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China opens its borders to foreigners who take Chinese shots, as geopolitical vaccine silos emerge

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Hong Kong (CNN) – China facilitates the entry of foreigners into the countries. But there is one condition: they must have received a Covid-19 made in China vaccine.

At least 23 Chinese embassies around the world issued new visa policies over the past week with this condition, including the United States i United Kingdom – both places where Chinese vaccines are not available.

China’s Foreign Ministry says the measure is to start international travel in an “orderly” manner and that vaccinated travelers will still face state quarantine on arrival.

But experts have expressed concern about China’s decision to prioritize national vaccines over those approved by the World Health Organization and with a higher efficacy rate.

They say it runs the risk of pressuring countries to approve Chinese vaccines and setting a dangerous precedent that, if adopted by other nations, could leave the world in vaccine-based silos.

It also raises practical questions: What options do people have if they live in countries that have not approved vaccines made in China?

“It’s very much the end of vaccine diplomacy,” said Nicholas Thomas, an associate professor of health security at Hong Kong City University. “(Es) essentially saying that if you want to visit us, you have to take our vaccine.”

A man receives a dose of Sinovac Covid-19 vaccine during the mass vaccination program on March 2, 2021 in Yogyakarta, Indonesia.

A man receives a dose of Sinovac Covid-19 vaccine during the mass vaccination program on March 2, 2021 in Yogyakarta, Indonesia.

Ulet Ifansasti / Getty Images

What is behind the movement?

The timing of China’s new visa rules is remarkable.

After the Quad, a partnership between the United States, India, Japan and Australia, met last week, U.S. President Joe Biden announced together they would finance, manufacture and distribute at least one billion vaccines for the Indo-Pacific by the end of 2022.
These vaccines would be developed in the US and manufactured in India, which has been dedicated to its own vaccine diplomacy around the region. Some saw this as a direct opposite of China’s vaccine diplomatic efforts, which it did recently criticized by U.S. Secretary of State Antony Blinken, who says Chinese vaccines include “ropes.”

China has been one of the leading countries in vaccine development and, as of March 15, China had exported vaccines to 28 countries, according to the Chinese mission to the UN. Massive public vaccination programs with Chinese vaccines are underway in Indonesia and Turkey. In China alone, 65 million people have been vaccinated with the five vaccines approved by the country nationally.

But none of China’s vaccines have yet been approved by the WHO or published full data from phase 3 trials, leading to a lack of clarity about the effectiveness of the vaccines. Available data suggest that vaccines in China may actually be less effective than other vaccines; Sinovac, for example, had an effectiveness rate of 50.38% in final phase tests in Brazil, lower than the 78% announced in China and lower than the effectiveness rate of other vaccines such as Pfizer, which reported 95% efficiency rate.
Health authorities officers unloaded the Covid-19 vaccine produced by Sinovac China, under the guard of police from the pharmacy warehouse in Surabaya, Indonesia, on January 13, 2021.

Health authorities officers unloaded the Covid-19 vaccine produced by Sinovac China, under the police guard of the pharmacy warehouse in Surabaya, Indonesia, on January 13, 2021.

Ahmad Mukti / Riau Images / Barcroft Media / Getty Images

This means that China cannot claim its preference for self-produced vaccines because it is because they are superior to other vaccines. Instead, Thomas sees China’s new visa rules as a “power movement,” which will pressure people to take one of China’s vaccines.

Sarah Chan, a bioethics lecturer at the University of Edinburgh School of Medicine, says that if someone’s livelihood depends on traveling to China to work, this could push them to take the vaccines, despite the their lack of data. Scott Rosenstein, director of Eurasia Group’s global health program, said he could also pressure countries to authorize Chinese vaccines.

Some people may suffer from health conditions which means they are unable to perform certain traits. “It’s just not justified that so much of what we do depends on whether or not we’ve had a vaccine, much less whether we’ve had a particular version of the vaccine,” Chan said.

While China’s new visa rules encourage travelers to take Chinese vaccines, Zhao Lijian, a spokesman for China’s Ministry of Foreign Affairs, rejected the idea of ​​”vaccine nationalism.”

“Regardless of where a vaccine is made, it’s a good vaccine as long as it’s safe and effective.” He said at a press conference on Monday. “China is ready to move forward in mutual recognition of vaccination with other countries.”

What are the long-term effects?

China’s move comes as countries around the world address the broader question of whether to deploy so-called “immunity passports” to open international trips to people who have antibodies to the coronavirus, either because they have recovered from ‘he or by means of a vaccine.

But this raises more questions: if an immunity passport grants special rights to vaccinated people, what vaccines should be counted?

One option is to follow WHO authorization. Currently only four vaccines, including two versions of the AstraZeneca / Oxford vaccine, have received an emergency use list from the WHO, and none are manufactured in China.

Another option is to let the 194 member states of the World Health Organization vote: those vaccines approved and recognized by most countries would set the standard, according to Thomas.

Dr. Akay Kaya, right, and a nurse Yildiz Ayten from Bahcesaray Public Hospital arrive in the remote village of Guneyyamac in eastern Turkey to vaccinate residents 65 and older with the Sinovac CoronaVac vaccine Covid-19, February 15, 2021.

Dr. Akay Kaya, right, and a nurse Yildiz Ayten from Bahcesaray Public Hospital arrive in the remote village of Guneyyamac in eastern Turkey to vaccinate residents 65 and older with the Sinovac CoronaVac vaccine Covid-19, February 15, 2021.

Bulent Kilic / AFP / Getty Images

But a uniform vaccine passport for the world is a long way off. For now, countries are likely to simply recognize the vaccines they have approved for use, and there are already indications that they are leading to silos.

He The European Commission announced this week a green digital certificate with a QR code to show if a person has been vaccinated. But member states will just give up free movement restrictions for people vaccinated with shots that have received EU marketing authorization: people who have received Chinese shots can stay cold.

“It’s this beer-making challenge that I think will be interesting to see,” Rosenstein said. “It will create some tension and increase that pre-existing diplomatic tension of the vaccine.”

Rosenstein said even people could choose to take several vaccines so they can travel to other regions, a step unlikely to have negative health effects, but which could stress the supply of vaccines.

What is the best way forward?

Even apart from the problems in deciding which vaccines are accepted, there are other issues related to immunity passports: we don’t know how long it will last Covid-19 hard, either from virus recovery or vaccines. There are also ethical issues: while the WHO is working on a “smart digital certificate” that includes information on vaccination, it discourages the use of vaccine passports to travel. “There is a global shortage of vaccines,” said Hans Kluge, WHO director in Europe Thursday. “So that would increase inequalities.”
A woman has a phone showing a mock-up of China's new digital health certificate, the first known implementation of a "virus passport" concept, March 9, 2021.

A woman has a phone showing a mock-up of China’s new digital health certificate, the first known implementation of the “virus passport” concept, on March 9, 2021.

Nicolas Asfouri / AFP / Getty Images

Chan sees a lot of problems with immunity passports, especially high-tech digital ones that include data privacy issues. He also points out that once everyone has had the opportunity to get vaccinated, vaccine passports could quickly become obsolete, meaning that money could be better spent elsewhere.

A better approach would be to make sure vaccines are as widely available as possible, he said. Then, when much of the world’s population has been vaccinated, immigration authorities can use simpler approaches, such as asking the public to find out if they have had a vaccine. If some people lied, the risk to the general population would still be small, as most people had been vaccinated, he added.

Thomas also expects a scenario at best in which countries do not follow China’s example; instead, they treat all vaccinated people in the same way, regardless of the vaccine, as long as the vaccine has data confirming its effectiveness. He hopes that countries can stop treating the launch of the vaccine as a race and instead treat it as a global health problem.

“Viruses don’t care about borders, they don’t care about nationalities or races, or religions, or ideologies, or ethnicities, or anything like that, they just want to replicate and mutate,” he said.

“And I think unless we take a truly global approach to vaccines and recognize that we just have to do the best we can globally, then we’ll be seeing Covid’s latent puddles that will grow back in the future and possibly as the second wave of the Spanish flu, mutating in such a way that it makes it worse than before “.

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