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Chinese COVID vaccine finds few volunteers in Pakistani trial

Despite close ties with Beijing, conspiracy theories make many hesitate

Pakistan has selected five hospitals in three major cities for a clinical trial of a Chinese COVID-19 vaccine but so far is having trouble getting the expected 8,000 to 10,000 participants to sign up. (Source photos by Reuters)

ISLAMABAD -- Pakistan, one of China's closest allies, has been struggling to find volunteers for its part of a multicountry Phase 3 clinical trial of a Chinese vaccine against the new coronavirus.

"Hospitals ... have been facing difficulties in recruiting volunteers for the trials because of the flood of misinformation, mainly on social media," a senior official at the National Institute of Health (NIH), a government-run research body, told Nikkei Asia on condition of anonymity.

In September, Pakistan approved the final phase of clinical trials for the single-dose vaccine candidate Ad5-nCoV, codeveloped by CanSino Biologics, a Tianjin-based Chinese vaccine company, and the Academy of Military Medical Sciences, a Chinese military-backed research arm. In return, China will supply COVID-19 vaccines to Pakistan as priority.

For the Ad5-nCoV Phase 3 trial, slated to conclude in January 2022, nearly 40,000 volunteers are expected to participate from Argentina, Chile, Mexico, Saudi Arabia, Russia and Pakistan.

Islamabad, which is economically close to Beijing and has $50 billion in infrastructure projects under China's Belt and Road Initiative, has selected five hospitals in Karachi, Islamabad and Lahore for the clinical trial, in which 8,000 to 10,000 people are expected to take part. Pakistan has also received massive Chinese medical and financial assistance since the outbreak of the coronavirus.

The government of Pakistani Prime Minister Imran Khan has been receiving massive medical and financial assistance from Beijing under President Xi Jinping.   © Reuters

The NIH official said that trouble in collecting trial volunteers is not a phenomenon unique to Pakistan. "Globally, many people distrust particular vaccines, or new ones, which they might perceive to be inadequately tested," the official said.

According to the World Health Organization, 47 vaccine candidates were being clinically evaluated as of Nov. 5, of which 11 -- including Ad5-nCoV -- were in Phase 3 trials.

Pakistan's Phase 3 trial is its first ever for any vaccine. Asking ordinary people to volunteer for even the small earlier phases of vaccine trials is rare for the country of 220 million, leading health authorities to confront a challenge of vaccine hesitancy.

The government has not officially released the number of volunteers who have so far signed up. However, The Indus Hospital (TIH) in Karachi one of the five hospitals selected for the trial -- said around 500 had volunteered there since Oct. 13, though its target is 2,000.

TIH official Fawad bin Rashid told Nikkei that people have misconceptions about vaccine trials, but "the number of people who were willing to volunteer for the tests have gradually been increasing, and hopefully the target could be achieved."

Campaigns against foreign vaccines are not new to Pakistan.

The country has already grappled with disinformation around long-established vaccines, particularly for polio. Many parents refuse the polio vaccine for their children, believing it is poisonous or part of a U.S. plot to sterilize children in Islamic nations, making Pakistan the polio virus' last refuge in the world, along with neighboring Afghanistan.

Propaganda and conspiracy theories about the coronavirus have been widespread. A survey conducted in October by Gallup Pakistan showed that 55% of Pakistanis were unsure if the virus is real and that 46% considered it part of a conspiracy.

A video of cleric Kaukab Noorani Okarvi falsely accusing doctors of killing coronavirus patients has spread widely on social media. He also asserts that the COVID-19 vaccine would include a microchip letting Jews control people's minds.

Other theories include: the government gets more foreign funding if more people test positive; Pakistanis have natural immunity, keeping deaths comparatively low; and the disease is more harmful to Westerners than South Asians.

However, some people are defying the disinformation and taking part in the trial in the hope of ending a pandemic that has so far killed more than 1.2 million across the globe. Rashid, the TIH official, cited the example of a taxi driver who signed up and was quoted as saying that Islam teaches us to serve humanity.

Unlike the U.S. and Europe, where companies or sponsors of clinical trials run awareness campaigns and advertisements to enroll volunteers, the clinical trial for the coronavirus vaccine is a low-profile affair in Pakistan.

The government and physicians have begun efforts to overcome COVID-19 disinformation by engaging media and clerics. On Tuesday, the government published front-page advertisements in newspapers urging people to volunteer for the trial.

Daily new coronavirus cases in Pakistan peaked at more than 6,000 in June before falling sharply. However, a new wave has started, with 1,376 new cases and 30 deaths confirmed on Friday, bringing the cumulative number of cases to 340,251 and deaths to 6,932.

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