How Local Vaccine Hesitancy Might Characterize China’s Post-Pandemic Global Position

4 mins read

By Paola Zuleta

At the beginning of 2021, China, in a similar fashion to other countries, laid forward a vaccination plan, but with some distinct differences. For instance, in China, vaccination priority has been given to all border operations, i.e. customs, arrival quarantine services, and transportation of goods and/or people into the country. At the local level, delivery services, such as parcel and home-order food delivery have also been given vaccination priority. This constitutes a part of the Chinese vaccination strategy that ought to be contrasted with those of most other countries, wherein the main focus are those belonging to identified risk groups as well as healthcare workers. As such, the difference in underlying context is great. Whereas in most countries the vaccination strategy aims to primarily stop already widespread community transmission from affecting the most vulnerable in society, in China, the aim is to build a defence against new outbreaks by targeting likely “super spreaders”.

The Chinese vaccination plan is also highly ambitious in nature, according to which over half a billion people, or approximately 40% of the population are expected to be fully vaccinated by July 2021, something that would correspond to four million vaccinations per day. However, according to the latest numbers, only around 700 000 daily doses are administered at present. This has been found to correlate with a growing vaccine hesitancy throughout Chinese society. Although two types of Chinese-developed vaccines are already on the market, and three more expected to launch soon, fewer people in China seem to be interested in getting the vaccine, causing the government to be increasingly concerned to vaccinate as many as possible – with state-led campaigns, incentives, initiatives, and regulations growing in number the past months.

The main reason cited as motivation not to get vaccinated has been the alleged low efficacy and safety concerns of the vaccine, attributed to a delayed provision of official and comprehensive information on the vaccine and the undergone clinical trials. In this regard, the main source of concern regards potential side effects, owing to the Chinese pharmaceutical industry’s lack of transparency and prior issues in concerning vaccine quality issues. While the official vaccination narrative centers on achieving herd immunity, and characterizes vaccination as a national priority, some suggest that vaccination campaigns might be driven by the search of a return on financial investment on vaccine development research and vaccine production. To a certain extent, public hesitancy can partly be attributed to harsh measures taken against what the state characterizes as disinformation on the subject. For instance, social groups asking for more scrutiny of pharmaceutical companies have found themselves censored, whereas messages featuring outright misinformation such as conspiracy theories were removed from public outlets such as social media. This has resulted in a steady stream of positive messaging regarding the vaccine, such as the Sinovac vaccine being attributed a 100% efficacy for severe-case prevention, and emphasis on the lack of reports of severe side effects attributed to Chinese vaccines. Moreover, Chinese vaccines have been portrayed as equal, or even superior, in quality vis-à-vis vaccines by Western companies. For example, some reports have made claims of an increasing universal acceptance of Chinese vaccines, citing foreign recipients stating, “Eastern vaccines compared to Western are safer and more efficacious,” as such arguing that Chinese vaccines “add prestige and (bring) honor to ‘Made in China.’” At the same time, safety concerns attributed to Western vaccines have been highlighted, particularly concerning deaths from blood clots believed to be caused by the AstraZeneca vaccine. As such, the Chinese narrative also suggests a more reliable efficiency and safety of traditional inactivated vaccines, the technology used in Chinese vaccines, compared with more modern vaccine technology such as mRNA used by Pfizer and Moderna. However, seeing how the Chinese government is also developing its own mRNA vaccine, the focus of potential technological drawbacks associated with those vaccines are only lightly insinuated.

As experienced in many countries, misinformation can spread rapidly and undermine the state’s efforts in upholding national public health, a risk that is arguably higher in a country of 1.4 billion people as is China, prompting the need for governmental overview of the narrative. However, lack of transparency may also feed underlying societal insecurities and contribute to public hesitations. Moreover, the fact that the domestic virus transmission in China is largely under control may also result in individual disincentives to accept the vaccine, seeing how the present risk of contracting the virus is minimal. As part of governmental initiatives endorsing vaccination, different tactics have been employed, from post-vaccination perks and ease of access to public spheres, to schools collecting information on parents’ vaccination status, or vaccine-conditional employment. The latter has reportedly often been the case in workplaces located next to governmental agencies or buildings. In this regard, some measures have been highlighted as going beyond pragmatic purposes. For instance, during this year’s Two Sessions – the biggest political event of the year- journalists who were not vaccinated were not admitted into the premises, augmenting domestic and international media’s already narrow access to high-level political meetings.

Furthermore, China is also deliberating the use of vaccine passports for facilitating entry into the country. As of present, only a handful of countries are considered for such passports, whereas they would only be applicable for individuals inoculated with one of the Chinese vaccines. If put into action, some predict that this could constitute a worrying trend, seeing how it would effectively keep several people, particularly from Western countries, out of China, whereas many Chinese would be hindered from leaving the country for the near future. However, this might rather be another incentive to heighten vaccination levels connected to China’s post-pandemic global position. For instance, according to current vaccination progressions, China is expected to reach herd immunity in approximately five years, compared to six months for the UK. While the West’s virus containment measures have been much less effective compared to China, would Western countries manage to reach herd immunity and begin to mutually open up societies, it might constitute a potential challenge to the China model of pandemic management.

Paola Zuleta, research assistant at the Swedish Defence University and, since June 2021, graduated master student from Uppsala University. Currently in Beijing, China, so spare time is dedicated to explorations of the city. Otherwise, music is a dear hobby, and you might occassionally find me playing the violin. Major interests are great power politics, East Asian foreign policy, Chinese society and culture, and undeciphered ancient languages.

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