An employee manually inspects syringes of the SARS CoV-2 Vaccine for COVID-19 produced by Sinovac at its factory in Beijing. [AP]

Provincial governments across China are placing orders for experimental, domestically made coronavirus vaccines, though health officials have yet to say how well they work or how they may reach the country’s 1.4 billion people.

Developers are speeding up final testing, the Chinese foreign minister said during a UN meeting last week, as Britain approved emergency use of Pfizer Inc.’s vaccine candidate and providers scrambled to set up distribution.

Even without final approval, more than one million health care workers and others in China who are deemed at high risk of infection have received experimental vaccines under emergency use permission. There has been no word on possible side effects.

China’s fledgling pharmaceutical industry has at least five vaccines from four producers being tested in more than a dozen countries including Russia, Egypt and Mexico. Health experts say even if they are successful, the certification process for the United States, Europe, Japan and other developed countries might be too complex for them to be used there. However, China said it will ensure the products are affordable for developing countries.

One developer, China National Pharmaceutical Group, known as Sinopharm, said in November it applied for final market approval for use of its vaccine in China. Others have been approved for emergency use on people deemed at high risk of infection.

“We must be prepared for large-scale production,” said Vice Premier Sun Chunlan, who has overseen much of the country’s response, during a visit Wednesday to developers, according to the official Xinhua News Agency.

Sun visited one of Sinopharm’s Beijing subsidiary companies; another producer, Sinovac, and a research lab under the National Medical Products Administration, a regulatory agency that approves medical products for public use.

The government has yet to say how many people it plans to vaccinate. Sun said plans call for vaccinating border personnel and other high-risk populations this month.

The companies are using more traditional techniques than Western developers.

They say unlike Pfizer’s vaccine, which must be kept frozen at temperatures as low as minus 70 degrees Celsius (minus 94 Fahrenheit), theirs can be stored at 2 to 8 C (36 to 46 F). The Chinese producers have yet to say how they might be distributed.

Health experts question why China is using experimental vaccines on such a vast scale now that the outbreak is largely under control within its borders.

Health officials previously said China will be able to manufacture 610 million doses by the end of this year and ramp up to one billion doses next year.

The government of Jiangsu province, where the major city of Nanjing is located, issued a procurement notice for vaccines from Sinovac and Sinopharm on Wednesday for emergency use vaccinations. Authorities in Sichuan province in the west, which has about 85 million people, announced on Monday they were already buying vaccines. An official newspaper in Anhui province, southeast of Beijing, said a local residential committee issued a notice asking whether residents want a vaccine.

The Sichuan and Anhui announcements said the vaccine, given in two shots, would cost a total of 400 yuan (Sh6,674).

Vaccines from Sinovac and Sinopharm were approved for emergency use in July.

In October, Zhejiang province south of Shanghai offered the public vaccination under emergency use authorisation. It said people considered high-risk would get priority.

In November, the Communist Party secretary for Sinopharm said almost one million people had received its vaccine.

In September, Sinovac’s CEO said about 3,000 of its employees had taken their vaccine. He said the company provided tens of thousands of doses to the Beijing city government.

Developers have yet to disclose how effective their vaccines are and possible side effects.

Sinopharm has clinical trials under way in 10 countries including the United Arab Emirates, Egypt, Jordan, Peru and Argentina with nearly 60,000 volunteers. It has built two facilities in China capable of producing 200 million doses per year.

Sinovac has trials in Brazil, Turkey and Indonesia. Its most recent publicised data, a study in the science journal the Lancet, showed its candidate produced lower levels of antibodies in people than those who had recovered from Covid-19. The company projects it will be able to produce a few hundred million doses of the vaccine by February or March of next year.

Another producer, CanSino, is testing in Russia, Pakistan and Mexico and pursuing partnerships in Latin American countries.

Its vaccine, which has been used on an emergency basis with the Chinese military, uses a harmless adenovirus to carry genes into human cells to generate an immune response.

A fourth company, Anhui Zhifei Longcom Biologic Pharmacy Co., is conducting final stage trials across China.

And in Russia, Moscow began distributing the Sputnik V Covid-19 shot via 70 clinics on Saturday to the most exposed groups, marking Russia’s first large-scale vaccination against the disease, the city’s coronavirus task force said.

The Russian-made vaccine will first be made available to doctors and other medical workers, teachers and social workers because they run the highest risk of exposure to the disease.

“You are working at an educational institution and have top-priority for the Covid-19 vaccine, free of charge,” read a phone text message received by one Muscovite, an elementary school teacher, early on Saturday and seen by Reuters.

President Vladimir Putin has ordered a nationwide voluntary vaccination programme to begin next week. He said Russia will have produced 2 million vaccine doses within the next few days.

The head of the Russian Direct Investment Fund (RDIF), Kirill Dmitriev, said in an interview with the BBC on Friday that Russia expects to give the vaccine to about 2 million people this month.

“Over the first five hours, 5,000 people signed up for the jab - teachers, doctors, social workers, those who are today risking their health and lives the most,” Mayor Sergei Sobyanin wrote on his personal website on Friday.

Already vaccinated

Russia has already vaccinated over 100,000 high-risk people, Health Minister Mikhail Murashko said earlier this week during a separate presentation to the United Nations about Sputnik V.

Among the first people signing up to the Moscow roll-out, Nadezhda Ragulina, an administrator at a Moscow clinic, said she wanted the vaccine as she had witnessed many Covid-19 patients.

“This is my decision... Some people close to me also have had an experience (of Covid-19). That’s why I want to protect myself, my relatives, to obtain the immunity,” she told Rossiya-24 state TV channel.

Moscow, a city of around 13 million people, has been the epicentre of Russia’s coronavirus outbreak. It reported 7,993 new cases on Saturday, up from 6,868 the day before and well above the daily tallies of around 700 seen in early September.

The age for those receiving shots is capped at 60. People with certain underlying health conditions, pregnant women and those who have had a respiratory illness for the past two weeks are barred from vaccination.

Russia has developed two Covid-19 vaccines, Sputnik V which is backed by the Russian Direct Investment Fund and another developed by Siberia’s Vector Institute, with final trials for the both yet to be completed.

Scientists have raised concerns about the speed at which Russia has worked, giving the regulatory go-ahead for its vaccines and launching mass vaccinations before full trials to test its safety and efficacy had been completed.

The Sputnik V vaccine is administered in two injections, with the second dose is expected to be given 21 days after the first.

Deputy Prime Minister Tatiana Golikova said on Friday that the vaccinated should avoid public places and reduce their intake of medicine and alcohol, which could suppress the immune system, within the first 42 days after the first jab.