(Bloomberg) -- China said it would bolster vaccination among its senior citizens, a move regarded by health experts as crucial to reopening an economy stuck in an endless loop of harsh Covid Zero curbs. But it stopped short of announcing mandates that helped raise inoculation rates in other countries. 

Instead, officials vowed to push shots harder in places like nursing centers, and make those unwilling to get inoculated provide a reason for their refusal, according to a statement Tuesday from the National Health Commission. The government will also use big data to identify elderly people who need the vaccine, the statement said.


In China, only 69% of those aged 60 and above and just 40% of over 80-year-olds have had booster shots. In the US, over 70% of those over 65 have received a first booster, while 44% have already received a second.

Shares of CanSino Biologics Inc., drugmaker that’s rolling out a vaccine that can be inhaled, jumped 6.2% in Hong Kong, the biggest gain in two weeks.

The push comes days after protests against the punishing Covid Zero regime erupted in cities from Beijing to Shanghai and Chengdu to the far western outpost of Kashgar. Frustrated citizens took to the streets last weekend, urging an end to the curbs. Besides bringing misery to tens of millions of people across the country, the restrictions have also disrupted businesses and slowed growth in the world’s second-largest economy.

At the briefing, the first by the top health body since the protests, officials struck a conciliatory tone toward residents unhappy with Covid curbs. Local authorities must respond to and resolve “reasonable” Covid requests from the public in a timely manner while reducing the inconvenience caused by outbreaks, said NHC spokesman Mi Feng. He avoided directly answering reporters’ questions on the street unrest. 

Lockdown Pain Fails to Break Elderly Vaccine Resistance in China

The low elderly vaccination rate is viewed as a roadblock to opening up, like the rest of the world. Authorities fear mass infection among unprotected seniors could overwhelm the nation’s health-care infrastructure, yet haven’t done enough to persuade the vulnerable group to come forward for inoculation.

The highly infectious nature of the variant that’s circulating could eventually skirt the restrictions that are in place, making a widespread outbreak unavoidable, experts said. It would be very hard to suppress the mass spread of any omicron variant in China because there is so little immunity in the population, said Eric Topol, director of the Scripps Research Translational Institute in La Jolla, California.

“Unless they get uptake of better vaccines and boosters quickly across the whole population, it looks like lockdowns will no longer hold and a huge surge is in store,” Topol said. “It looks like major trouble is brewing.”

No Mandates Yet

While cash incentives and insurance for “vaccine accidents” have been offered by local officials to dispel hesitancy, the central government has forbidden the use of mandates.

China is still persisting with Covid Zero while most of the rest of the world has moved on to restore normalcy. Years of propaganda demonizing Western countries for their lax attitude toward the virus have caused deep-rooted fear of Covid in China, and the Communist Party’s wariness to suddenly reverse that stance is also delaying the country’s reopening.

Yet policymakers have been signaling change, albeit slowly.

Chinese President Xi Jinping and his new leadership team issued a new playbook on Nov. 11, with 20 key parameters to guide officials on the ground as it eases the contentious Covid Zero policy. 

Along with measures about key practices from quarantine to testing, the new instructions also vow to promote vaccine usage, especially booster shots for the elderly. China’s top health authorities earlier this month said they’re drafting plans to accelerate inoculation efforts. 

While China’s top health officials have been emphasizing in recent months that elderly people who are on medication to treat chronic disease are still fit for vaccination, the lack of trustworthy data on the safety and efficacy of domestic vaccines has also become a hurdle. 

Traditional Technology

The shots approved in China are home-grown vaccines made with traditional technology. They have been shown to be less effective than those from companies including Pfizer Inc., BioNTech SE and Moderna Inc that use breakthrough new mRNA methods. 

Fear of potential side effects after taking the vaccines spread among the country’s elderly, and cash rewards haven’t been enough to change the minds of many. 

The pace of immunization has also slowed in China, meaning it’s been months or more than a year since millions of people got their most recent inoculation.

Also, lack of specifics regarding who should get vaccinated in China leaves room for varied interpretations among health-care workers. Some injection sites in China require blood pressure tests, and immunization is delayed in people with uncontrolled hypertension, local media reported.

Officials appeared to attempt to address this in the latest statement, which included a list of conditions eligible for vaccine exemption. The elderly can refuse the shot if they have had serious allergies to previous vaccines, acute illnesses currently in treatment like chemotherapy, or if they are in their final stage of life, it said. 

--With assistance from Michelle Fay Cortez.

(Updates with booster coverage chart.)

©2022 Bloomberg L.P.