[Depth of the Ring Time] What is the root cause of Taiwan's deep "vaccine shortage"?

  [Global Times reporter Zhao Juehui] Editor’s note: On June 17, when Taiwan’s epidemic prevention commander Chen Shizhong attended the “Legislative Yuan” meeting, he supported the self-produced new crown pneumonia vaccine and expressed “sorry” for the slow rate of vaccine procurement and purchase, but no Forget about making excuses such as "some countries are over-purchasing."

Regarding the response to the new crown pneumonia epidemic, the Taiwan region was once called "outstanding students for epidemic prevention" by the "New York Times" and other American media last year, but now this "myth" is being shattered-the "advanced deployment" of the DPP authorities is not only not advanced, Instead, the island faces a backward situation of lack of a new crown vaccine.

In Taiwan, the complex interweaving of political and economic interests, as well as technical "innate deficiencies", has led to difficulties in vaccine procurement and research and development.

Since the spring of this year, the "vaccine island" has become a common expression in the media on the island. After the sudden spread of the epidemic in May, public anxiety has also increased.

"The people need a vaccine" calls one after another, but for the DPP authorities frequently saying that "it will be possible to launch a self-produced new crown pneumonia vaccine as scheduled at the end of July", the people on the island are obviously not confident enough and generally hold a wait-and-see attitude.

 From "Premium Students for Epidemic Prevention" to "Vaccine Beggar"

  A recent report by the British Broadcasting Corporation (BBC) believes that since the Taiwanese authorities have maintained good epidemic prevention results until May this year, they are quite complacent and fail to maintain their due vigilance over the possible recurrence of the epidemic.

In March of this year, some countries and regions called for the suspension of vaccination due to severe side effects such as blood clots after the people were vaccinated with the AstraZeneca vaccine.

Although the relevant person in charge of the epidemic prevention department of the Taiwan authorities stated that "the chance of thrombosis among the yellow race is far lower than that of the white race" and called on the people on the island to continue to vaccinate AstraZeneca, but in fact the willingness of the people in Taiwan to be vaccinated is not high. .

It was not until the outbreak of the epidemic in May that when people scrambled to get vaccinations, they found that the island was in a dilemma of lack of vaccines.

The US "Fortune" magazine commented that the current round of the epidemic has exposed the weaknesses of the island's epidemic prevention. On the surface, the DPP authorities claim that they have purchased enough vaccines to vaccinate the majority of the people, but in fact there are only a small part of the vaccines. can use.

  Statistics from the "Our world in Data" website that tracks vaccination status on June 15 show that the number of people on the island of Taiwan who have received at least one dose of the new crown vaccine is 985,000, accounting for only 4.14% of the total population, far below 20.4%. World average.

Taipei citizen Li Jiajie reluctantly told the Global Times reporter: "From the perspective of per capita GDP, Taiwan is also in the ranks of developed countries, but in terms of vaccination, it turns out to be the least developed level in the world."

  The embarrassing situation facing the island is directly related to the lack of vaccines.

According to statistics from Taiwan’s "Key Review" website, as of the 15th of this month, the island has announced that it has ordered and received 31.8 million doses of the new crown vaccine, but only 2.116 million doses have been received, of which 1.24 million doses are still donated by Japan and are truly donated by the people. The Progressive Party authorities have obtained less than 1 million doses of vaccines through the New Coronary Pneumonia Vaccine Implementation Plan (COVAX) and purchases.

According to related BBC reports, when Taiwan began negotiating vaccine purchases last year, the first batches of vaccines produced by European and American vaccine companies had already been booked out by other countries and regions.

  In fact, Taiwan is not without the opportunity to quickly obtain adequate vaccines.

The Taiwan Affairs Office of the State Council has repeatedly stated that the mainland is willing to make arrangements quickly so that the majority of Taiwan compatriots will have mainland vaccines available as soon as possible.

However, under the political manipulation of "anti-land and anti-land", the DPP authorities refused on the grounds that "mainland vaccines are not safe and risky", "Taiwan needs to insist on original factory procurement", and "Taiwan-made vaccines will be launched soon" and other reasons. The mainland vaccine.

Some Taiwan media said that the attitude of the DPP is one sentence: I would rather Taiwan not have a vaccine than the mainland's "fake good intentions."

Wang Renxian, chairman of the Taiwan Anti-epidemic Association, told the Global Times reporter that the DPP authorities had a natural disadvantage in international vaccine procurement. After that, they excluded the mainland vaccine and the BNT vaccine that Fosun Pharma participated in the research and development and agency of the vaccine. , Can be said to be "self-breaking the road."

  Not only "should" the mainland, the DPP authorities have frequently found excuses to shirk their responsibility for ineffective "vaccine procurement".

On the 11th of this month, the DPP authorities claimed that the Taiwan region had ordered 10 million doses of AstraZeneca vaccine produced in the country from Thailand. However, due to Thailand’s policy of "vaccine prior to use in Thailand", Taiwan’s progress in obtaining vaccines It is delayed.

On the evening of the 12th, the Deputy Spokesperson of the Prime Minister's Office of Thailand directly issued a denial, saying that "Thailand has not blocked the export of vaccines" and "slapped the face" to the Cai authorities.

  Luo Zhiqiang, dean of the KMT Revolutionary Practice Research Institute, recently lamented how Taiwan has turned from an enviable “premium student for epidemic prevention” to a “vaccine beggar” seeking help everywhere. This is simply a “Taiwan miracle”.

He said that since the outbreak of the epidemic, the Tsai government has had a year and a half to prepare well, but it was intoxicated by the export of masks and declared "Taiwan Can Help" on foreign media, which caused the vaccine procurement work to lag behind.

 "Green Label Vaccine" is hard to be a life-saving straw

  When talking about vaccines made in Taiwan on the 17th, Chen Shizhong claimed that vaccines made in Taiwan belong to a strategic industry.

However, the actual research and development of Taiwan's self-produced vaccines has also been criticized by public opinion on the island.

Affected by various factors, the vaccine research and development of manufacturers on the island is not progressing smoothly.

In the "Taiwan Vaccine Promotion Association" announced at the end of last year, the top two in the "Top Ten Vaccine News" in 2020 were "Global R&D of New Coronavirus Vaccines" and "Taiwan's New Coronary Vaccine R&D Progress Is Seriously Lagging".

  In September last year, Chen Shizhong announced that Taiwan’s vaccine strategy has shifted from "emergency authorization manufacturing" to international pre-purchase and support for production by domestic manufacturers.

Previously, the island had tried to obtain emergency authorization from vaccine manufacturers such as AstraZeneca to be manufactured by Taiwanese manufacturers. However, Chen Shizhong said that due to the large demand for such production, the island is difficult to digest, and it is easy to fill the production capacity of Taiwan’s vaccines. , Therefore make policy adjustments.

  Wang Renxian, who served as the commander of the Central District Infectious Disease Prevention and Treatment Network of Taiwan’s Department of Health during the SARS epidemic, told the Global Times reporter that before the DPP authorities made this decision, Taiwan-made vaccines were not The focus of the vaccine policy, the authorities did not give enough support to vaccine manufacturers, driven by various interests behind it, caused such a policy shift.

  According to the analysis of the "Multidimensional TW" monthly magazine, as early as March 2020, high-end vaccines for enterprises on the island were authorized by the National Institutes of Health (NIH) and obtained the technology and platform for vaccine development.

It stands to reason that the authorities should prepare a special budget as early as possible to help guide enterprises to accelerate development.

However, it was not until the middle of 2020 that the Taiwan authorities approved the high-end, Lienya, and Guoguang vaccines to enter the phase I clinical trial. At the end of the same year, the high-end vaccine entered the phase II clinical trial.

In this process, the procurement of overseas vaccines has continued to hit walls, and the test data of island manufacturers have become more clear. The DPP is willing to disclose that it will implement a pre-procurement plan for the island’s vaccines.

As the policy shifted, the DPP authorities began to "betting on" Taiwan-made vaccines.

On May 30, the DPP authorities announced that they had purchased 5 million doses of vaccines from high-end and Lianya manufacturers, and signed a follow-up expansion purchase contract with an additional upper limit of 5 million doses.

In other words, the number of self-produced vaccines purchased by the Taiwan authorities can reach 20 million doses.

  At present, the high-end vaccine on the island has just released the results of Phase II clinical trials, and Lianya Vaccine is still undergoing Phase II clinical trials. However, the earliest Guoguang vaccine had to re-run Phase I clinical trials because its antibody levels failed to meet the standards.

  On the 10th of this month, the high-end vaccine company developed by the island’s high-end vaccine company developed Phase II clinical trial data. This is Taiwan’s first new crown vaccine to release Phase II clinical trial data. The high-end company will also report to Taiwan’s Food and Drug Administration based on the above data. "Apply for emergency use authorization.

This vaccine can be said to have been placed high hopes by the DPP authorities. Taiwanese leader Tsai Ing-wen has visited high-end vaccine companies twice before.

Taiwan's "New News" magazine and other media disclosed that the reason why the green campers chose the high-end vaccine platform is largely because Lin Zouyan, the general host of the second phase of the high-end vaccine trial plan, was Tsai Ing-wen’s first post in 2016. "Minister of Health and Welfare", and is familiar with Tsai Ing-wen's important medical staff and former Director of the Department of Health, Li Mingliang, and others.

According to Taiwanese media, high-end vaccines are dubbed "green-label vaccines" by the industry.

  One of the most questioned high-end vaccines is that on May 18 this year, before the blinding of its phase II clinical trial, Tsai Ing-wen announced that the Taiwan-made vaccine would be launched at the end of July, which made the island’s public opinion question the DPP authorities. Are you using political power to "escort" high-end vaccines.

  Earlier this month, Chen Peizhe, an academician of Taiwan’s “Chinese Academy of Sciences,” announced his resignation as a “self-produced vaccine review committee” due to unbearable pressure from the green camp. He also bluntly stated that the biggest reason for not maintaining professionalism and impartiality was the Taiwan authorities.

Zhao Shaokang, chairman of Taiwan’s “China Broadcasting Corporation,” asked, “The second phase of the high-end vaccine in May has not yet solved the blindness, and Tsai Ing-wen announced that it can be administered at the end of July, but she said that the food and drug department should strictly review it? Taiwan-made vaccines Should the review committee seriously check? Even if the Taiwan authorities are free, do you dare to take the risk?"

  "Choosing which vaccine to get is a political science." The island media "New News" stated that there are green camp "blessings" behind high-end vaccines, and there are "non-green scholars" behind Lianya Vaccine.

The clinical trial execution hospital of Lianya Biotech is Taiwan’s “Tri-Service General Hospital”. The convener is Zhang Fengyi, a professor of infectious diseases, who served as the “Director of the Department of Health’s Disease Management Bureau” during the “SARS” period in 2003.

 Insufficient research and development capabilities are "ignored"

  Under various manipulations behind the scenes, the confidence of the Taiwanese people in vaccines produced in Taiwan has also continued to decline.

A recent survey conducted by the Taiwan portal "yahoo Qimo" showed that 68% of netizens surveyed did not want to receive high-end vaccines, and less than a quarter of those who expressed their willingness to vaccinate.

Although Taiwan's medical standards are relatively high, the research and development and production of various vaccines are not long-term.

Zhang Hongren, chairman of the Taiwan Research and Development Biotechnology and New Drug Development Association, said at a meeting on the emergency development strategy of Taiwan’s new crown vaccine last year that in terms of vaccine self-sufficiency rate, compared with Europe and the United States (100%), Japan (59%), and South Korea ( 38%) and China (85%), and Taiwan's self-sufficiency rate (8%) is clearly lagging behind.

Public reports show that most of the various conventional vaccines used in Taiwan are imported from outside the island, while only a small part is produced locally, and some people on the island are only willing to vaccinate imported vaccines.

A Taipei citizen said disappointedly: "We are still waiting. Although we don't want to launch vaccines in Taiwan, but because the epidemic is too terrible, and the imported vaccines are not enough, many people have no choice but to choose. How about self-produced vaccines, no one knows. ."

  Wang Renxian told the “Global Times” reporter that Taiwan’s vaccine research and development capabilities have limitations. Although there is a certain basis for the development of traditional vaccines such as inactivated vaccines, such as the island’s largest vaccine manufacturer Guoguang Biotechnology, the quality of influenza inactivated vaccines is good, but Research and development institutions and manufacturers on the island have little experience in new vaccines such as mRNA (messenger ribonucleic acid) vaccines and adenovirus vector vaccines, and "lack of these new technologies and related supporting industries."

The above-mentioned factors mentioned by Wang Renxian have to a certain extent affected the choice of Taiwanese manufacturers in the development of new crown vaccines.

According to media reports on the island, the three vaccines currently undergoing clinical trials by Taiwanese manufacturers—high-end, Lianya, and Guoguang—are all recombinant subunit protein vaccines, that is, "put the eggs in the same basket."

Industry insiders believe that this is because Taiwan does not have the strong production capacity of inactivated vaccines like the mainland, nor does it have the ability to innovate in vaccine pathways such as mRNA and adenovirus vectors. Therefore, there are not many choices.

  Wang Renxian emphasized that the Phase II clinical trials of Taiwan’s self-produced vaccines mainly verify the safety and antibody levels, but the true protective effect requires Phase III clinical trials. “If it is an mRNA vaccine and an adenovirus vector vaccine, only the results of the Phase II clinical trial will be obtained. Emergency use authorization is acceptable, but the high-end and Lianya vaccines are'innately insufficient', and it is impossible to believe their protective power."

Speaking of the relatively slow progress of Taiwan’s self-produced vaccines, Zhuang Shilihe, a doctor who has been paying attention to the new crown vaccine for a long time, told the Global Times reporter that recombinant protein vaccines are a relatively mature technical route. The technical route is used as an explanation for the slow progress of Taiwan manufacturers’ research and development. The reason is not working.

  A large number of voices on the island are also questioning the DPP authorities’ attempt to approve the emergency use of high-end vaccines based on the results of phase II clinical trials.

The Kuomintang "legislator" Zheng Liwen recently criticized that Tsai Ing-wen's professional political leadership has led the outside world to question that the success of high-end vaccines is a political decision that overrides science and lacks credibility.

Former “Director of the Disease Management Bureau” Su Yiren also said that because self-produced vaccines still lack phase III test data, Taiwan cannot consider self-produced vaccines for the time being, and people’s safety should be put first.

  Despite the widespread criticism, public opinion on the island predicts that high-end vaccines will be authorized for emergency use in the near future.

Wang Renxian predicts that in the future, as the procurement of vaccines and Taiwan-made vaccines continue to arrive, Taiwan may form a situation: some people will choose Taiwan-made vaccines, some people will choose foreign vaccines, and some people will choose to go to the mainland or The United States vaccinates.

Wang Renxian said: "In principle, these people together can basically complete Taiwan's vaccine protection net, but it will be difficult to see."