China’s covid-19 vaccination campaign gets off to slow start

Photo AFP
Photo AFP

Summary

  • Infections are low and people aren’t in a hurry; officials are using social pressure and incentives as encouragement

A year after Covid-19 swept through China, the virus is under control. Now authorities have to motivate a population that feels little urgency to get vaccinated by using a mix of social pressure, incentives, education and coercion.

While surveys show vaccine acceptance remains high, the motivation to go out and get inoculated is lagging in the world’s second-largest economy given low infection rates.

China’s public health officials say the aim is to get 40% of the population vaccinated by summer. With the country administering more than 4.5 million shots a day in the past week, 161 million had been given by the end of Friday, according to the National Health Commission. Oxford University data-tracking project Our World in Data said about 11% of China’s population had received at least one dose.

That is a long way from herd immunity—which would require about 80% coverage—and compares with about a third of the U.S., according to the U.S. Centers for Disease Control and Prevention.

Another challenge for China is the low efficacy rate of its vaccines currently in use. Preliminary data suggest that they range somewhere between 50% to 80%. To optimize the protection rate, China was looking into, for example, adjusting the dosage, adding an extra shot or changing the interval between injections, George Gao, director of China’s Center for Disease Control and Prevention, said Saturday.

A senior Chinese official said last month that vaccine coverage is fundamental to the recovery of the world’s second-largest economy, during a teleconference call with local officials to accelerate the country’s vaccination drive. One of the country’s most highly regarded public health experts has tied success to patriotism and national security.

With motivation low, China’s neighborhood committees, companies and schools have been deputized to bring vaccines to people rather than wait for them to sign up. Community workers and residential-compound managers are calling people and knocking on doors, showing older people how to book slots on their mobile phones, handing out fact sheets, setting up information stalls and answering questions from those who remain hesitant. A dozen people said they had been asked multiple times by their building management or workplace to sign up for a vaccine.

In the capital, Beijing, shops, restaurants and markets can put up a green certificate at their entrance if 80% of their employees have been inoculated. Bright red banners on streets and catchy jingles on social-media platforms remind people to get the shots.

The city had administered at least one dose to half its 21.5 million residents by early April, and a local health official said last week that it aims to cover its adult population by the end of May.

Si Weijiang, partner at the Shanghai-based DeBund Law Offices, booked his slot after his workplace circulated a sign-up sheet through all-purpose mobile messaging app WeChat, and he received his first shot March 25 in a gymnasium turned vaccination site.

“I regard getting vaccinated as my social duty," he said, adding that his qualms about the vaccines’ safety were assuaged after seeing some of his colleagues and friends get inoculated.

China’s domestic vaccination had already started off slowly this year. With vaccine makers constrained by production capacity and focused on exporting doses, it fell short of reaching an internal target reported by The Wall Street Journal to fully inoculate 50 million people before Lunar New Year in mid-February. Other Asia-Pacific countries that succeeded in controlling the spread of the coronavirus have also lagged behind much of the West in inoculations.

A few months ago, Chinese public-health experts picked up on a lack of urgency to get vaccinated. A nationwide survey by researchers from Peking University, China’s CDC and the National Health Commission collected data that found vaccine acceptance between March and December last year was around 90% among more than 2,000 respondents. But the proportion of those who wanted to get inoculated as quickly as possible fell to 23% from 58% between the height of China’s outbreak and when it had brought the virus under control.

The predominant reasons for hesitance, this and another study of healthcare workers in the eastern province of Zhejiang found, were inconvenience, safety concerns and a feeling that the risk of infection was low.

None of the five vaccines approved in China have been included in the World Health Organization’s emergency-use list, and Chinese vaccine-makers haven’t publicly released detailed efficacy data. In recent years, scandals involving ineffective, fake or substandard vaccines have damaged the image of Chinese vaccine makers and vendors. Still, nearly half of the respondents in the nationwide survey said they preferred domestic vaccines over imported ones.

“There are so many reasons, or excuses, for me to wait and see," said Simon Zhang, a marketing manager for an Italian company who moved from Italy to his hometown of Zhengzhou in central Henan province in February. He pointed to worries about the vaccine’s effectiveness against future variants and the potential short duration of its protection.

Another concern is that China can’t maintain forever the strict border controls that have helped it contain infections, said Zhong Nanshan, an epidemiologist who leads China’s National Health Commission’s Covid-19 expert group, in a recent interview with domestic media.

“If China completely opened to the world now, that would be very dangerous because most people don’t have immunity," he said.

As of late March, China had set up more than 27,000 vaccination sites, a Chinese CDC official said. The centers are open into the evening, and teams have been deployed to universities, police stations and housing compounds to provide door-to-door service. Some local governments have doled out incentives such as shopping coupons worth about $7.50, or free ice cream and eggs.

Some at times have threatened punitive measures: Last week, officials in Wancheng town in the southern island province of Hainan province apologized for threatening to bar people from public transport if they refused to get vaccinated, according to the Communist Party-run tabloid Global Times.

In around four border towns in the southwest, shots were briefly compulsory. After Ruili, on the Myanmar border, locked down because of a cluster in late March, local authorities launched a five-day blitz on April 2 to vaccinate 300,000 people. On Tuesday, local authorities suspended the campaign to focus on testing the population for a second time instead, local officials said.

Production bottlenecks in some areas could continue to hamper quicker progress. Several cities extended the time frame for a second dose. Haikou, Hainan’s capital, suspended them last week except for people working at the annual Boao Forum policy gathering.

And glass vials used for vaccine packaging are still in short supply, wrote Cui Ernan, an analyst at consulting firm Gavekal Dragonomics: “Solving this issue and achieving herd immunity within the year is still improbable, but not impossible."

This story has been published from a wire agency feed without modifications to the text.

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