In the first week of 2020, the first China-made HPV vaccine was approved by Chinese drug regulators. The domestically produced HPV vaccine became a major topic of discussion on Chinese social media. On Weibo alone, the topic received more than 580 million views since early January.
The human papillomavirus (HPV) vaccine prevents infection with the specific viral infection that causes cervical cancer. The earliest HPV vaccine, ‘Gardasil’ by American multinational pharmaceutical company Merck & Co., first became available in 2006. Along with Pfizer’s ‘Prevnar 13’ – the vaccine deployed for the prevention of pneumococcal pneumonia – Gardasil is among the world’s best-selling vaccines.
With the introduction of the first Chinese HPV vaccine, the virtual monopoly position of Merck’s vaccine might now change as the Chinese vaccination is entering the market.
The Chinese vaccine is named ‘Cecolin’ (馨可宁), and was co-developed by drug maker Innovax (万泰沧海生物技术) and Xiamen University. It is intended for girls and women aged 9-14 (two shots needed) and 15-45 (three shots needed). According to CGTN, some 8 million shots will be produced in China in 2020.
Gardasil and Cecolin are not entirely the same, however. Gardasil is a so-called quadrivalent vaccine, which targets four different antigens (HPV types 6, 11, 16 and 18), while Cecolin is a bivalent vaccine only protecting against HPV 16 and 18 types, the two most common viruses leading to cervical cancer. Another type of HPV vaccine is the nonavalent kind, the Gardasil 9 vaccine, preventing diseases caused by HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58.
Nearly all sexually active people will be exposed to HPV at some point in their life, and if girls and women are given the vaccine before any natural infection with HPV, the vaccines have been shown to protect against pre-cancer of the cervix. Males can also get the quadrivalent and nonavalent HPV vaccines to protect against genital warts, anal precancers, or the spread of HPV to sexual partners.
While Chinese media emphasize the fact that China is now the third country in the world, after US and UK, to succeed in producing its own HPV vaccine, one of the topics receiving the most attention on Chinese social media is the price of the Cecolin vaccine.
Cecolin is currently priced at 329 yuan (US$47) per shot, which is considerably cheaper than the approximate $250 per dose of the Gardasil vaccine in the United States.
The nonavalent vaccine costs about 1300 yuan or more per shot in China ($186+), with the quadrivalent Gardasil being priced at approximately 800 yuan per shot ($115), and the imported bivalent vaccine costing 600 yuan per dose ($86).
Weibo user shares receipt of 9-valent vaccine, 1338 yuan per dose.
Many Weibo commenters praise the arrival of the Chinese vaccine and its relatively low price. A complete vaccination programme would now only be either 660 or 1000 yuan ($94/$143, depending on needing two or three shots) instead of $260 or more.
“Whoa that’s cheap!” some commenters write, with others saying: “This makes it possible for the poorer girls to get their shots.”
But there is also a lot of discussion on the quality of the vaccine, and whether the bivalent vaccine is effective enough (for clarity -the two HPV types the vaccine protects against causes 84.5% of all cervical cancers in China). Some Weibo users say they would still like to get the more expensive nonavalent vaccine instead – even if they will need to spend around 4000 yuan ($570) on their completed shots.
Other commenters are most concerned with the general availability of HPV vaccines in China, as there is still a shortage of vaccinations.
The imported HPV vaccine was issued 1,46 million times in 2017, going up to 7 million shots in 2018 and 8,7 million in 2019. On Weibo, some commenters say they have previously gone to Hong Kong to get their shot.
One user from Nanjing writes: “I made an appointment for my site and needed to wait for four months, I finally got it. I don’t want to wait around for the domestic shot to become available here.”
A Weibo user from Liaoning is appreciative that those who want to have the vaccine now have more options: “If you can financially afford it, you can choose the nonavalent vaccines, if you can’t afford it, you can get the quadrivalent or bivalent ones.”
Starting from May of 2020, Cecolin will be available at community hospitals across various regions in China.
By Manya Koetse
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