has not occurred.

The maker of the drug, Sinovac Biotech, has not released the data. Quite why, I don’t know, but we can all have our suspicions. The most innocent explanation is that there are no longer enough COVID-19 cases within China to make a large enough sample of patients. The Beijing-based company has struggled to conduct its own research in its home market.

But Sinovac is being used and tested in Brazil. Researchers there said in mid-January that the Sinovac vaccine was only 50.4% effective, when you include mild infections. They initially gave a 78% efficacy rate, but then admitted it does not include patients who still caught the virus but had “very mild infections.”

The World Health Organization sets a minimum standard that a vaccine must have an efficacy of at least 50% for it to qualify. The figure means that of 100 people given the vaccine, 50 are guaranteed not to get it at all, while the other 50 may or may not, and may have a milder version of the disease if they do.

Indonesia also ran trials on Sinovac, and found it to be 65.3% effective. The highest efficacy came from tests in Turkey, where researchers said it proved 91.3% effective, both nations reporting interim results from late-stage trials.

If you’re being charitable, you’ll chalk up Sinovac Biotech’s inability to publish its results to the difficulties of squaring away research from all over the world. If you’re being suspicious, you may wonder what kind of side effects and hospitalizations are contained in the figures they undoubtedly have.

One Hong Kong doctor here joked that the Hong Kong population is taking part in another phase of Sinovac’s late-stage trials, without knowing it. We chuckle, knowing there’s a grain of truth.

Hong Kongers, for a population that thrives on a famously entrepreneurial and risk-taking economy, are surprisingly risk-averse in their daily life. Widespread, mild hypochondria has stood them in good stead in the face of an unknown disease. Mask wearing and social distancing took off right away, even before “social distancing” became a thing.

It is not going to help the vaccine program. On top of that, every death or hospitalization of someone who has taken a COVID-19 jab gets blown up in the city’s tabloids. The first two deaths, the authorities said on investigation, were coincidence. “Natural” heart attacks are gonna happen if you inject a lot of people, just like some will die in car crashes. Now we have six coincidences …

There’s a political angle to the vaccines, undoubtedly. We have two vaccines available, the Chinese one with insufficient data and a Western one with data supplied.

Hong Kong did not start administering any vaccines until it was able to give out a Chinese-made one, rushing through Sinovac with incomplete and non-public testing data. Only then could the Pfizer-BioNTech vaccine that the city had reserved be flown in. Another standard for the Hong Kong drug authorities is that the drug be approved elsewhere in reputable markets, and the Pfizer drug had been given the seal of approval in Britain and the United States.

Here in Hong Kong it is not the “Pfizer drug.” The name Pfizer (PFE) is nowhere to be found. This is the BioNTech/Fosun drug, which has the made-up drug name of Comirnaty, as you can see from the Hong Kong booking form. A subsidiary of the conglomerate Fosun International (FOSUF) gets involved. And yes, Comirnaty is the exact same one that Pfizer makes.

BioNTech is the brains behind Comirnaty, the first mRNA vaccine ever to get approved anywhere in the world, when Britain gave it the all-clear. Pfizer was pulled in to help commercialize and mass produce the drug. It contains a molecule of a type called messenger RNA that carries instructions to make a protein that can bind with SARS-CoV-2, the virus that causes COVID-19. Unlike a conventional vaccine, the kind we have all taken for polio or smallpox, it does not contain any of the virus itself, which is present in “old-fashioned vaccines,” in a weakened or denatured state.

Pretty smart, huh? I think of it like a Trojan Horse of a drug. That’s not quite right, it’s sending your body a message to generate body doubles so that when the virus arrives, it gets confused, and attacks the dummy instead.

Why has Pfizer been erased? All pharmaceuticals companies have to have a Chinese joint venture to sell drugs in China. That’s where Fosun Pharma, the largest drugmaker in China, comes in.

I was worried this partnership would mean the drug will be made in China. But BioNTech will be making the drug in Europe, at production bases in Germany and Belgium, with Fosun acting as distributor as well as conducting the regulatory applications and marketing in China.

Pfizer is BioNTech’s global partner — except in China. Hong Kong Chief Executive Carrie Lam, whose every uttering seems politically calibrated to please Beijing, says Pfizer is a “co-supplier” alongside Fosun Pharma.

Fortunately, it’s the same drug, and that’s the one I’ll be getting. I would in no circumstances whatsoever get the Sinovac drug that has been approved when it shouldn’t have been approved, in my view. The Pfizer drug has peer-reviewed data showing it’s 95% effective, as per the E.U. product factsheet.

For Sinovac, Hong Kong health authorities say they’ve seen some but not all of the numbers. Yet again, they have also not released them to the public, or said which numbers they’ve seen. On top of that, Hong Kong health authorities are giving the Sinovac drug to all ages, from 18 and up. Even in mainland China, it is not given to people over 60.

Numbers out of China are often, well, just numbers. One friend of mine who runs a business says most Chinese companies have two sets of books, one with financials they show to the public or partners, and another that give the real picture. He insists his company does not!

We have an added layer of politics involved. China is keen to build a medical database and has used a “voluntary” program to collect biometrics including DNA and facial-recognition scans from the Uighur population in Xinjiang. This “health check” info can and will be used by the Communist authorities. Folks mistrust the Hong Kong government badly enough to expect them to do the same.

Then of course the entire world has to contend with anti-vaccer misinformation. Much of that stems from a completely discredited piece of research indicating that there’s a link between the measles/mumps/rubella shot and autism.

THIS IS NOT TRUE, people! The concept was based on a discredited piece of research unfortunately published in the esteemed medical journal The Lancet, in 1998. The journal retracted it partially in 2004 and completely in 2010.

The damage, however, was done, or at least the info was out there on the Internet. An article in the Annals of Pharmacotherapy, another peer-reviewed journal, calls the alleged autism-vaccine connection “perhaps, the most damaging medical hoax of the last 100 years.”

I’m no scientist, but I trust that the medical establishment has been working double and triple time on COVID-19. A 95% efficacy on the Pfizer/BioNTech shot hasn’t been shot down. And with just about all the vaccines, “efficacy” in medical terms of granting complete immunity is different from “efficacy” in real-life terms. It is rare for people given any COVID-19 vaccine to get hospitalized.

I’ve noticed that expatriates in Hong Kong appear more willing to get vaccinated. This may be because they’re keen to travel. China’s very slow take-up on vaccinations is likely to hamper efforts to deploy its newly introduced “vaccine passport,” which also raises a lot of concerns over health-record privacy and sharing that information between governments.

In the United States, a commendable 32 doses per 100 people has been administered (not quite 32% vaccination because some people might have had a second shot). In China, the figure is 3.8 doses per 100 people.

It’s a very personal decision whether to get the shot or not. I understand, I’ll reiterate, if people hesitate about adopting this new technology. I don’t buy the first generation of a new phone or computer, and when I once did, it broke quicker than I expected.

Tuesday, I’ll try the new technology. I put my faith that the medical community has been working double, triple, quadruple time to get this right. Any company that produces a faulty vaccine would be destined for the scrapheap.

The medical community has been fooled before, yes. See MMR-autism, above. I’ll set this skepticism aside. I have kids, I meet a lot of people that I don’t want to infect. It’s the right thing, I feel, to do. One small shot for my arm, a giant leap of faith for mankind.