In Vaccine Geopolitics, a Great Game Played With Ukrainians’ Health
Lyudmyla Boiko’s family has already had a harrowing, and lethal, encounter with the coronavirus.
Several family members fell ill, and her daughter-in-law’s mother died. Now, Ms. Boiko, a 61-year-old employee of a botanical garden in eastern Ukraine, is deeply worried about her husband, who has underlying health problems but has not yet caught the virus. She is pinning her hopes on a vaccine.
“I don’t care where the vaccine is produced as long as I’m sure it is safe,” Ms. Boiko said. “Safety should be the first priority.”
But in Ukraine, it is hardly the only consideration.
The country, already caught up in the broader tug-of-war between East and West in European politics, has now also become a focal point in the geopolitics of coronavirus vaccines — so far, to Ukraine’s detriment.
First, talks with Pfizer and other Western vaccine makers to obtain early shipments collapsed after the Trump administration banned vaccine exports. Now, unless the incoming Biden administration steps in, the earliest commercial purchases of Western vaccines will not be delivered before late 2021.
Not surprisingly, Ukraine’s plight has caught the eye of Russia’s state-controlled news outlets, which have highlighted the failure of Ukraine’s Western allies to step up in a moment of need — and offering Russia’s vaccine as an alternative.
Ukraine’s leaders, who have raised worries about the safety and efficacy of the Russian vaccine and would, in any event, almost literally die before accepting help from Russia, their blood enemy, turned to China, buying its first vaccine in a hurried negotiation in the final two weeks of December.
“Russia, as always, uses this in its hybrid war, as an information weapon,” Maksym Stepanov, Ukraine’s health minister, said in a telephone interview of the country’s effort to inoculate its population. “The issue of vaccines is politicized.”
The Russian taunting has outraged Ukrainian public health experts, though there is little they can do to counter it without an alternative vaccine supply.
“Russia is pursuing an active policy of aggression, even with the vaccines,” said Oleksandr Linchevsky, a former deputy health minister. “It’s in Russia’s political interest that Ukraine receive the vaccines from elsewhere as late as possible,” because it wants to fill the gap with its own vaccine.
Ukraine, with a population of 42 million, is scheduled to receive eight million vaccine doses under the Covax program that supplies low- and middle-income countries that might not otherwise be able to gain access to vaccines. But those doses are not due to arrive until at least March. Negotiations for Western shipments later in the year are continuing, Mr. Stepanov said.
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Answers to Your Vaccine Questions
While the exact order of vaccine recipients may vary by state, most will likely put medical workers and residents of long-term care facilities first. If you want to understand how this decision is getting made, this article will help.
Life will return to normal only when society as a whole gains enough protection against the coronavirus. Once countries authorize a vaccine, they’ll only be able to vaccinate a few percent of their citizens at most in the first couple months. The unvaccinated majority will still remain vulnerable to getting infected. A growing number of coronavirus vaccines are showing robust protection against becoming sick. But it’s also possible for people to spread the virus without even knowing they’re infected because they experience only mild symptoms or none at all. Scientists don’t yet know if the vaccines also block the transmission of the coronavirus. So for the time being, even vaccinated people will need to wear masks, avoid indoor crowds, and so on. Once enough people get vaccinated, it will become very difficult for the coronavirus to find vulnerable people to infect. Depending on how quickly we as a society achieve that goal, life might start approaching something like normal by the fall 2021.
Yes, but not forever. The two vaccines that will potentially get authorized this month clearly protect people from getting sick with Covid-19. But the clinical trials that delivered these results were not designed to determine whether vaccinated people could still spread the coronavirus without developing symptoms. That remains a possibility. We know that people who are naturally infected by the coronavirus can spread it while they’re not experiencing any cough or other symptoms. Researchers will be intensely studying this question as the vaccines roll out. In the meantime, even vaccinated people will need to think of themselves as possible spreaders.
The Pfizer and BioNTech vaccine is delivered as a shot in the arm, like other typical vaccines. The injection won’t be any different from ones you’ve gotten before. Tens of thousands of people have already received the vaccines, and none of them have reported any serious health problems. But some of them have felt short-lived discomfort, including aches and flu-like symptoms that typically last a day. It’s possible that people may need to plan to take a day off work or school after the second shot. While these experiences aren’t pleasant, they are a good sign: they are the result of your own immune system encountering the vaccine and mounting a potent response that will provide long-lasting immunity.
No. The vaccines from Moderna and Pfizer use a genetic molecule to prime the immune system. That molecule, known as mRNA, is eventually destroyed by the body. The mRNA is packaged in an oily bubble that can fuse to a cell, allowing the molecule to slip in. The cell uses the mRNA to make proteins from the coronavirus, which can stimulate the immune system. At any moment, each of our cells may contain hundreds of thousands of mRNA molecules, which they produce in order to make proteins of their own. Once those proteins are made, our cells then shred the mRNA with special enzymes. The mRNA molecules our cells make can only survive a matter of minutes. The mRNA in vaccines is engineered to withstand the cell’s enzymes a bit longer, so that the cells can make extra virus proteins and prompt a stronger immune response. But the mRNA can only last for a few days at most before they are destroyed.
Before President Trump’s executive order banning vaccine exports from the United States, Ukraine had been in talks with Pfizer, Moderna and Johnson & Johnson to speed up delivery. Although the negotiations are continuing, the delivery times are being pushed back.
Ukraine’s president, Volodymyr Zelensky, has barely contained his outrage at his country winding up far back in the line for vaccines despite its precarious geopolitical position.
Russia has for six years been backing a separatist war in two eastern provinces of Ukraine while trying to drive a wedge between Kyiv and its Western allies. Vaccine politics are playing into the Kremlin’s hand.
“We are supposed to be like political acrobats to manage to get into a priority list” for vaccines, Mr. Zelensky said in an interview last month. The American export ban, he said, “put Ukraine at the end of the line.” In an end-of-the-year statement to Ukrainians, Mr. Zelensky wrote bitterly that, unfortunately, “the richest” countries would have vaccines first.
In late December, Ukraine hastened talks with Sinovac Biotech, a Chinese supplier, announcing on New Year’s Eve an order for 1.9 million doses, for delivery in early February. That is hardly enough, but still a geopolitical victory for China, providing a measure of relief when Western countries have looked the other way.
The vaccine situation has spawned an information war in Ukraine, fanned by Russia. Television stations broadcasting pro-Russian views and politicians aligned with Russia have accused Mr. Zelensky of allowing Ukrainians to die out of a stubborn refusal to take medicine from an enemy.
“The Ukrainian government wants to leave Ukrainians without the right for medical protection” by not accepting the Russian vaccine, called Sputnik V, for use in Ukraine, Viktor Medvedchuk, a politician favoring closer ties with Russia, said in a television interview.
Pro-Russian media outlets have reported with much fanfare that Biolik, a pharmaceutical company based in Kharkiv, in eastern Ukraine, has appealed to the health authorities for a license to manufacture Sputnik V, despite officials saying they have no plans to approve it.
The false promise of relief is a cruel twist of the propaganda knife for Ukrainians who are tired, as are people everywhere, of worrying about their loved ones.
Viktor Lyashko, Ukraine’s chief public health official, has said the country will not approve register Sputnik V not because it is Russian but because of deficiencies in its clinical trials.
But others object to the vaccine simply because it is Russian.
“We cannot rely on a Russian state company during an armed aggression against Ukraine,” said Arsen Zhumadilov, the director of medical procurement for the Ukrainian government. Russia is offering the potentially lifesaving vaccine even as its military intervention in the east has killed more than 13,000 people.
“It is so politicized it cannot be used,” Oleksandr Danylyuk, a former director of Ukraine’s national security council, said of accepting a vaccine from Ukraine’s enemy in the war. “There is no green lighting here. It would be impossible to do it.”
The rate of coronavirus infection in the country has slowed in recent weeks but still averages more than 7,000 new cases per day. Since the beginning of the pandemic, 19,712 Ukrainians have died from the virus. The country announced a lockdown starting this weekend.
“I understand the conflict around the Russian vaccine,” said Ms. Boiko, who worries about her husband, who has a heart ailment. “But I wish it were over soon.”
Andrew E. Kramer contributed reporting from Moscow.
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