TAIPEI -- Taiwan on Monday joined a small group of the world's COVID-19 vaccine producers as it rolled out a new domestic vaccine made by Medigen Vaccine Biologics Corp.
President Tsai Ing-wen was one of the first Taiwanese to receive a dose of the protein subunit vaccine. But the rollout has been met with relatively little fanfare because of misinformation shared on social media and criticism from the opposition Kuomintang.
As Taiwan's sixth round of vaccinations began on Monday for people age 36 and over, only 69% of applicants included Medigen in their vaccine choices, prompting the Central Epidemic Command Center to open up registration for the remaining 298,000 doses to people aged 20 to 35.
This despite preliminary data showing a seroconversion rate in the ninetieth percentile, according to Taiwan Food and Drug Administration director Wu Shou-mei.
More than one million people have signed up for Medigen -- many of them appear to be younger Taiwanese or foreigners.
James Bell, a New Zealand native, who was due to get his first dose of Medigen on Monday morning, told Nikkei Asia that his Taiwanese clients were surprised he had chosen the domestic vaccine because it is not yet internationally recognized.
"I had to tell them in as nice of way as possible... I don't really care about brands, I just want to get vaccinated as soon as possible. I find this whole thing we have in society where people are shopping for vaccines like they are shopping for phones is really weird," Bell said.
Even his Taiwanese wife expressed some concern about Medigen, whose efficacy has been questioned in Taiwan's Chinese-language press.
Much concern comes from the fact that when Medigen was granted emergency authorization use on July 19 it had only completed phase two clinical trials in Taiwan. A small phase three trial in non-laboratory conditions is now underway in Paraguay, one of Taiwan's few diplomatic allies and a country that is also facing a severe vaccine shortage.
Two top Kuomintang figures, former Health Minister Yaung Chih-liang and former KMT vice chairman Hau Lung-bin, tried and failed this month to ask a court to revoke Medigen's emergency use authorization due to insufficient testing.
Taiwanese social media, meanwhile, has been hit hard with vaccine misinformation and conspiracy theories since its most serious outbreak began in May, ranging from fears that the vaccines would include a microchip or cause miscarriage to claims traditional Chinese medicine can defeat the delta variant.
Other concerns may be more practical as some Taiwanese, familiar with diplomatic isolation, are worried that if they receive Medigen it will not be recognized when they travel abroad.
Chunhuei Chi, director of the Center for Global Health at Oregon State University, said Taiwan is facing not only coronavirus but also a "political virus" from the "persistent misinformation attacks that spread just like the virus."
Chi said contrary to public concerns, preliminary research showed Medigen was as effective or possibly more so than AstraZeneca and had also received technical support from renowned research institutions like the U.S. National Institutes of Health.
In a bid to promote Medigen, former Vice President Chen Chien-jen and his wife have revealed they participated in phase two trials. They were given a placebo dose but later opted to receive Medigen after the study ended.
The difference between phase two and phase three trials is that one is conducted in laboratory-like conditions, while the other is held in the real world. Phase three, however, can come with ethical concerns as some subjects will be given a placebo.
Taiwan began the vaccine race last year with five options in development, although only Medigen has crossed the finish line after another close contender, United Biomedical, did not meet the Food and Drug Administration's antibody standards last week.
After facing a severe vaccine shortage in the late spring, Taiwan has inoculated 9.26 million people, or 39% of its population, with one dose. But only 745,000 people have received both doses as of Friday, according to state news outlet Focus Taiwan.
While around 600,000 doses of AstraZeneca have been obtained through the COVAX program, the majority of Taiwan's vaccines have been obtained as donations of AstraZeneca and Moderna from the U.S., Japan, and Lithuania.
Three of Taiwan's top tech companies have privately signed contracts to secure future doses of Pfizer-BioNTech after a deal with Taiwan's government fell apart earlier this year over reported influence from China.
Taiwan has seen fewer than 16,000 confirmed cases and 827 deaths, but the vast majority occurred during the most recent outbreak in May and fears persist about the arrival of the delta variant.
For the 18 months prior, Taiwan was considered one of the most successful places in the world at containing COVID and even saw several months in 2020 without a single case.