Authors: Yves Tiberghien and Jackie Jiaqi Zhao, UBC
On August 23, Taiwanese President Tsai Ing-wen became the first world leader to receive an all-new vaccine designed and manufactured in Taiwan, MVC-COV1901 from Medigen Vaccine Biologics Corporation, which has yet to complete phase trials. three. This is the most recent and controversial step in Taiwan’s vigorous response to the sudden wave of COVID-19 it experienced in May.
Taiwan has been remarkably effective in stopping the spread of COVID-19 in 2020, mobilizing its central epidemic command center as early as January 20, 2020. Taiwan immediately ramped up production of tests, masks and respirators, closed its borders and launched efficient contact tracing with coordinated information sharing. Schools and restaurants remained open. With such measures, Taiwan ended 2020 with just 799 cases, seven deaths and economic growth of 2.9%.
Taiwan initially continued to maintain control. As of April 30, 2021, he had experienced a total of 1,128 cases and 12 deaths over 16 months. But in May, the dam burst. Cases reached 8,511 at the end of May (with 600 new cases per day at the end of this month) and 14,804 at the end of June. Deaths reached 730 on July 9.
The emergence of new, highly transmissible variants triggered the peak. But Taiwan’s preparedness had weakened, due to complacency over time and the delay in vaccine deployment. Before the outbreak, the government relaxed its quarantine measures for unvaccinated airline pilots. A handful of China Airlines pilots were later found to have contracted the virus. From there, it spread to Taiwan’s adult entertainment “teahouses” and finally to local communities in mid-May.
Taiwan has succeeded in overcoming this sudden wave mainly by refocusing on its basic methods and maintaining high levels of social cohesion. Lockdown measures have been raised to level three, including a warrant to wear the mask in all public places, a ban on non-essential indoor services, stopping religious recreation and gatherings, and the use of the Distance Learning. Contact tracing and quarantine measures were tightened while foreign nationals were not allowed to enter the island.
The measures worked. As of September 17, Taiwan had an average of eight new cases and zero new deaths per day (on a seven-day moving average) and a very low total death rate of 35 per million.
But the May surge highlighted Taiwan’s vulnerability due to the late vaccine rollout. As of June 15, only 0.1% of the population was fully vaccinated and 4% had received a dose. The delay was motivated by the public’s reluctance to take the AstraZeneca vaccine. Only 41% of the public were ready to get the vaccine in April, given Taiwan’s full control over the pandemic.
In response to the crisis, Taiwan has stepped up ordering of Western vaccines. He obtained 17 million doses, including 3.4 million doses from Japan and 2.5 million doses from the United States. But these are insufficient. Thus, Taiwan had to switch to plan B.
In order to acquire more Pfizer-BioNTech doses while complying with the company’s decision to distribute the vaccine through its Shanghai subsidiary, Taiwan authorized an unusual deal between the private and civil society. Electronics companies Foxconn and TSMC, as well as the Tzu-Chi Buddhist Foundation, have ordered 15 million doses of Pfizer vaccine and 1.84 million doses have been delivered to Taiwan to date. Yet this arrangement has proved controversial, given the complicated state of relations between the two sides of the Strait – 33% of the public do not want to take this vaccine due to its shipment through Shanghai.
Meanwhile, Taiwan’s efforts to develop its own vaccine have gained public attention. The Medigen vaccine was developed in cooperation with the American company Dynavax. It completed its phase two trials in July and was granted emergency use clearance on July 19. Phase three trials have started in Paraguay, a country with diplomatic ties with Taiwan.
This vaccine strategy divides the Taiwanese public. Although the Medigen vaccine is based on early antibody count data, which are positive, it will take longer to verify its actual effectiveness. Its rapid deployment is becoming a highly political issue, and the opposition doubts its effectiveness and its security. Only 54% of Taiwanese are ready to take it. The controversy over the slow roll-out of vaccines is now in the hands of the Progressive Democratic Party government.
In the first four weeks of the deployment until September 17, nearly 721,000 Taiwanese received the vaccine. 13 people have died after taking it (possibly from other causes), but the death rate is extremely low and comparable to other vaccines. In total, only 7 percent of the population is fully vaccinated to date (and 49 percent have received at least one dose).
Two lessons emerge from Taiwan’s recent experience with COVID-19 – even the best metrics erode over time through complacency and fatigue, and it’s nearly impossible to be COVID-19 safe without adequate vaccine deployment.
Yves Tiberghien is Professor of Political Science, Konwakai Chair in Japanese Research and Director Emeritus of the Institute of Asian Research at the University of British Columbia. He is also Distinguished Fellow at the Asia-Pacific Foundation of Canada. He is the author of everything just released The East Asian Paradox (Cambridge University Press 2021).
Jackie Jiaqi Zhao is a doctoral candidate in law at the Peter A Allard School of Law at the University of British Columbia.