Why China may struggle to meet its Covid-19 vaccination target by June

Zhuang Pinghui
·6-min read

Last week, tenants of an office building in Beijing’s Chaoyang district were informed that new recruits would not be allowed to enter without producing a Covid-19 vaccination certificate. Instead, a notice said they should go directly to a vaccination facility and get a jab.

The building management later apologised after complaints were made to the mayor’s hotline, but said it was only following orders from lower-level government.

Meanwhile, primary schools in Dongcheng district were urging pupils’ parents and grandparents to take jabs and promising to commemorate classes with high numbers of inoculated families, while district authorities in Shanghai tried to tempt people to have a vaccine by offering cooking oil, milk and cash coupons.

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Such “carrot and stick” measures reflect the urgency needed if China is to hit its target of vaccinating 40 per cent of the population – 560 million people – by June.

By Wednesday, the country had administered 243.9 million doses, having given about 4.51 million doses a day on average since the National Health Commission (NHC) started to release a daily count. Roughly 10 million doses per day would be needed to reach the June target.

“From my calculation, the target looks unlikely to be reached, not even if only counting people vaccinated with just one dose, if the vaccination pace continues like this,” said Yanzhong Huang, senior fellow for global health at the Council on Foreign Relations, a New York think tank.

“On the supply side, the capacity cannot keep up. The vaccines need to be given to domestic use and for exports or donations, which is also lagging behind China’s promises. China pledges large production capacity, but it takes time to turn capacity into output.”

Vice-premier Sun Chunlan inspected a vaccine administration site in Beijing on Thursday. She also held a video conference meeting with Covid-19 vaccine manufacturers, urging them to step up supplies to help advance their administration in a strong and orderly manner, according to state news agency Xinhua.

China has approved for market launch two vaccines by China National Biotec Group (a subsidiary of Sinopharm), one by Sinovac and one by CanSino; the CanSino vaccine requires only one dose. The three-dose vaccine by Anhui Zhifei Longcom was last month granted emergency use approval.

“Our production capacity can reach 5 billion doses, and produce 3 billion doses this year,” Zheng Zhongwei, an NHC official in charge of Covid-19 vaccine development, said on the sidelines of the Boao Forum for Asia this month. “The capacity will be well released starting from the second half of the year.”

Zheng said Sinopharm and Sinovac could each produce 6 million doses a day, an amount Sinovac chairman Yin Weidong described as not meeting domestic demand.

“Vaccines are in acute shortage in China,” Yin told the audience at the Boao forum. “It’s like the vaccines are produced today, administered tomorrow and have zero stock the day after tomorrow.”

CanSino, which has pledged an annual capacity of 500 million doses, this week started production at its expanded Tianjin facility, while two other facilities were being built. Zhifei says it has an annual production capacity of 300 million doses, enabling it to provide its three-dose regimen for 100 million people.

Zheng Zhijie, a professor at Peking University’s public health faculty, said the vaccination drive faced not only a shortage of vaccines but also a lack of public enthusiasm.

“People think we are doing very well so there is no need to take the vaccines. They worry about side-effects and communities have to work very hard to motivate people to be vaccinated,” Zheng said, adding that people should be vaccinated as soon as possible despite the Chinese vaccines appearing to have lower efficacy than Western ones.

None of the approved Chinese vaccines reported general efficacy rates higher than 80 per cent, whereas vaccines by Moderna, Pfizer and Novavax delivered protection rates of around 90 per cent or above.

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“Chinese vaccines are still good vaccines,” Zheng said. “They pass the World Health Organization’s requirements for an effective vaccine and work well against serious diseases and death. People should take them if available.”

Even if China did vaccinate 40 per cent of its population by June, it would probably reach 70 to 80 per cent of the population – the desired standard to achieve herd immunity – only by the end of the year, or early next year by more conservative projections, lagging behind other major countries.

The head of the European Union’s vaccine task force recently said the bloc would be able to produce enough vaccines to achieve herd immunity in adults by mid-July. Ugur Sahin, chief executive of BioNTech, whose Covid-19 vaccines have been widely used in the US and Europe, also said Europe would reach herd immunity in July or August. The US is on track to fully vaccinate its entire 255 million adult population by early July.

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The immunisation gap, and therefore China’s reluctance to fully open its borders, not only threatens to affect the economy but may become a political issue.

“China has claimed a victory of epidemic control and reopened with some form of normality, but it is a mixed blessing,” Huang, of the Council on Foreign Relations, said.

“Most people [in China] are not infected or susceptible to the coronavirus. If China’s borders remain closed while other countries open, people will start to question the effectiveness of this epidemic control, posing a political risk.”

China can consider reopening only when it abandons its zero-tolerance strategy regarding infections, he added.

Xiang Hao, associate professor at Wuhan University’s public health faculty, said China relaxing restrictions on inbound travel depended not only on vaccination at home but how well the pandemic was being controlled globally.

“We need to step up. Vaccines with lower protection rates can still block the virus from transmitting in the community if the population is widely inoculated,” Xiang said.

“But it’s hard to pin down a time for completely opening the border. It also depends on how Covid-19 is controlled in the world, such as in India, where the situation is not optimistic.”

Additional reporting by Orange Wang

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