Tag Archives: vaccine

Have I Been Given a Dodgy Pfizer Shot in Hong Kong?

March 24, 2021 By in Asia, Business, China, Coronavirus, Covid-19, Hong Kong, Investment, Stock market, Vaccine Tags: , , , , , , , , , , , , , , , Leave a comment

Lies, damn lies, and statistics in the vaccine age, as Hong Kong and Macau stop administering the Pfizer/BioNTech drug.

This story first appeared on TheStreet.com on Wednesday, March 24, 2021.

I’ve been given a dodgy vaccine dose.

Hong Kong and Macau have today suspended delivery of the Pfizer/BioNTech/Fosun shots. The Chinese local distributor, Fosun, requested the halt of the first batch of the vaccine to reach these shores. Batch 210102 consists of 585,000 doses. Eight days ago, I got one.

The markets moved on the suspension. The Hang Seng Index opened slightly lower after yesterday’s 0.8% drop in the S&P 500. But as morning word broke of the vaccine halt, the Hang Seng faltered, ending Wednesday down 2.0% at its lowest level in more than 10 weeks. The Hong Kong benchmark is now in a technical correction. It has fallen 10% since a February 17 peak.

Now, I’m not too worried. About the vaccine, at least. I’m worried the negative news will delay shots getting into arms, and ultimately the economic opening up of Hong Kong and Asia in general.

There have been reports of “more than 50” instances of defective packaging for the Pfizer drug made by front-line nursing staff. Those reported defects include cracks in the tops of the glass vials, leaks, or stains on the outside. There’s no apparent safety threat.

The defective doses have been thrown out. Fosun, which received the packaging complaints, wrote to the governments in Hong Kong and Macau, telling them to suspend use of the drug as a precaution. It’s undecided how long the suspension will last. Fosun distributes the drug in China, while Pfizer sends it around the rest of the world.

The sudden halting of the BioNTech vaccine will raise further doubts in the minds of a Hong Kong public that is already highly skeptical about getting inoculated, as I explained before I got my shot. The Pfizer/BioNTech drug is one of only two available so far in Hong Kong. The administration of the Chinese-made Sinovac vaccine can continue.

We need to be very careful about how we respond to such reports. The tendency, as I exaggerated at the start of this article, is to think “Oooh, vaccine, dodgy.” AstraZeneca (AZN) is contending with far worse such misperceptions. The authorities should investigate if the Pfizer doses already administered have had the right strength.

I was, by chance, asked to provide some media training today for a major fund manager. The media coaching is something that I do very occasionally, when my corporate news sources request it. Here I was, giving the reporter’s eye view to companies administering their PR.

My early comments focused on three biases that are prevalent in today’s media: negative news bias (we remember bad news better), availability bias (we ascribe greater importance to news we’ve recently read) and confirmation bias (we seek out, by choice of news source or through algorithmic suggestions, news stories and data that support what we already believe).

The halting of the vaccines has Availability Bias written all over it. So, too, do the issues over the AstraZeneca jab concerning both blood clots in Europe and the veracity of its 79% efficacy rate.

An easy way of thinking about the combination of these biases: You never read about a plane that doesn’t crash.

It’s an exaggeration, we have all probably read a story about a pimped-out Gulfstream or a stealth bomber or two. We just remember the plane crashes.

Nevertheless, there have been an average of 14 fatal accidents for commercial and cargo planes globally per year over the last five years, according to the Aviation Safety Network, resulting in 345 deaths per year. In 2020, there were five commercial passenger-plane accidents, killing 299 people.

There were 42,060 people who died in vehicle crashes in the United States alone in 2020. The pandemic and empty roads seem to have encouraged reckless driving: the figure was up 8% over 2019, and the highest since 2007, even though people drove 13% less. What’s more, the fatality rate per 100 million miles driven spiked 24%, the largest annual jump ever, since the National Safety Council started collecting data in 1923. Speed, drugs and perhaps empty roads coupled with a deadly pandemic that encourage reckless behavior are factors.

Hardly anyone is afraid of hopping in a car. Plenty of people are terrified to fly. Yet even when you break it down into accidents per mile travelled, driving is far more dangerous.

It is far more dangerous to get Covid than to get a Covid vaccine. Covid is killing more than 20,000 people per week in Europe. Controversially, it might have been advisable for Europe to continue to give people the AstraZeneca vaccine even if they knew it was causing dangerous blood clots… but on further investigation, and to the best of our knowledge, it is not, anyway.

I need to write “to the best of our knowledge,” because we’re handling a health emergency in real time. The newly developed drugs involve vaccines developed in a year, when the process normally takes a decade. We have learnt a lot about Covid over the course of the pandemic, and will continue to learn about both it and the drugs designed to contain it.

Many European nations screeched to a halt with their AstraZeneca programs when the red flag was raised over concerns about suspiciously timed blood clots. At that time, there were 18 cases of cerebral sinus vein thrombosis, of which one was fatal, out of 20 million people vaccinated in Europe. That’s 0.00009% blood clots, and 0.000005% that were fatal.

Random chance determines that some people are going to get blood clots, and that seems to be what has been going on, although the clotting issue is still being investigated. In fact, the number of blood clots was lower than average in the general population, AstraZeneca says. But blood clots have become the plane crashes of the vaccine age.

Here in Hong Kong, I can tell you every single case of hospitalization after someone got a vaccine. On Monday, the latest info available, there were 20 people taken to hospital after receiving a dose, as this daily report outlines. “A female aged 58 suffered from dizziness,” one report starts. “A male aged 46 suffered from palpitation and increase in blood pressure,” another begins. “A female aged 20 suffered from loss of consciousness and abdominal pain,” and so on.

While this public record may be necessary, it also isn’t all that useful. What we want to know is, did the vaccine cause those effects? Did the person faint or get high blood pressure because they were stressed out? As a direct result of the drug? Because they don’t like needles? Or because they watched a scary movie on their phone while they waited?

Our Negative News Bias tells us it’s directly because of the vaccine drug. Our Availability Bias tells us everyone feels faint, when in fact 20 Hong Kongers had typically very minor reactions out of 23,400 people who got a dose that day: 0.085%. And we don’t even know why those 0.085% of people had that response. Confirmation bias tells anti-vaccers they were right all along.

The Hong Kong government reports that around 403,000 people have so far been vaccinated against Covid-19. Of those, 150,200 received the BioNTech vaccine, and 252,800 got the Sinovac jab. So about one-quarter of the original BioNTech Batch 210102 has been administered. The second Batch 210104 of 758,000 doses is all in storage.

The Sinovac numbers are higher because it was available first, and was for a while the only anti-Covid dose you could get. Mainland China is encouraging people to get a Chinese-made vaccine if they want streamlined entry to China, even though a Chinese vaccine is not available in many places, including the United States.

The BioNTech vaccine has been proving far more popular with the folks I know. Yesterday, about twice as many people signed up for the BioNTech/Pfizer shot as the Sinovac option. Its 95% efficacy figures are far higher than for Sinovac, which has variously been cited as 50.4% effective in Brazil, 65.3% in Indonesia and 91.3% in Turkey. The World Health Organization suggests a minimum efficacy of 50% – meaning 50 out of 100 people have total immunity – for a vaccine to be approved.

I’ve already indicated that I do not think the Sinovac drug should have been cleared in Hong Kong. The company has not released its clinical trials data to the public. It has not been properly peer reviewed. Hong Kong has broken its own public health rules to approve the drug, desperate to get a Chinese alternative into arms first before any “foreign” drug.

The 95% efficacy rate of the Pfizer/BioNTech drug has yet to be challenged. Should these defect reports dent its reputation in the public eye? According to the Hong Kong director of health, there have been eight incidents of cracked BioNTech vials, 22 air-pressure issues leading to leaks, 16 reports of vial seals being loose, and 11 cases of stains or marks on the outside.

That’s 57 incidents out of a batch of 585,500 doses. That’s a rate of 0.0097%. I like those odds. I’ve got an appointment to get my second dose three weeks after the first – assuming that this temporary halt in the vaccine program lifts.

It’s an appointment I intend to keep.

Vaccine Skepticism May Hold Back Asian Recovery

March 24, 2021 By in China, Communist Party, Coronavirus, Covid-19, Geopolitics, Hong Kong, Stock market, Vaccine Tags: , , , , , , , , , , Leave a comment

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.