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Slow progress in vaccinating China’s elderly

When other When countries start vaccinating their populations against covid-19, they start with those most likely to die from the disease. China is doing the opposite. Instead of focusing on older adults and people with medical conditions that make them more vulnerable, it starts with healthy working-age groups. When officials started paying more attention to getting older people vaccinated, they were wary, worried about side effects. Now, they finally see the urgency of the task.

Infections will surge as China abandons many of the toughest containment measures associated with the epidemic. Ensuring that older people are adequately vaccinated and that boosters are given in a timely manner are critical to keeping the death toll to a minimum. The country is still far from the level of protection it needs. Of the roughly 260 million people over the age of 60, 86% have received at least two doses of the vaccine and 69% have received three doses (see chart). But in many cases, the vaccines were given months ago and are now wearing off. Among those over 80, the numbers look even more worrisome. Only 40% got three shots. In England, by contrast, around 80% of people over the age of 80 have received a booster immunization in the past three months.

Only in recent days has the Chinese government begun to raise its alarm. On Nov. 29, the National Health Commission issued a directive calling on officials to “speed up” vaccination efforts for the elderly, especially those over 80. The interval between the second and third dose should be shortened from six months to three months, it said. It urged that “whole of society” should be mobilized to ensure older people get shots. CaixinA Beijing magazine said officials had been told to ensure 90% of people over 80 had received at least one shot by the end of January, up from 77% at the end of November.

This will be a difficult process. When the government kicked off its vaccination campaign in 2021, doctors often advised older adults that it was too risky to get vaccinated if they had common conditions like high blood pressure or diabetes. This hesitation was due to the lack of data at the time on the possible side effects of the Chinese vaccine in the elderly (foreign vaccines are not allowed in mainland China). Older adults are underrepresented in trials. Although this fear has dissipated among experts, it persists among older adults. It may not help that the state still advises against vaccination if the underlying health condition shows “acute” symptoms (an undefined term).

Most of the elderly in China have no experience of vaccination since childhood. They must pay for the seasonal flu vaccine. Most people don’t bother to buy it. Obscure statistics in China obscure the resulting death toll. To treat and prevent disease, many people prefer traditional remedies that use natural ingredients, although the effectiveness of these remedies has not been proven. The government hails them as a testament to ancient Chinese wisdom. It lists several such concoctions among its approved drugs to treat covid symptoms. Mainland officials sent care packages to Hong Kong residents earlier this year when the city suffered a surge in the number of new crown pneumonia cases. These include an approved drug that contains licorice and rhubarb roots.

The surge experienced in Hong Kong illustrates the risks now facing the rest of China. Like the mainland, the region has been trying, with much success, to crush the coronavirus rather than find a way to live with it. Then there’s the highly contagious Omicron variant, which the mainland is now battling. Thousands of people have died from the disease, mostly elderly people who have not been fully vaccinated. Hong Kong has one of the highest COVID-19 death rates in the world.

With the end of the zero-coronavirus policy, China may find that rising infections encourage more elderly people to get vaccinated. By halting mass lockdowns, mass testing, and mandatory quarantines of infected people and their contacts in state facilities, the country should be able to redeploy its army of pandemic personnel to the task of delivering a vaccine. But attitudes from officials and the public have proved hard to change. On December 7, the mouthpiece of the CCP People’s Daily, published an article on how people with chronic diseases should cope with covid infection. It doesn’t mention the importance of getting vaccinated before then.

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