JUDY WOODRUFF: And we now take a different look at just how critical these vaccines can be.
Indonesia has recorded more than four million COVID cases.
And the virus has killed more than 140,000 people there.
Nick Schifrin explores how the U.S. and its allies are trying to achieve
vaccine inroads in China's backyard.
NICK SCHIFRIN: In Indonesia's newly dug COVID cemeteries, the grievers are barely old enough
to wear a mask, row after row, column upon column, from the air, all symmetrical, as if preplanned.
But, on the ground, these graves were dug so quickly, the names are written in pen. The flowers
and the heartache, are fresh. At the pandemic's peak this summer, grave diggers in head-to-toe PPE
buried more than 200 bodies here a day. Across the country, the daily death toll was 3,000.
At first, the medical savior was China. Indonesia was the first country to approve
Sinovac outside of China. China sent Indonesia its first Sinovac shipment in December 2020.
In January, President Joko Widodo received the vaccine on live TV.
It's a pattern repeated worldwide. China exported nearly one billion Sinovac doses to more than
100 countries. It's created Sinovac plants in 15 countries. Indonesia has bought 125 million doses.
But then health care workers started getting sick and dying.
DR. VERA IRAWANY, ICU Doctor: The cases made us feel overwhelmed. We feel like we want to scream.
It's very exhausting because we are still racing. It's still a marathon.
NICK SCHIFRIN: Dr. Vera Irawany is an ICU doctor in Jakarta.
She's seen firsthand Indonesia's strained health care system. Between January and June, more than
350 health care workers caught COVID. Dozens died. The majority of them had received Sinovac.
DR. VERA IRAWANY (through translator):
Many patients came to us with critical conditions, even though they have been vaccinated. We were
surprised because, even though these people were vaccinated, the results were still bad.
NICK SCHIFRIN: A University of Hong Kong study published last July found
the Pfizer vaccine produced 10 times the level of antibodies as Sinovac.
Another study shows Sinovac's efficacy rate is only 50 percent.
TEDROS ADHANOM GHEBREYESUS, WHO Director General: I'm happy to announce that the
Sinovac-CoronaVac vaccine has been given WHO emergency use listing.
NICK SCHIFRIN: But even though China never released efficiency data,
in April, the World Health Organization approved emergency use for Sinovac
in a vaccine distribution program know as COVAX.
DR. CHRIS BEYRER, Johns Hopkins University: I would say that, at this point, putting forward,
donating or contributing Sinovac to COVAX is no longer supported by the scientific evidence.
NICK SCHIFRIN: Chris Beyrer is an epidemiologist at Johns Hopkins university.
He says the Pfizer and Moderna mRNA vaccines are new technology,
while Sinovac uses traditional technology that uses an inactive SARS-CoV-2 virus. Scientists
say the Chinese company over-inactivated the virus, decreasing its efficacy.
DR. CHRIS BEYRER: It's a very old-school technology, and it turns out that it just
doesn't generate the same level of immune responses, but particularly
as the coronavirus as changed and evolved over time with these new variants of concern.
NICK SCHIFRIN: In April, China's top disease control official
admitted Chinese vaccines -- quote -- "don't have high protection rates."
But earlier this month, Chinese officials claimed
the vaccine was effective against Delta in preventing severe cases and death.
ZHENG ZHONGWEI, Chinese National Health Commission (through translator):
The current vaccines remain effective against all variants of the virus.
NICK SCHIFRIN: Dr. Dicky Budiman is an epidemiologist at Griffith University in
Australia and advised the Indonesian government.
DR. DICKY BUDIMAN, Griffith University: Indonesia has 270 million population.
Even the commitment from China is not even fit with half of our total population.
But, still, that's a very, very significant and very important step for Indonesia
to start with their vaccination program.
NICK SCHIFRIN: Indeed, initially, Sinovac was Indonesia's only choice,
and Indonesia's first trials showed the vaccine was 95 percent effective in
preventing serious illness and death, although it dropped from April to June to 79 percent.
DR. NADIA TARMIZI, Indonesia COVID-19 Vaccine Program: Can you imagine if we don't we need to
wait and then we don't have any protection? It will be very worse for Indonesia.
NICK SCHIFRIN: Dr. Nadia Tarmizi is the spokesperson for Indonesia's vaccine program.
DR. NADIA TARMIZI: We think, if we don't have any protection with the vaccine, or,
for example, if we need to wait until mRNA vaccine available in our country,
we will have been facing a problem worse than the condition. At least there is still protection.
JOE BIDEN, President of the United States: The United
States will purchase a half-a-billion doses.
NICK SCHIFRIN: But Sinovac's lower efficacy created a diplomatic opening.
In June, the U.S. donated 500 million doses to COVAX, including three million to Indonesia.
Last month, Dr. Irawany received a Moderna booster. Others have received Pfizer.
DR. VERA IRAWANY (through translator): We hope to get the best. If we talk about evidence,
data, then the mRNA vaccines are what is the best for now and are proven to be effective.
NICK SCHIFRIN: But vaccine diplomacy remains a competition.
Last month, on her first trip to Southeast Asia, Vice President Kamala Harris planned
to announce the U.S. would donate one million vaccines to Vietnam.
But during a three-hour flight delay, China stepped in and announced it would donate
two million of its own vaccines. And, today, most of Indonesia still only has access to Sinovac.
DR. NADIA TARMIZI: Whatever vaccine that'S available,
it will give you protection. So, of course, Sinovac will be still available.
NICK SCHIFRIN: The vaccine competition continued this week. Yesterday,
Chinese President Xi Jinping promised to export another one billion vaccine doses this year.
JOE BIDEN: The donations come with no political strings attached.
NICK SCHIFRIN: Today, President Biden announced the U.S. would donate an
additional 500 million vaccines across the world.
But global health experts say that's not enough. For Indonesia right now,
only 16 percent of the population is fully vaccinated.
DR. CHRIS BEYRER: Until now, we have had a lot of wealthy countries, of course,
pre-purchasing vaccines and hoarding vaccines, so that COVAX, even if it had the money,
didn't have the ability to purchase the high-efficacy vaccines.
NICK SCHIFRIN: And so the gravediggers continue their work. Indonesia's cases are down from
their peak, but in areas outside the main cities, scientists warn that the worst wave is imminent.
For the "PBS NewsHour," I'm Nick Schifrin.