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Russia Beat the World to a Vaccine, so Why Is It Falling Behind on Vaccinations?

Last August, Russia became the first country in the world to approve a COVID-19 vaccine for public use. In a televised announcement, Vladimir Putin praised the scientists responsible: “We owe our gratitude to those who have taken this first, very important step for Russia and the entire world.” Eight months later, the country has administered at least one dose of its vaccine, known as Sputnik V, to fourteen million people, about six per cent of its population. The United States, which first approved a vaccine in December, has vaccinated over a third of its population; more than twenty countries in Europe—including France, Germany, and the Netherlands, which have faced criticism for their slow and inefficient vaccine rollouts—have managed to inoculate more people in per-capita terms than Russia. So what happened? How did Russia go from being first out of the gate with a registered COVID vaccine to sixty-fifth place in the world for vaccinations?

When Sputnik V was authorized in Russia—scientists at the Gamaleya Institute, in Moscow, developed the drug—the vaccine had been tested on fewer than a hundred people and no one in the general public knew the results. “I hope that the Russians have actually definitively proven that the vaccine is safe and effective,” Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, said at the time. “I seriously doubt that they’ve done that.” But, as I reported in February, although the rollout was rushed, the science behind the vaccine itself was credible and sound.

Sputnik V is a vector vaccine, meaning it uses a viral “vector” to introduce the gene for the spike protein of the SARS-CoV-2 virus, which spurs your immune system to produce antibodies. (This is the same underlying technology used in both the Johnson & Johnson and AstraZeneca vaccines.) In February, the results of Sputnik V’s Phase III trial were published in The Lancet, showing an efficacy rate of ninety-one per cent. Fauci, whose initial doubts were shared by many in the Western scientific community, came around. “I’ve taken a look at some of the reports,” he said last month, concluding that Sputnik V appears “quite effective.”

Inside Russia, Sputnik V has been available to doctors and other medical personnel since the fall, and to the general public since early December. In mid-January, Putin ordered the government to embark on the “mass vaccination of the entire population,” calling Sputnik V the “best in the world.” I managed to get vaccinated at a city-run clinic in Moscow just before the New Year. Across the capital, vaccination points opened up at banks and shopping malls. But an initially high tempo of vaccination has since receded. In March, Moscow vaccinated an average of roughly thirteen thousand people each day; New York City, by way of comparison, is vaccinating between sixty and seventy thousand.

Russia’s health ministry initially set a goal of vaccinating sixty per cent of the country’s adult population by July. And yet, at the current rate, it will take another year and a half to get there. The problem, it seems, is both supply and demand. According to a March article in Proekt, an investigative news Web site, there is “a deficit of vaccine out in the Russian regions and a deficit of people who want to be vaccinated.”

By many accounts, Russia is home to one of the world’s most vaccine-hesitant populations when it comes to COVID-19. Recent polling puts the share of people who are disinclined to be vaccinated at sixty to seventy per cent. “It’s an old Russian tradition,” Vasily Vlassov, an epidemiologist and a professor at Moscow’s Higher School of Economics, said. “Don’t trust the bosses.” It’s one thing to generally support or at least passively tolerate the ruling system, and another to have faith in its ability to look after your individual well-being. In this sense, the vaccination campaign is perhaps more instructive about Russian public attitudes than, for instance, last summer’s constitutional referendum that allowed Putin to run for another two presidential terms was. Ekaterina Borozdina, a professor of sociology at the European University at St. Petersburg, who recently conducted thirty interviews to study vaccine hesitancy among Russian middle-class professionals, told me, “I wouldn’t say that people don’t believe in vaccines themselves—though such people also exist—but, rather, they don’t have faith in the process of vaccination, which is seen as yet another program forced on them from on high.”

In the case of Russia’s COVID-19 vaccine, however, the most notable aspect of the state’s propaganda campaign is its relative absence. “There is no clear signal,” Denis Volkov, the deputy director of the Levada Center, a polling and research organization in Moscow, said. After months of dodging the question, Putin was finally vaccinated in late-March—but not in front of cameras and without clarifying which Russian vaccine he received. (In addition to Sputnik V, Russia has two other COVID-19 vaccines registered for public use.) For a president fond of photo ops—two days before his vaccination, the Kremlin released a series of photos showing Putin, dressed in a sheepskin coat trimmed with fur, driving an all-terrain vehicle through the snowy tundra in Siberia—his vaccination came off as a conspicuous non-event. “When they need to, the authorities are certainly capable of organizing a big public campaign, with politicians and actors and musicians and big rallies,” Volkov told me. “But, with the vaccine, it’s as if the state has gone silent, it has decided to step aside.” Perhaps, he mused, the Kremlin had opted not to force people to do something that wasn’t widely popular; better to save administrative muscle for, say, parliamentary elections this September.

The message of Russian officials, repeated on news programs on state television, focusses less on the need to be vaccinated than on trumpeting the effective end of the pandemic. The situation in Russia is portrayed as relatively sanguine, unlike in European countries that remain trapped in endless lockdowns. Vaccination can feel less urgent when you can enjoy the veneer of post-pandemic freedom without getting anything jabbed into your arm. In Moscow and other cities throughout the country, you can go to the theatre; have dinner afterward at a packed, buzzy restaurant; and, if you’re still in the mood, go drink and dance at a night club until morning. This laissez-faire approach naturally comes with a cost—namely, a high rate of infection and death over the past year.

Anton Barchuk, an epidemiologist at the European University at St. Petersburg and Tampere University, carried out a sample study this spring of several hundred residents of St. Petersburg. His preliminary analysis suggests that between forty and fifty percent of the city’s population may have been exposed to the virus. He imagines a similar figure for Moscow. I recently attended a small birthday dinner in the capital: of the nine people present, seven had come down with COVID-19 over the past year. I was the only one who’d been vaccinated. Reliable death figures are hard to come by—officially, one hundred thousand people are registered as having died of COVID-19 in Russia—but the latest data released by the state statistics agency and analyzed by the Times this week suggest that actual excess-mortality figures have exceeded four hundred thousand since the start of the pandemic. This count would seem to place Russia higher in terms of per-capita death than hard-hit countries such as Brazil and the United States. According to the Times, whereas COVID-19 killed around one in every six hundred people in the United States, it killed one in every four hundred in Russia. “We’re on the path of reaching herd immunity not through the path of vaccination but excess mortality,” Barchuk told me.

The lack of demand for vaccinations may not be troubling the Kremlin, at least for now, because there is a relatively low stockpile of the vaccine itself. As the Proekt investigation revealed, the vaccine is in short supply in regional centers outside Moscow and St. Petersburg. In smaller towns, dozens of vaccination points have been closed after running out of vaccine; when fresh shipments do arrive, they typically last for only a few days.

In the months since Sputnik V’s approval, Russian officials have repeatedly rounded down the amount of vaccine that the country is expected to produce. Last December, they promised as many as eighteen million doses per month by the spring; in March, that figure was downgraded to seven million. The challenge of producing a new vaccine in unprecedented quantities is not unique to Russia. “Scaling up is a very difficult task,” Ilya Yasny, the head of scientific research at Inbio Ventures, an investment fund in Moscow, said. Vector vaccines are based in the organic, and thus unpredictable, world of biology. “Every production facility and every bioreactor comes with its own surprises. Human cells can be very capricious. They might grow or not grow. They are living organisms, and require constant adjustments and corrections.”

The production of the second of Sputnik V’s two viral vectors has proved especially tricky. (This is one reason that the scientists at the Gamaleya Institute have promoted the idea of “Sputnik Light,” a vaccine that consists solely of the first shot of Sputnik V.) Mixing viral vectors in a vaccine regimen is a way of making sure that the body’s immune system targets the pathogen and doesn’t develop an immune response to the vector, but it also requires making essentially two distinct vaccines. “Using two vectors makes a lot of sense in terms of the science,” Anton Gopka, who runs a venture-capital firm focussed on biotechnology, said. “But it makes things more difficult for production.”

The last issue related to supply is that Russia is hardly Sputnik V’s only market: its very name, a reference to the first Soviet satellite launched into space, in 1957, suggests the geopolitical ambitions that the Kremlin has for the vaccine. Seeing Sputnik V implemented far and wide would be a welcome soft-power victory for Putin’s Russia. To date, its use has been approved in sixty countries. As of early March, Russia had shipped four million doses—more than a third of its supply—to foreign markets. (Even as Russia is sending doses abroad, it is importing Sputnik V made at production facilities in India and South Korea to meet its domestic needs.) The European Medicines Agency has begun a rolling review of the vaccine, for possible approval in the European Union. This might be another reason that the Kremlin is not more concerned about low demand: citizens won’t be so upset when doses are flown off to Argentina or Serbia. Taken together, as Proekt put it, “Relatively low rates of vaccine production, small existing stocks, and large international contracts explain the Kremlin’s slowness in launching a broad information campaign to convince Russians to be vaccinated.”

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