BUDAPEST — At the Ferenc Liszt International Airport, people wait in long lines to check in for their early morning flights. For Nora, a 22-year-old Hungarian university student, it’s a big day.
Today is the first day she can travel without quarantine to many Europeans destinations, despite getting vaccinated against the coronavirus in the spring of 2021. Her earlier travel plans had been thwarted by the vaccine she had received: two doses of the Chinese-produced Sinopharm.
Nora is just one of thousands of Hungarians who were vaccinated early, often with Sinopharm or Russia’s Sputnik V, but have since regretted their choice and have scrambled to get an EU-approved vaccine so they can travel.
Nora solved her problem in October, when she was able to walk into a Hungarian clinic to receive a single-shot Johnson & Johnson vaccine.
So far, the European Medicines Agency (EMA), which is responsible for the evaluation and supervision of medicinal products within the EU, has approved only four vaccines: Pfizer/BioNTech, Moderna, AstraZeneca, and Johnson & Johnson. Citizens and residents of the EU who received those vaccines are mostly exempt from testing or quarantine when travelling to other EU countries.
While Sinopharm does not have EMA approval, it has been granted emergency use by the World Health Organization (WHO), meaning a handful of European countries, including Austria and Spain, will accept it. Sputnik has neither EMA nor WHO approval, which means that in the EU, for example, only Hungary, Slovakia, Cyprus, and Greece, will accept it as proof of immunization.
Another Hungarian, Daniel, 23, was in a similar situation. Now working in Germany, he received two doses of Sinopharm in Hungary in April, he told RFE/RL over the phone. Like other interviewees quoted in this article about their vaccination choices, he preferred to only give his first name for reasons of medical privacy.
“Back then, I accepted the Chinese vaccine so I could see my grandmother,” he said. But after receiving Sinopharm, he could not travel back to Ireland where he attended university without a coronavirus test and going into quarantine. So he decided to get a third vaccine, a single-shot Johnson & Johnson, in Austria, where he was also registered for vaccination. “They just asked me if I had received any vaccines in the last four months and I told them no. Which was true,” he said.
Even Russians who have received Sputnik are travelling abroad to receive Western-approved vaccines. In recent weeks, hundreds of Russians have flocked to Serbia to get Pfizer shots, taking advantage of organized “vaccine tours” put on by companies in the capital, Belgrade.
At the start of 2021, Hungarian Prime Minister Viktor Orban’s vaccination strategy seemed bold and perhaps even forward-thinking, carried out with the cavalier populism that often defines his politics. Rather than waiting for EMA-approved vaccines, Hungary was the first EU country to buy Sputnik and Sinopharm, putting the country at the front of the vaccination pack.
Bypassing the European Commission, Hungary has since stockpiled more than 5 million doses of the Chinese vaccine and 2 million doses of the Russian and also entered talks with Russia about launching its own Sputnik production operation.
On April 26, the Hungarian authorities said that every Hungarian over the age of 18 could register for an appointment to get Sinopharm. By comparison, at the same time in the United Kingdom — another vaccine early-starter when compared to their European neighbors — only people over the age of 45 were able to register for their first dose.
Many young Hungarians heeded the call, eager to get a pass back to their social lives of pubs, nightclubs, and communal sports. They were less wary of the Russian and Chinese vaccines than their older compatriots, many of whom were skeptical about medical products coming from communist or former communist countries.
As of November 11, 60.6 percent of Hungary’s total population had received at least one vaccine dose, and 58.5 percent of the total population had received two, according to data from the European Center for Disease Prevention and Control. More than 2 million of these shots were Chinese (17 percent) and 1.8 million were Russian (14 percent).
At 58.5 percent, the amount of Hungary’s total population that is fully vaccinated is approximately 6 percent lower than the EU average, but a good deal higher than in neighboring countries, such as Romania (33.9 percent) or Slovakia (44.8 percent).
For those who want to travel, though, and who have received the Sputnik vaccine, a simple solution doesn’t seem to be on the horizon. Despite starting a rolling review in March, the EMA will reportedly not make a decision on the approval of Sputnik before the first quarter of 2022. According to media reports, the approval process has been hindered by Russia repeatedly postponing inspections.
The situation is looking a little rosier for those vaccinated with Sinopharm. While the EMA has never started a review for the Chinese vaccine, the WHO’s emergency approval for Sinopharm has opened up more options, including travel to the United States from November 8 and to the United Kingdom from November 22.
Increasingly Controversial Practice
For people vaccinated with Sputnik who want to travel, the best option available is trying to get a third shot with a different vaccine — a practice that has become increasingly controversial in Hungary.
Oliver, a 26-year-old resident of Budapest, wanted to get a Johnson & Johnson shot after two doses of Sputnik but his doctor refused.
According to Hungary’s Health Ministry, the Johnson & Johnson vaccine should not be given to patients who have already received shots of Sputnik or AstraZeneca. The ministry’s recommendation states that the third shot could weaken preexisting protections, as Johnson & Johnson, Sputnik, and AstraZeneca are all vector vaccines, which inject a modified version of a virus into a person’s body.
Some doctors are resolute about following the Health Ministry’s advice. “Those who received Sputnik jabs will have to wait until the European Union and Russia settle the uncertainty around vaccination,” Daniel Eorsi, a practicing doctor in Budapest, said.
“In line with the legislation in effect, the patient has the right to choose which vaccine they would like to get, as long as it does not contradict professional recommendations,” Eorsi said. And the Health Ministry does not recommend mixing vaccinations, he added.
Hungary’s Health Ministry did not respond to RFE/RL’s questions for this article.
But Oliver desperately wanted to go to Malta. So, despite the Health Ministry’s guidelines, he found another vaccination center where he could receive a Johnson & Johnson shot. “Before inoculating me, the doctor informed me that the protection will become weaker,” he said.
Even senior government officials are skirting the rules. HVG, a leading Hungarian economic and political weekly, reported that Gergely Gulyas, the head of the prime minister’s office, consulted multiple doctors before deciding to get a Johnson & Johnson vaccine after receiving two doses of Sputnik.
The different application of medical practice on the ground in Hungary illustrates the much larger, global debate about the efficacy of third shots from different vaccine providers.
“In the absence of good quality clinical trials, the Hungarian recommendation for mixing [different] vaccinations cannot be verified or disproved,” Szabolcs Dobson, an expert in the approval of medicines, told RFE/RL. He added that there is now some evidence that vector vaccines can be combined.
While some studies have shown that mixing vaccines can be effective and even, in the case of vector vaccines, boost a person’s immune response, experts have said that there is still not enough conclusive data.
“I think I gained a lot of time,” Daniel said, a few months after receiving his Johnson & Johnson vaccine in Austria. “I felt freer because I knew I was protected and my family knew I was protected. I wouldn’t do it any other way.”
By Lili Rutai