Ethan Zhang had to go back to work. However, the work took place in Ivory Coast, and since January the global coronavirus outbreak had stranded the 26-year-old translator in mainland China.
Then friends told Mr. Zhang how he could get his hands on what is perhaps the most coveted award in the world: a coronavirus vaccine. Although China's vaccine candidates have not been formally proven safe or effective, officials have injected them into thousands of people across the country, allegedly as part of an emergency policy. Such a campaign, his friends said, is ongoing in the city of Yiwu, east China.
Mr. Zhang took a plane from Beijing to Yiwu that night. He stood in line for four hours outside a hospital. He paid $ 30. He got his shot.
And he expressed little concern that the substance that had been injected into his arm is still in the testing phase, an attitude that is of concern among global health experts.
"I feel relieved now that I have protection," said Mr. Zhang. "Since they use it on some people in an emergency, it shows that there is a certain guarantee."
China has made its unproven candidates widely available to demonstrate its safety and effectiveness to a country that has long been skeptical of vaccines after a spate of quality scandals. Government officials and senior pharmaceutical companies pride themselves on being vaccinated.
The campaign may have turned out too well. Yiwu's 500 cans were consumed within hours. Other cities limit the dose or ask people to provide proof that they are traveling. The overwhelming demand has inspired a home industry of scalpers – called "yellow cows" in China – the people who usually get the latest iPhones or hot train tickets – and charge up to $ 1,500 for an appointment.
These users could take great risks. People who have taken ineffective vaccines may think they are safe and are acting risky. You may be excluded from taking another, better vaccine because you have already been injected. In some cases in the past, unproven vaccines have created health risks.
The potential problems often go undiscussed. Copies of a candidate's vaccination authorization form that were reviewed by the New York Times did not state that the product was still being tested.
"These types of risks have not been clearly identified," said Yanzhong Huang, a senior fellow on global health at the Council on Foreign Relations and an expert on health care in China.
Any reports of death or illness could rekindle suspicions about vaccines. China has vowed for years to clean up its vaccine industry after scandals.
"We risk losing confidence in people if adverse effects actually occur," said Kristine Macartney, director of the National Center for Immunization Research and Surveillance in Sydney, Australia.
It is unclear how many people have already received a vaccine candidate. China has provided three of its four candidates for late-stage human testing, known as phase 3 trials, to tens of thousands of state-owned company employees, government officials and company executives since July. Upon completion of the Phase 3 studies, the companies would present the results to the regulatory authorities in the countries where they plan to sell their vaccines. The authorities would review them and rate them for approval.
Local governments have announced that they plan to make the current vaccines available to more people. Beijing says it is monitoring those who received the vaccines but has not released any details.
The contrast with the United States is stark. A growing number of polls have shown that many Americans would not take the coronavirus vaccine, which could jeopardize efforts to fight the pandemic. According to a global online survey published in Nature magazine in October, respondents from China gave the highest percentage of positive responses when asked if they were taking a "proven, safe and effective vaccine."
"There's this trend in China:" Everyone gets it, so I want it too, "said Jennifer Huang Bouey, senior policy researcher at RAND Corporation." Your problem is different from the US. You probably need to think about how not to cause a stir with vaccination, and not as much as how to try to introduce it. "
Chinese officials have defended the supply of vaccine candidates. Zheng Zhongwei, a top official at the Chinese National Health Commission, said last month that in the face of the overseas outbreaks, the move was a "very necessary means of protecting people's lives and health". Last week, Sinopharm chairman Liu Jingzhen announced that around 100,000 people have taken the company's vaccine and have so far had no side effects. He said 56,000 of them traveled overseas after taking the vaccine and none were infected.
China's drive has taken on nationalist overtones, and many celebrate the fact that the country has candidates in late-stage trials.
Wang Mingtao, a 43-year-old employee of a gold mining company in Ghana, posted a video about Douyin, China's version of TikTok, of people lining up at the Beijing headquarters of Sinopharm, the state-owned Chinese drug maker, to get the vaccine with the slogan : "My country is powerful."
Mr. Wang, who had traveled to Beijing from northern Xian City, said he was not worried about taking an experimental vaccine. He paid $ 150 for the vaccine, which was made by a subsidiary of Sinopharm, the Beijing Institute of Biological Products.
The doses are not always given as they should. On September 26th, Mr. Wang was shot two times, one in each arm. The two doses should be given 14 or 28 days apart. Mr. Wang said he was in a rush to travel and did not want to return to Beijing.
"The country says this vaccine is fine," he said, "so I think it's better to just take it."
Mr. Liu, chairman of Sinopharm, said that "under special circumstances," the two doses could be given to each arm at the same time, according to Guangming Daily. The two shots are said to be administered days apart for a stronger immune response, said Clarence Tam, an assistant professor at the National University of Singapore's Saw Swee Hock School of Public Health who studies vaccines.
The early publications helped highlight a potential problem: the use of an approved vaccine. The demand is so high that the government and businesses both domestically and in other countries are struggling with the distribution that Beijing has promised treatment to be.
Wendy Zhang, a 26-year-old medical worker from eastern Jinan City, said she had to wait 57 days to get her second vaccine in October because candidates ran out. She said she felt relieved after getting it.
"There were no side effects after vaccination, which indicates that the safety of the vaccine developed by China is beyond doubt," said Ms. Zhang.
Eden Huang, a 19-year-old student who had recently arrived in Amsterdam, tried to register four times when Sinopharm said it allowed students to register their interest in a vaccine. He also called various hospitals in Zhejiang Province, but to no avail.
"I am very concerned," said Mr. Huang. "European governments don't take Covid as seriously as our Chinese government."
Mr. Huang said he was not concerned about any safety issues, citing reports that studies have tested the vaccines on more than 60,000 people. "This vaccine would do me more good than harm," he said.
For those out of luck, there is always the scalper. For a fee between $ 600 and $ 1,500, they can book vaccination appointments, they say.
Many weren't sure how to book these appointments. A scalper named Mr. Li, who refused to give his full name for fear of being punished by the authorities, said he worked with companies and booked appointments with Sinovac, a private company with a vaccine in late studies Companies.
"Some people were especially grateful to me for helping them," said Mr. Li, although he was concerned that he might be doing something illegal.
Others were more careful when it came to getting the vaccine.
In Shaoxing, a city that recently gave people access to the vaccines, He Meili, a taxi driver, said her company had told her and others it could help arrange the treatments for $ 120.
"I would like to wait and see," said Ms. He. "I'm still a little worried."
Liu Yi contributed to the research.