Taiwan blames China for slowing down its access to Covid-19 vaccines. The reality is more complicated

As countries ravaged by the coronavirus rushed to vaccinate their populations earlier this year, there was little sense of urgency to get inoculated in Taiwan.

The island of 23 million people had recorded close to zero local infections for months, and demand for the vaccine was so low that only 1% of the population was vaccinated.

But in this pandemic things can change quickly. Today, Taiwan is battling its worst outbreak yet, reporting more than 1,000 new cases in the past week, and has a population that wants the vaccine — but can’t get it.

Now, the Taiwanese government is asking the United States for a share of the shots President Joe Biden plans to send abroad, as it waits for other deliveries to arrive.

But in theory, there could be a solution for Taiwan right on its doorstep: Chinese vaccines.

China has sent tens of millions doses of its domestically developed vaccines around the world. But tensions across the Taiwan Strait have run high since the pandemic, with Beijing blocking Taiwan’s participation at the World Health Organization, courting Taipei’s dwindling allies and ramping up military pressure on the self-governed island, which it considers part of its territory.

Amid growing hostility and distrust, Taipei has outright refused to accept Chinese-made vaccines from Beijing, citing Taiwanese law banning the import of Chinese vaccines for human use. That’s a move Beijing has blasted as tantamount to “sacrificing people’s well-being for its own political interests.”

Taipei doesn’t see it that way, and has accused Beijing of blocking its supply, rather than trying to boost it.

On Wednesday, Presidential Office spokeswoman Kolas Yotaka said on Twitter: “Taiwan access to vaccines continues to be slowed down by Chinese interference, while they insist we buy Chinese made ones. If you really want to help please don’t stand in the doorway, don’t block up the hall.”

Yotaka did not offer details on alleged Chinese interference. But in February, the island’s Health Minister Chen Shih-chung revealed in a radio interview that Taiwan and BioNTech were about to sign a contract for 5 million vaccine doses in December, until the deal fell through due to “political pressure.” While BioNTech has a distribution deal in greater China with the Shanghai-based firm Fosun Pharma, Beijing denies obstructing the Taiwan deal.

But as a war of words around vaccines rages on, the reality is Taiwan’s slow vaccine rollout goes far deeper than geopolitical tensions with China.

Limited supplies

Taiwan has ordered 20 million vaccine doses — enough to fully vaccinate 43% of its population. But, so far, only about 700,000 doses have arrived, and all are made by AstraZeneca.

According to the island’s official Central News Agency (CNA), Taiwan signed a deal with AstraZeneca last year to purchase 10 million doses of its vaccine. In March, 117,000 doses were finally shipped from a South Korean factory, becoming the first vaccines to arrive on the island.

Taiwan also ordered 4.76 million doses through COVAX — the global initiative backed by WHO to ensure equitable access to Covid-19 vaccines. The first batch of 199,200 shots arrived in early April, followed by a second delivery of 400,000 doses on Wednesday.

In February, Taiwan signed a contract for 5 million doses with US vaccine maker Moderna. The island’s Central Epidemic Command Center said the shots were expected to be delivered this month. Last week, Taipei’s top official in Washington said the shipment is now scheduled to arrive in June, CNA reported.

Hsiao Bi-khim, Taiwan’s de-facto ambassador to the US, said as demand for vaccines in Taiwan was initially low, she had focused on helping Taipei’s diplomatic allies secure vaccines. But now she is working to ensure Taiwan’s orders are delivered on time, according to CNA.

Low interest

The Taiwanese government rolled out its vaccination program in late March, offering the first shots to medical staff. The program was later expanded to include police officers, care workers, the elderly and the military.

In mid-April, it allowed people outside the government’s priority list to be vaccinated at a cost of 600 New Taiwan dollars ($21) per shot.

But interest in taking the vaccine was low, as people had been enjoying a largely normal life for months, going to bars, restaurants, concerts and baseball games. There were also concerns about side effects, amid reports of blood clots in people who had received the AstraZeneca vaccine.

“Over the last 1.5 years, Taiwan did not experience a major outbreak, so many residents did not feel they were in any immediate danger,” said Chen Hsiu-hsi, an epidemiology professor at National Taiwan University. “This is why not many people had the incentive to take Covid-19 vaccines.”

But the spike in cases this month has caused alarm, prompting some residents to rush to get vaccinated. Before the latest batch from COVAX arrived on Wednesday, Taiwan had used up two-thirds of its 300,000-dose vaccine supply.

As supplies run short, the Taiwanese government has suspended the paid-for program, reserving all remaining doses for frontline workers, according to the CNA.

Chen Hsiu-hsi, the epidemiologist, said about 30% of Taiwan’s medical workers had now been vaccinated. He is hopeful that number will reach 50% with the newly arrived 400,000 doses of the AstraZeneca vaccine.

Developing its own vaccines

When it comes to developing its own Covid-19 vaccine, Taiwan has lagged the efforts of the US, the UK, Germany, China and Russia.

The island’s three coronavirus vaccine candidates went into clinical trials last August, five months after China and the US started testing their first vaccine candidates in humans.

While some health experts have blamed the Taiwanese government for not providing enough support for the island’s drug companies to develop vaccines, it looks as if they are finally making headway.

On Tuesday, President Tsai Ing-wen said two Taiwanese vaccine candidates had reached the end of stage 2 clinical trials.

According to Tsai, the two vaccines developed by Taiwanese companies, Medigen Vaccine Biologics Corporation and United Biomedical, are expected to become available by the end of July, if they secure emergency use authorization next month.

Chen, the epidemiologist, said he was optimistic about Taiwan’s domestically developed vaccines. “They have reported good results in stage 2 clinical trials, and it looks like they also respond well to different variants in a laboratory setting.”

Until then, Chen said, Taiwan will need to rely on foreign vaccines to deal with the crisis — but just not those from its closest neighbor with the largest supply.