Why is the vaccination rate among China's elderly population so low?

#46: With Yanzhong Huang, Jennifer Bouey, Ben Cowling

Jan 19, 2023

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Yanzhong Huang, Council on Foreign Relations

“Three reasons. First, the local governments in their pursuit of zero Covid found mass PCR testing, quarantine, and lockdowns more efficient than vaccines in containing Covid-19. Second, in developing its vaccines China failed to recruit enough elderly people in the phase-III clinical trial. The lack of data on the elderly and the unwillingness to prioritize this segment of the population in the vaccination campaign signaled that the vaccine might not be safe for the elderly. Third, since zero Covid shielded the population from the virus, it gave the elderly a false sense of security that discouraged them from getting vaccinated.”

“First, apart from those who resided in Wuhan in 2019, many did not believe that COVID-19 posed a threat to their health during zero-Covid, and did not anticipate a sudden change in the policy. Second, some hospitals and doctors advised against vaccination due to concerns about complaints of complications, especially from those with more severe health issues. On that front, the government failed to control the widespread misinformation regarding the vaccine's side effects. Finally, the lack of political will to implement measures to increase booster uptake among the vulnerable in 2022 was a missed opportunity to prepare for the reopening.”

“China has achieved one of the highest levels of vaccine uptake in the world and, as of November 2022, reportedly around 92% vaccination rates (2+ doses). However, older adults were not part of the target group at the start of China’s vaccination drive because clinical vaccine trials had not included them. And when vaccine approvals were extended to them, strongly-worded warnings about potential risks for recipients with underlying medical conditions were issued. Finally, China succeeded in keeping cases to very low levels until late-2022, meaning that older adults did not worry about infection and therefore perceived little benefit from vaccination.”

If you want to learn more about this topic, here’s a list of further reading:

Getting China’s old people vaccinated has been slow work. The Economist, NA
Could China’s latest coronavirus wave have been prevented? Drum Tower, David Rennie and Alice Su
Lost Opportunities to Contain COVID-19 in China. RAND Corporation, Jennifer Bouey

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