My Say: The ripples of Covid-19 vaccination


In 1972, in a conversation with legendary US secretary of state Henry Kissinger, former Chinese premier Zhou Enlai was asked about the impact of the 1789 French Revolution. Zhou answered, “Too early to say.”

It was a truly magnificent answer. Alas, the truth is much plainer than fiction. Zhou was actually answering in reference to the more recent French students’ revolt in 1968. Nonetheless, the general idea that monumental events have long, outstretched reaches over time is worth exploring.

For instance, Tamim Ansary, in his book The Invention of Yesterday, sketches the link between the construction of the Great Wall of China and the fall of the Roman Empire. Another example he provides is how climate change in Scandinavia may have contributed to the humbling of the Song dynasty in China, the Turkification of the Islamic world, the Afghan expansion into northern India and the Crusades.

Covid-19 is one such monumental historical event. Its next phase — global vaccination — is, I believe, another such event. It really is too early to tell what the long-term effects of Covid-19 will be, particularly on education, social structures, inequality, social protection and economic growth.

We can hazard (relatively) educated guesses, but some effects will only be seen decades out. The same is true of vaccination. In just a year, we have managed to not only sequence the genetic code of this novel coronavirus but also develop several vaccines — with a variety of scientific methods — and mass produce them for distribution globally.

Such a testament to science and technology, as well as global production and distribution, will leave ripples. We are starting to see the start of some of these ripples. How will they collide with other ripples as we make our way through time is something we can only conjecture. It is only with the passage of time that we will be able to see some of the unintended consequences of the global efforts on vaccines and vaccination. In this essay, I want to discuss four ripples.

The first is on vaccine production and distribution. Recent data (as at March 26) from the European Commission showed that the total vaccine doses produced by China, the US, India, the EU and the UK. While the production numbers are incredible in their own right — for instance, China has produced 229 million doses while the US, India and the EU have produced 164 million, 125 million and 165 million doses respectively — it is the breakdown of production for domestic and export purposes that is most striking.

China, for example, produced 120 million doses for its domestic market and exported 109 million doses. India’s number was 70 million domestic and 55 million for export, while the EU registered 88 million doses for domestic use and 77 million doses for export.

The US, in contrast, produced all of its 164 million doses for its domestic market. It did not export a single dose. The same is true of the UK with its 16 million doses. To be clear, I do not know where the long-term ripples of this will lead to but I believe it will lead to something. The world will observe the behaviour of a present global leader and a past global leader, as well as other vaccine-producing countries, and these observations will lead to future consequences.

Second, similar to vaccine production, countries are also drawing lines in the sand with regard to vaccine intellectual property rights. Given the devastation of Covid-19 globally, it is obvious that countries would like to speed up the production and distribution of vaccines, especially in their own countries.

Doing this, however, requires a waiver on intellectual property rules specifically on Covid-19 vaccines. According to Médecins Sans Frontières, most of the developing world is in favour of this, including China, India and most of Southeast Asia (there is no data on Malaysia), but opponents to the waiver include wealthier countries such as those in the EU, the US, Japan, Australia and, strangely, Brazil.

To be fair, some of these stances may change. For instance, the White House is reviewing the possibility of lifting the intellectual property shield on Covid-19. But at a recent World Trade Organization meeting, richer members blocked a push by over 80 developing countries to waive patent rights.

Just as is the case with limits on vaccine exports, I believe that decisions not to waive patent rights will be remembered moving forward and will have large repercussions. For instance, should there be a future scenario where developing countries are pioneers of a global solution, they may be less accommodating in sharing those solutions with the wealthier nations than they might be with China and India.

The schism between developed and developing countries — already vast after centuries of colonialism and oppression — is far more likely to widen than it is to narrow after this episode.

Third, this is not to say that developing countries are not indulging in some form of vaccine geopolitics either. In mid-March, via embassies in about 20 countries, China announced that it would specifically facilitate visas for those who had received a Chinese-made Covid-19 vaccine.

This issue is not a technical scientific one — China can always ask its top medical regulators to inspect any World Health Organization-approved vaccine for safety. The issue is strictly political. Given China’s economic power, and the need for nearly every country in the world to build economic ties with it, China may therefore sway countries towards procuring only the Chinese vaccines while eschewing others.

This may also lead to retaliation from the usual suspects, leading to a far more bifurcated world, not just in terms of health but also in things like investments, trade and technology. This will certainly have important repercussions over the next few decades.

Domestically, how Malaysians — from the most powerful politicians to the most humble of us — have behaved will also be remembered. A crisis as destructive as Covid-19 will always be a marker or point of reference for everyone and we are not out of the woods yet.

The new daily cases remain high even if active cases have dropped significantly since January. And it is in this instance that I think vaccinated individuals, particularly those with more public-facing roles, have an even larger responsibility to play in keeping us safe.

The good news is that there is now clinical evidence that the Moderna, Pfizer and AstraZeneca vaccines are highly effective in preventing asymptomatic infections. Prior to this, it had not been proved that vaccinated individuals could be infected (though they would not suffer the onset of the disease) and may transmit the virus to others. Now, it looks like they may not get the virus at all.

This is great but while more Malaysians are getting vaccinated every single day, there are still millions more of us who are not yet vaccinated. As such, those who are “safe” have a higher obligation to keep the rest of us “safe”. We must not confuse personal safety with societal safety.

Nicholas Khaw is an economist at the Khazanah Research Institute

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