Omicron lineages BA.5.2 and BF.7 account for 97.5% of all local infections in China, according to the Chinese Center for Disease Control and Prevention. With new cases spreading rapidly, the National Health Commission (NHC) announced a national fourth booster vaccination campaign. Consequently, Chinese vaccine developers are focused on expanding their COVID-19 pipelines to include targeted vaccines with the ability to tackle new variants, says GlobalData, a leading data and analytics company.

According to GlobalData’s Pharma Intelligence Center, there are currently 19 COVID-19 vaccines in clinical development in China, with only 3 candidates in Phase III trials. Most of these are mRNA vaccines (58%), followed by subunit vaccines (16%), inactivated vaccines (11%), and others including recombinant vector vaccines, and DNA vaccines.

Anupama Mishra, Pharma Analyst at GlobalData, comments: “Currently, 87% of the Chinese population has completed a primary homologous vaccination series with two doses of either Sinopharm or Sinovac’s vaccines, while only 55% have received a third booster dose, according to the World Health Organization (WHO). Both vaccines are inactivated vaccines and are not targeted against the prevailing Omicron variants. This has led to high demand for heterologous booster doses, which differ from the primary vaccine given to fully vaccinated recipients.”

The WHO has urged China to increase adoption of mRNA vaccines, given their high efficacy against variant strains. According to the WHO, two doses of Sinopharm’s vaccine, BBIBP-CorV, are 79% effective against COVID-19 symptoms and hospitalization, compared to roughly 95% for two doses of mRNA-based vaccines from either Pfizer/BioNTech and Moderna.

Currently, BioNTech/Pfizer’s mRNA vaccine is approved for use only by German nationals living in China, while Moderna’s vaccine has not been granted any type of approval.

Mishra adds: “Chinese regulators must approve or import mRNA vaccines and increase heterologous booster dosing to strengthen their national immunization program.”

According to GlobalData’s Pharma Intelligence Center,13 homegrown vaccines have been approved for use against COVID-19 in China. In December 2022, Clover Pharmaceutical’s SCB-2019 was granted Emergency Use Authorization and was also included in the NHC’s fourth booster dose implementation plan.

Clover anticipates long-term demand for SCB-2019 due to the large market opportunity for annual booster doses in China. Since most of the Chinese population has been vaccinated with a homologous vaccine series, high demand is anticipated for new vaccines to administer as heterologous booster doses.

The NHC has also announced an upgraded vaccination strategy by expediting research and review of clinical trials for vaccines with potential to be tailored against omicron variants or designed to target multiple variants in one dose.

Mishra concludes: “As COVID-19 continues to surge in China, it is becoming increasingly important for Chinese pharmaceutical companies and regulators to allow approval of newer, more effective vaccines and to expand vaccination programs for the nation to develop herd immunity. As a result, pharmaceutical companies that develop vaccines with efficacy against Omicron subvariants will gain a significant competitive advantage in China.”