How Vietnam lost its pandemic-beating edge

Vietnam was one of the quickest to react to the epidemic and is now one of the slowest to prepare a way out.

Vietnam has justifiably been praised as one of the world’s best performers during the Covid-19 pandemic. By the end of 2020, the country of 96 million people had recorded fewer than 1,400 cases, less than two dozen deaths and was one of the few Asian states to notch positive economic growth in 2020. 

But infection rates have spiked since early May and Vietnam now ranks behind most other Southeast Asian nations in vaccinating its population. Its laxity earlier this year means it may not be able to inoculate more than half its population until at least next year, if not later. 

Between the beginning of the pandemic and May 7 this year, Vietnam recorded only 3,137 Covid-19 cases, with the majority diagnosed in 2021. However, since May 7, infection numbers had climbed to 11,635 as of June 16, with 61 confirmed deaths. 

In comparison with most other countries, Vietnam is still a world-beater. With a population of only 16 million compared with Vietnam’s 96 million, neighboring Cambodia has now reported more than 40,100 cases, with 693 new cases on June 16.

Thailand, with a population size closer to Vietnam’s, has recorded more than 205,000 cases. 

However, Vietnam is now ranked as one of the worst performers in Southeast Asia for its vaccination campaign, having so far only administered 1.6 million vaccines. 

Laos, the region’s second poorest nation, has fully vaccinated 5.6% of its population. Cambodia, with a gross domestic product (GDP) about a 10th the size of Vietnam’s, has fully vaccinated an astonishing 15.7% of its population, the best in the region after Singapore. 

Vaccination battle

Why has Vietnam been one of the world’s best performers in keeping Covid-19 infection rates low and maintaining economic growth during the pandemic, yet is now one of the worst performers when it comes to vaccination? 

For starters, these two issues aren’t necessarily causal. Many countries that suffered the worst infection rates in 2020 are now at the forefront of vaccinations. Britain and the US, two of the worst performers last year in terms of Covid-19 excess mortality, are now leading the way in vaccinations. 

One narrative being peddled is that it is only wealthy countries, and mostly those in the West, that have enjoyed successful vaccination campaigns because they have hoarded inoculations from poorer parts of the world. 

Yet, with a GDP of US$261 billion in 2019 and one of the world’s few economies that grew in 2020, Vietnam was ranked as the 46th richest country by the World Bank last year.

Peru, ranked five places behind Vietnam in GDP rankings, has fully vaccinated 6% of its population. Kazakhstan, eight places behind Vietnam, has fully vaccinated 7.8%. 

Even within Southeast Asia, as the aforementioned data reveals, there is no simple causality between a country’s wealth and its vaccination campaign. 

According to the latest estimates, Vietnam has already contracted for 31 million doses of Pfizer’s vaccine, agreed to purchase 50-150 million doses of Russia’s Sputnik V and is likely to receive about 38.9 million doses of AstraZeneca from the Covax facility. 

Another 30 million vials are likely to come from corporate purchases and talks have been had with Taiwan’s Medigen for 3-10 million doses.

But most of these deals were secured after the spike in infections in late April and early May, while deliveries of the majority of the vaccines are unlikely until at least the end of 2021, if not early to mid-2022. 

The Pfizer-BioNTech vaccine wasn’t approved by local regulators until June 12. The Chinese-made Sinopharm jab was approved only on June 4. 

If current rates of vaccination continue and deliveries are forthcoming, Cambodia could fully vaccinate about 40-50% of its population by the end of 2021. Laos, which will likely now suffer a shortage of doses, could get there by mid-2022. 

But if the majority of vaccines don’t arrive until later in the year for Vietnam, then it may take well into next year to achieve a 50% popular share immunity.   

According to Asia Times analysis, if Vietnam wants to fully vaccinate 50% of its population with two-dose inoculations within a six-month period, it will need to administer about 533,000 vaccines each day. That’s clearly not happening at present.

Vietnamese authorities likely believed in early 2021 that they didn’t need to rush and potentially waste money on vaccines. After all, of the still relatively low number of cumulative Covid-19 cases Vietnam has recorded to date, almost 75% came after May 1. 

Had it not been for new variants in late April that have also affected the entire region – 65% of all Cambodia’s infections and 67% of Thai infections were recorded after May 1 – then Vietnam may well have continued in 2021 as it did in 2020. In March and April, Vietnam was recording less than 20 new cases each day.  

There are a few other mitigating circumstances.  

The first vaccines that arrived in Cambodia and Laos were donated from China, in late December and January. The vast majority of vaccines administered in those countries, except for a few hundreds of thousands of Covax-donated doses, came from China’s Sinopharm or Sinovac. 

Vietnam, however, was the last Southeast Asian state to approve Sinopharm vaccines, when its regulators rushed to do so on June 4. 

Public backlash

Not only does Hanoi have a fractious dispute with Beijing over claimed territory in the South China Sea, anti-China nationalism is also running rampant in Vietnam.

Public opposition to using Chinese-made vaccines would likely be higher in Vietnam than in most other countries, while the Hanoi government would have faced a public backlash for allegedly being too close to the Chinese government.  

Vietnamese politicians were also likely somewhat distracted in early 2021 by the Communist Party’s National Congress, where a change of politicians takes place every five years. 

Nguyen Xuan Phuc was moved from prime minister to state president, a largely ceremonial role. In his place came Pham Minh Chinh, a former party official who lacks the experience in the government bureaucracy of his predecessors, with his only experience administering at the provincial level. 

Unlike almost every previous prime minister, Chinh had never even served as a deputy prime minister before taking over the role.

But Chinh, who took up the new role in early April, cannot be entirely blamed. Phuc stayed on as prime minister until April despite being named state president in January and was in charge of a government that failed to agree on vaccine purchases early enough. 

The government also appears to have taken its foot off the gas in recent months. 

According to the Oxford Covid-19 Government Response Tracker, which assesses the severity of restrictions with 0 the least severe and 100 the most, Vietnam reacted far quicker and more severely than any other Southeast Asian country in early 2020. By April 2020, its stringency index was 96. 

However, according to the response tracker, since the spike in early May its stringency index has only risen to 77, about the same as it was for much of 2020 when infection rates were minimal. 

Indigenous vaccines

Zachary Abuza, a professor at the Washington-based National War College, speculated in a recent article that part of Vietnam’s reasoning for not securing vaccine deals early “was its own interest in developing indigenous vaccines.”

Indeed, it now has four vaccines under development by Nanogen, Vabiotech, Polyvac and the Institute of Vaccines and Medical Biologicals (IVAC).

Nanocovax, developed by startup Nanogen Pharmaceutical Biotechnology in collaboration with Vietnam Military Medical University, went to Phase 3 clinical trials this week and is expected to be available by the end of 2021. 

One insinuation from experts has been that the Vietnamese government saw the international and domestic demand for vaccines as an ideal moment to boost its pharmaceutical and biotech industry. 

Earlier this month, the Ministry of Health spoke with the World Health Organization’s Covax program about setting up a manufacturing facility in Vietnam, a franchise project to produce vaccines for domestic and international use. Reports suggest that talks with Johnson & Johnson included a deal for local production of vaccines. 

This, though, appears to have backfired. In early June, the communist government had to turn to Beijing to appeal for Sinopharm vaccines. That hasn’t gone down too well in nationalist Vietnam, where China is the historical bete noire. 

The government has also gone cap in hand to the public, appealing for private donations to its “vaccine fund.” On June 6, local media reported the government had collected US$329 million from private donations, mostly large businesses, in the previous two weeks to go towards its vaccine fund. 

Abuza noted this week that the government has only so far budgeted $630 million of the $1.1 billion needed to buy the 150 million vaccines it has ordered. It remains too early to tell the public’s thoughts about the government’s vaccine policy and related donation drive.

In 2020, the government’s response heaped considerable legitimacy upon the Communist Party, which since the early 2010s has often failed in its pledges to construct an effective, transparent and modern system of governance. 

Burnished credentials

It also used the pandemic to burnish its nationalist credentials, which had fallen to the wayside in recent years over public complaints the communist government was not standing firm enough on Vietnam’s claims in the South China Sea.

Phuc, the former prime minister and now state president since early 2021, repeatedly spoke about the pandemic through war-like language and invoked an “all-in-it-together” mentality. 

In the latest State of Southeast Asia report, published by the ISEAS-Yusof Ishak Institute in Singapore, Vietnam was ranked by regional opinion-makers just behind Singapore in second as the country with the best responses to the pandemic. 

Some 92% of Vietnamese respondents ranked their country as the region’s best performer, higher than any other nationality ranked their own country’s performance, including Singaporeans. 

Confusion and delays over the vaccination campaign could test the advances the communist government has made, however. 

As neighboring countries rapidly vaccinate ever-larger percentages of their population, Vietnam is falling behind thanks in part to poor planning by the government. By seemingly turning to China for vaccines, that likely has dented some of the nationalist legitimacy it secured last year as well. 

Moreover, questions are being raised over how the slow vaccination campaign affects Vietnam’s economy. If it cannot achieve herd immunity until at least 2022, potentially requiring even more lockdowns and restrictions in heavily industrialized areas of the country in the interim, its growing role in global supply chains could come under pressure. 

Whereas Vietnam was one of the Southeast Asian states quickest to react to news of an epidemic in Wuhan in early 2020, it has been one of the slowest to prepare for a way out of the pandemic. 

By David Hutt – Asia Times – June 18, 2021