The WHO Approval and Support for China’s COVID-19 Vaccines in Taiwan

Written by Wen-Chin Wu, Greg Sheen, Hans H. Tung, Chien-Hui Wu.

Image credit: Syringes with vaccine with World Health Organization logo by Jernej Furman/Flickr, license CC BY 2.0

As COVID-19 began to spread from China to the world in early 2020, experts predicted that Taiwan would have “the world’s second-worst outbreak after China” ). Nevertheless, Taiwan was almost COVID-19-free until mid-May 2021 due to a set of successful policies, such as strict border control, population-based contact tracing of confirmed cases, and encouragement to wear facial masks. The “normal” pre-COVID-19 life lasted for almost one year until May 19, 2021, when Taiwan declared a nationwide COVID-19 Level 3 alert. The total number of confirmed COVID-19 cases in Taiwan since early 2020 had soared from 1,132 on May 1 to 8,511 on May 31, 2021. With the sudden surge in cases and deaths, the question of when and how the government would procure enough vaccines for its citizens had become extremely salient.

Before the outbreak in May 2021, Taiwan had procured only 316,200 doses of AstraZeneca (AZ) vaccines. Yet, the low number of daily confirmed cases and the reported side effects of the AZ vaccine discouraged Taiwanese citizens from vaccination. Now that the public had started worrying about contracting the virus and the death toll of COVID-19 increased since May 2021, the Taiwanese government was struggling to obtain vaccines from abroad.

Concerned about the central government’s failure to obtain supplies of vaccines from overseas and the slow development of domestic ones, many people, including entrepreneurs and local government heads, have begun sourcing vaccines elsewhere. According to a report in China’s Global Times, many Taiwan residents, including political figures, are losing faith in the incumbent Democratic Progressive Party (DPP):

so they came to the Chinese mainland to seek solutions such as getting vaccinated or purchasing Chinese mainland-made vaccines.”

While this claim is hardly mainstream, it suggests that China may be a source of COVID-19 vaccines for Taiwan. However, scepticism toward “made-in-China” products is high in Taiwan as in many other countries worldwide, and misgivings about Chinese vaccines are widely reported. As a result, the procurement of vaccines becomes politicized in Taiwan. In particular, Taiwan’s attempt to purchase supplies of the Pfizer-BioNTech vaccine encountered setbacks because Shanghai Fosun Pharmaceutical, a Chinese company, is the distributor of the Pfizer-BioNTech vaccine in the Greater China area including Taiwan. As a result, the anti-China sentiment makes it even more controversial for Taiwan to consider procuring vaccines from China. The vaccines are developed by Germany and the US but distributed by a Chinese company.

At the same time, two Chinese vaccines, those produced by Sinopharm and Sinovax, obtained WHO approval in June 2021. The WHO approval makes the option of accepting Chinese vaccines a fundamental subject of debate. While it is unlikely for the incumbent DPP government to introduce COVID-19 vaccines developed by China into Taiwan, it is still worthwhile to examine how the public in Taiwan view Chinese vaccines and how WHO approval is likely to affect their views when Taiwan is in urgent need of COVID-19 vaccines.

We utilized this window of opportunity to explore how Taiwanese citizens would support government procurement of foreign and Chinese vaccines before they arrive in Taiwan. Therefore, from late May to early June 2021, we recruited 956 respondents online and conducted a survey experiment to investigate the effect of WHO endorsement on Chinese vaccines. We found that although Chinese vaccines are very unpopular among Taiwanese citizens, the WHO endorsement of Chinese vaccines had a positive causal effect on acceptance of Chinese. We describe our findings below.

In our survey experiment, we manipulated two conditions: the origins of COVID-19 vaccines (Foreign vs China) and the information of WHO approval (Specified vs non-specified). Specifically, we randomly assigned each respondent to one of the following four groups under different vignettes, which varied in terms of the origins of the COVID-19 vaccines and whether the WHO had approved them. The first manipulation of vaccine origins investigated whether respondents’ support for government procurement differs according to the origin of the COVID-19 vaccines. We found the respondents were most supportive of the procurement of foreign vaccines (95.76%) and least supportive of Chinese vaccines (38.49%). In other words, our respondents prefer foreign vaccines in general over Chinese vaccines.

The second manipulation examined whether our respondents would be more supportive of a COVID-19 vaccine approved by the WHO and included in COVAX. Our survey results suggest that the support rate of Chinese vaccines approved by the WHO is 47.90%, which is 9.42% higher than the support rate for Chinese vaccines without any information concerning WHO approval.

Our study further found that respondents’ trust in China and the WHO plays a crucial role in inducing their support for the procurement of Chinese vaccines. Respondents with a low-level trust in China also disfavour Chinese vaccines, whereas those who trust the WHO more than China support the government procurement of Chinese vaccines approved by the WHO.

Our findings have an important implication to Cross-Strait relations. Taiwanese citizens’ distrust of and scepticism for China make Chinese vaccines unpopular in Taiwan. Yet, the WHO endorsement of Chinese vaccines can slightly enhance the acceptance of Chinese vaccines among Taiwanese. In other words, the availability of the WHO’s verification mechanism provides a natural solution to China’s credibility deficit as the WHO enjoys the reputation of being a professional agency to deal with pandemics. Furthermore, if China would become more transparent in its information and compliant with international standards, it can also establish its credibility in the eyes of the Taiwanese public.

Wen-Chin Wu is Associate Research Fellow, Institute of Political Science, Academia Sinica, Taipei, Taiwan. wenchinwu@sinica.edu.tw

Greg Sheen is Postdoctoral Research Fellow, Division of Social Science, NYU Abu Dhabi, Abu Dhabi, United Arab Emirates. gregcsheen@gmail.com

Hans H. Tung is Associate Professor, Department of Political Science, National Taiwan University, Taipei, Taiwan. Email: hanstung@ntu.edu.tw

Chien-Hui Wu is Associate Research Fellow, Institute of European and American Studies, Academia Sinica, Taipei. Taiwan. wch@sinica.edu.tw

This article was published as part of a special issue on Taiwan’s Covid-19 Spike. You can find all articles in the special issue here.

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