The Chinese government is on a mission: to convince elderly citizens that its latest Covid-19 vaccines are easy to take and effective.
In state media, a woman at a clinic in Tianjin said “there was no discomfort” with a new inhaled vaccine, while a woman in Shanghai joked that getting her booster was “a bit like drinking milk tea.” A man in Wenzhou reassured the hesitant: “It doesn’t hurt at all, and it’s a little sweet.”
Such state-sponsored messaging is critical as the Chinese government drops its heavy Covid restrictions and braces for a wave of cases that could overwhelm its medical resources. It should convince people not only that there is nothing to fear from the virus, but also that vaccines are essential to protect against the most serious consequences of the disease. The outbreaks in the coming weeks and months – and how deadly they will be – depend in part on whether older adults are willing to get vaccinated.
Since the dramatic turnaround to dismantle its “zero Covid” strategy last week, China has downplayed the severity of the Omicron variant rippling through cities, essentially encouraging the country to learn to live with Covid. A top epidemiologist concluded on Sunday that the death rate is comparable to that of the common flu. Another health expert said authorities were prepared for the strain on the country’s medical system.
On Monday, China reported 8,561 new local cases, compared to about 30,000 before the strategy shift. The numbers have become increasingly unreliable as officials have nearly stopped regular mass testing in recent days and made reporting home testing voluntary.
Uncertainties about the new approach and the hasty rollback of the rules are increasing.
Within the oldest part of the population of China, 40 percent have not received a booster; the World Health Organization has said such doses are especially vital with Chinese vaccines, which use an inactivated virus and tend to be less effective than foreign counterparts using newer mRNA technology. And many families are still hesitant about vaccine safety for their elderly relatives, even though new inhalable vaccines are portrayed as less scary than needle-requiring vaccines.
Health experts warn that the vaccination campaign may be too late to defend against the current spate of cases. Singapore, where officials lifted strict measures late last year, spent months communicating and preparing before the measures were relaxed.
Hong Kong authorities failed to encourage the elderly population to get vaccinated until it was in the midst of a major outbreak earlier this year. Without a high level of inoculation at the time, the virus was killing people at a rate that has surpassed almost every country since the start of the pandemic.
“Ideally, you would be prepared before you open the gates,” said Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations. “This really isn’t a recipe for a smooth transition — it’s going to be a bumpy ride.”
As China’s authoritarian government faced angry and infrequent protests against Covid restrictions, policymakers two weeks ago launched a new vaccination campaign targeting older citizens, a tacit acknowledgment that to ease the rules, they needed to do more to reduce the protect the most vulnerable.
Officials promised to bring vaccines to nursing homes, go door to door and use mobile stations. They quickly rolled out a newly approved inhaled vaccine, touting it as “easy,” “convenient,” and “like breathing fresh air” in a steady stream of television reports, newspaper articles, and local health information sheets.
Understand what is happening in China
Officials must overcome a deep-rooted skepticism they have fueled.
In early 2021, when China introduced its domestic vaccine, regulators restricted its use to people between the ages of 18 and 59, inadvertently leading to misinformation and hesitation within one of the most vulnerable segments of the population.
“That led to a storm of people saying it’s not safe for the elderly,” said Siddharth Sridhar, a virologist at the University of Hong Kong. “They really want to avoid that story now.”
Many families urged their elderly relatives to stay home, thinking the vaccines could complicate chronic health problems. Temporary vaccination clinics were reluctant to inject older people because the facilities did not have their health records to hand. Community health workers and family members questioned whether it was worth risking possible side effects when there were essentially no cases in many cities.
Nicolas Tian, 24, urged his grandparents not to get vaccinated, citing concerns about authorities limiting doses to younger populations.
“At first people generally thought that people over 60 years old were not suitable candidates for vaccination,” said Mr. Tian, who lives in the northeastern province of Shandong. He got vaccinated, but only because his government job required it.
Many public sector workers were among the first to get vaccinated at a time when doses were still limited. Although his employer called it a perk, Mr. Tian was not convinced.
“We all knew it treated us like lab rats, or at least that’s how I personally took it,” he said.
When his workplace later recommended that every employee find five people to get vaccinated, he felt that authorities had rushed to change the requirements to increase vaccination rates. He strongly advised family members against getting the shot.
“While the authorities said there was no harm in getting vaccinated, the popular thought was ‘it’s better not to vaccinate older people’.”
Since the approval of Chinese vaccines, officials have provided little information other than to assure the public that they are safe.
Authorities recently approved six domestic vaccines, four of them in the past week. Two of the vaccines do not require a needle and are instead administered via a nasal spray or inhaled via a nebulizer, technology considered to be the frontier for future Covid prevention.
Health experts and doctors quoted in state media have embraced the inhaled vaccines, saying they are effective, safe and suitable for older populations, without providing detailed data.
“The most obvious benefit of an inhaled vaccine is that it reduces fear of injection,” said Zhang Xin, a medical associate, at the state-run Xinhua news outlet of Convidecia Air, a Covid vaccine developed by CanSino Biologics. which was approved in September. .
Scientists hope that by eliciting an immune response in the nasal cavities and lungs, an inhaled vaccine could provide significant protection, particularly against transmission. In reality, little is known about the true effectiveness of the new inhaled vaccines, which are being studied around the world but have not yet been widely tested.
Early studies point to their potential power in fighting serious illness. A nasal spray developed by Hong Kong University, along with Xiamen University and Beijing Wantai Biological Pharmacy, has proven in phase III trials to be 80 percent effective against Omicron as a booster after two doses of inactivated vaccines and 55 percent effective in unvaccinated people.
Even without full information, the prospect of a coming tsunami of cases was enough to trigger action.
Mary Ma’s grandmother is almost 90 years old and has already received two injections. Ms Ma, who lives with her grandmother and mother in Wuhan, where the virus first emerged in 2019, is concerned about the adverse effects on seniors. She is also concerned about accidentally exposing her grandmother to Covid by taking her to get vaccinated, saying the designated hospitals for vaccinations are the same as those where Covid patients are treated.
But Ms Ma, 24, said she recognizes that being up to date on vaccinations is more important than ever now that pandemic restrictions have been lifted.
“Even though my grandmother stays home most of the time, I am still concerned about the risk of our young relatives bringing the virus home,” said Ms Ma.
“I think she should get vaccinated,” she said.